DIAG208-0213: The Veterinary In-Clinic Laboratory
Quality Concepts for In-Clinic Laboratory Testing, with Biochemistry and Hematology Instrument Performance Evaluation Practical

Enrollment is closed.

INSTRUCTOR(S):
Kathleen P. Freeman, DVM, BS, MS, PhD, DipECVCP, FRCPath, MRCVS, Certificate in Laboratory Quality Management (University of Wisconsin), Royal College of Veterinary Surgeons Specialist In Veterinary Pathology (Clinical Pathology) and European Veterinary Specialist in Clinical Pathology
Mark Rishniw, BVSc, MS, DACVIM (Internal Medicine & Cardiology)

COURSE OPEN: February 17-May 8, 2013
REAL TIME SESSIONS (RTS): Sundays, February 24, March 3, 10, 17, 24, 31 and April 28, 2013; 2:30-3:30pm ET (USA)
Course RTS Times in Your Area: World Clock Converter

Practice Sessions: In order to prepare you for a successful experience in your CE course, we request you attend a Practice Session prior to the first Real Time Session. Please arrive promptly at the start time; each Practice Session is up to 1 hour in length. For more information, please visit the CE Practice Area.

*The instructors for this course will be using audio which will require you to have a headset or speakers to listen. If you have any concerns regarding your computer's audio capabilities, please be sure to attend one of the Practice Sessions.

Level and Prerequisites: This advanced course will be open to veterinarians and veterinary technicians actively interested in veterinary laboratory testing, quality assurance, quality control and best practices within the veterinary in-clinic laboratory. In-clinic laboratory experience recommended if you are a veterinary technician enrolling in this course.
VIN CE Course: Open to veterinarians and veterinary technicians. This course has been RACE approved for veterinarians and veterinary technicians.

Course Description:
The quality concepts portion of the course will cover quality assurance, quality control and best practices for in-clinic laboratory testing, including hematology, biochemistry, urinalysis, parasitology and ELISA testing. It will cover statistical and nonstatistical QC, quality planning, biologic variation and reference change value, sensitivity/specificity, and positive and negative predictive value, optimal packing time for spun PCVs, and 'best practice' principles for urinalysis, parasitology and ELISA testing. An introduction to sigma metrics will be included.

The practical portion of the course will include performance evaluations of your hematology and biochemistry analyzers. The quality control materials used as part of the biochemistry evaluation will be subsidized by the VIN Foundation. The instructors appreciate your commitment to participate in the hematology and biochemistry instrument evaluations. The hematology evaluation requires fifteen in-clinic CBCs done on a single day and 3 sets of blood smear evaluation, as well as duplicate spun PCVs for 3 sets of blood samples prepared from fresh pooled normal canine blood from your practice. Each of the 3 samples should also be sent to your usual reference laboratory for comparison. Your data will be turned in to Dr. Mark Rishniw for analysis and results presented at the end of the course.

The biochemistry evaluation requires analysis of 3 quality control specimens daily for 5 days (15 biochemisty profiles) and sending out at least 1 quality control specimen per day to your reference laboratory for comparison (5 biochemistry profiles). You will enter your biochemistry data in the VIN Instrument Evaluation Calculator as part of the evaluation of this calculator for ongoing use by member of the VIN community. A summary of the information obtained by the participants in this course will be presented at the end of the course.

This course consists of seven (7) sixty (60) minute Real Time Session, supplemental library materials, interactive message board discussions, and a mandatory end-of-course test. Successful completion (scoring 80% or better) on the end-of-course test is required to earn a certificate of completion for the course.

Upon completion of this course, the participant should be able to

• Introduce participants to principles and concepts fundamental to Quality Assurance and Quality Control within the veterinary in-clinic laboratory.
• Provide participants with the knowledge and tools to encourage assessment and improvement of quality within the in-clinic laboratory.
• Provide participants with knowledge and tools to conduct statistical QC for their in-clinic biochemistry and/or hematology analyzer.
• Characterize the performance capability of in-clinic analyzers and reference laboratory analyzers. Evaluation of the biochemistry analyzer will be by having participants run Quality Control Materials (QCM1-3) on their biochemistry analyzers daily for 5 days and by submitting QCM to be run as "patient samples" by their own reference laboratory. Evaluation of the hematology analyzer will be conducted using pooled patient specimens to create 3 samples for 5 repeated evaluations (15 total CBCs) on a single day. Three samples will be submitted to the reference laboratory for a CBC.
• Provide information about performance capability of in-clinic analyzers in general, and specifically for participants in the course.

Course Materials: Course materials will be available in the course library prior to each Real Time Session.

Required Textbook(s): There is no required textbook for this course.

About the Instructors:
Dr. Freeman is a 1981 graduate of Oklahoma State University, College of Veterinary Medicine and received her MS and PhDs from OSU in 1984 and 1987, respectively. She was on faculty at OSU and then at Cornell University before taking a detour and teaching all sorts of Science courses and in the Educational Opportunity Program at Ithaca College for several years.
During these years she was also doing cytology and laboratory consultations for commercial laboratories.
She then moved into commercial laboratory medicine and worked as Director or Senior Clinical Pathologist at several laboratories. She moved to the UK in 1997 to develop a diagnostic laboratory service for the Animal Health Trust and was Head of Anatomic and Clinical Pathology there. She subsequently moved to Scotland and works from home for Idexx Laboratories, based in Wetherby, West Yorkshire.
She is past founding Chair of the ASVCP Quality Assurance and Laboratory Standards Committee and the founding Chair and current Co-Chair of the ECVCP Laboratory Standards Committee. She is currently a member of both committees.
She has special interests in QA, QC, customer service, cytology and general clinical pathology.
She obtained a Certificate in Laboratory Quality Management via e-learning from the University of Wisconsin and had the opportunity to work with James Westgard which she says was a great experience!

Dr. Rishniw has completed a PhD in physiology and developmental biology at Cornell University and is a consultant for the Veterinary Information Network.
Dr. Rishniw was previously staff cardiologist and chief of services at Cornell University and registrar in internal medicine at Melbourne University, where he received his DVM degree. He completed a residency in internal medicine at Washington State University and in cardiology at University of California, Davis.
Dr. Rishniw has published articles and chapters in peer reviewed journals and textbooks, and regularly presents clinical research at national and international meetings.

Course Outline:
Week 1 (Real Time Session February 24)
Content:

• Definitions of Quality
• Standards of Quality
  • Laboratory instrumentation for biochemistry and hematology analyses
  • How we look at quality in laboratory instrument performance

Week 2 (Real Time Session March 3)
Content:

• Instructions for running QCMs to characterize your in-clinic biochemistry instrument performance
• Instructions for making samples from a patient pool of EDTA-blood to characterize your in-clinic hematology instrument
• performance
• Interactive tool for looking at TE
• Introduction to statistical and non-statistical QC
• Statistical QC
• Pilot data from in-clinic and reference laboratories

Week 3 (Real Time Session March 10)
Content:

• Conducting hematology analyses
• Principles of Quality Systems for In-Clinic Laboratories
• Quality Concepts

Week 4 (Real Time Session March 17)
Content:

• Quality Concepts, continued
• Biochemistry analyses

Week 5 (Real Time Session March 24)
Content:

• Index of Individuality
• Reference Change Values/Critical Differences
• Specific types of testing

Week 6 (Real Time Session March 31)
Content:

• Specific testing, continued
• Future of Quality in In-clinic Laboratory Testing
• Introduction to Sigma metrics

*** BREAK for Data Analysis (April 1-27) ***

Week 7 (Real Time Session April 28)
Content:

• Summary of Data Analysis and Reports for Participating Clinics

CE CREDITS: 7

Tuition: Member $140 ($126 early bird special if enrolled by February 3, 2013)
Non-Member $227 ($204 early bird special if enrolled by February 3, 2013)

Maximum enrollment is set at 24.

***Please note: The cost of the quality control materials used in the practical portion of this course for biochemistry instrument evaluation and shipping to participants will be donated by the VIN Foundation ( http://www.vinfoundation.com/ ). The hematology specimens, costs of reagents and disposables for in-clinic analyses and specimens sent to the reference laboratory will be the responsibility of the participating individuals/clinics. In order to further offset some of these costs to the participating individuals/clinics, the instructors have donated their services allowing us to keep the per credit tuition for the course at a low level. You will not be allowed to take the theory part of the course unless you agree to participate in the practical portion of the course and accept the costs associated with the practical section.

*To ensure participants are ready and prepared for classes, enrollment will close when the maximum number of participants is reached or at 5pm ET the day of the first Real Time Session unless otherwise noted. If the first Real Time Session is on a weekend, course enrollment will close on the Friday before the first Real Time Session.

*For more information on how online CE works, see the Participant Resource Center.

TO ENROLL:

1. Enrollment qualifications: VIN CE courses are open to VIN member and non-member veterinarians. Veterinarians enrolling in a VSPN CE course must be a VIN member. Veterinary support staff must be a VSPN member to enroll in a VSPN CE or a VIN CE course open to VSPN member enrollment.
2. Each enrollee must be able to receive emails from @vspn.org and @vin.com addresses. Email is our major form of communication with participants; personal emails are highly recommended rather than clinic/hospital email addresses.
3. Each person is individually responsible for his/her own registration. To ensure that all information received is secure and correct, please do not enroll for a course on behalf of another individual.
4. For further assistance call 1-800-700-INFO (4636) or email (VIN CE) CEonVIN@vin.com or (VSPN CE) VSPNCE@vspn.org. Please include the course title, your full name, and contact information in your correspondence.

*Note: "This course is approved for 7 continuing education credits in jurisdictions which recognize AAVSB RACE approval; however participants should be aware that some boards have limitations on the number of hours accepted in certain categories and/or restrictions on certain methods of delivery of continuing education." Call VSPN/VIN CE at 1-800-700-4636 for further information. (Attendees are encouraged to check with their licensing jurisdiction(s) for information regarding recognition by their board).

Course withdrawal and refund policy: A complete refund of the paid course price will be issued when your withdrawal request is received prior to the listed start date of the course. If you wish to withdraw after the start date please contact the VIN/VSPN office 1-800-700-INFO (4636) to discuss eligibility for a pro-rated refund.
* Note: To ensure rapid handling of your request for withdrawal, we recommend that you call the VIN/VSPN office at 1-800-700-INFO (4636).

*For more information on VIN's upcoming CE courses, check the VIN Course Catalog.

Katherine James, DVM, PhD, DACVIM (SAIM)
VIN Education Coordinator

VIN CE Services: CEonVIN@vin.com
1-800-846-0028 or 1-530-756-4881 or direct line to VIN/VSPN from the United Kingdom: 01452226154
Andrea Pomposo (Andrea@vin.com); ext 126
Debbie Friedler (Debbie@vin.com); ext 756
Heather Schoffstall (Heather@vin.com); ext 116
Jennifer Boyle (JenniferB@vin.com); ext 169
Peggy Hall (Peggy@vin.com); ext. 195

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