A note to my colleagues

As you all know we just returned from a trip to Brea, CA, where we trained at the Beckman Coulter Training Center. First and foremost we would like to thank each of you whose schedules were adjusted to accommodate our trip. The class was titled DxC600i Intermediate Operations Training and was chiefly centered on our learning a more advanced level of operations and maintenance for the DxC integrated system. We write this letter in hopes of elucidating what we did on this excursion and ensuring to each of you that we are now resources that you can use. There is much more information than can fit into a single compact letter so, in advance, we must apologize for the length of this message; just know that there is much more that was not included.

 

Many thought this class was going to be an advanced maintenance or service class, we were wrong. Though we did spend the majority of our time and energy on troubleshooting, we were also introduced to the ability to set up new tests on the system (i.e. hCG5 taking the place of TBhCG), setting up and changing the parameters of certain tests (normal and critical ranges), and learning some of the theory behind specific Access and DxC testing and maintenance. This letter is devoted to the troubleshooting as it was the primary focus of the trip and of the questions we’ve already received, and let’s face it, the other stuff isn’t nearly as exciting nor as common.

 

This training was not a specific training on a certain number of maintenance/service functions, rather, it was a training session to teach us how to think about troubleshooting in a systematic way. Harry Whatley, our coach for the week, was the best mentor. He disliked the terms trainer and instructor because he wanted to be on the sidelines helping us to learn where to look for a solution not just rote learning specific maintenance tasks. The coach isn’t on the field telling the quarterback where to throw the ball, he’s on the sideline advising the quarterback what to look for and what to expect.

 

“When in trouble, or in doubt,

run in circles, scream and shout.”

-H. Whatley

 

Thinking systematically about troubleshooting really helps to zero in on the problem, and it isn’t a process that only works in the lab. Harry gave us some steps that we, in turn, pass on to you. These steps seem basic and we all do them in our head already but giving them a name and fleshing them out certainly helps you keep a clear head while facing the unknown whether it be the instrument or your car. The steps below are much like the acronym we all already know; Stop, Think, Act, Review.

The Flow of Troubleshooting

 

• WHAT’S WRONG (Stop)
  • QC/Calibration out? Strange results? Bizarre sounds? Smoke? Fire?
  • Are there messages on the system? Are there error codes on the results?
    • Error message will usually take you to a specific entry in the IFU and provide a solution (press the blue question mark by the event id!)
• HOW BAD IS IT (Think)
  • Assess the severity, Do we stop running patients to work on the problem or can it wait while we focus on patient care?
  • Is it everything run on the system or just one sample? Is it all your QC or just one? Is it every level of calibrator or just one?
  • Was it a Range problem, a Span problem, or a Back-to-Back problem?
• WHAT JUST HAPPENED (Think2)
  • Not asking about the problem, asking about a change in the environment around the instrument
  • New employee? New reagent pack/lot? New QC lot? Maintenance procedure completed recently? Power outage? Temp/Humidity fluctuation?
• USE RESOURCES (Think3)
  • Find out if this problem has happened before and how it was fixed. Ask co-workers, check logs, check the IFU (Instructions for Use) to see if a solution is proposed.
  • Ask someone who knows nothing about the system, a fresh perspective may be useful in finding a solution.
  • Call service (be ready for the call! have the codes or numbers ready and available before you call)
• MAKE A PLAN (Act)
  • Rule out what isn’t the problem. Think about what is unique to the problem and common to something that did work.
  • Use the scientific method. Change one variable at a time to discover the culprit.
    • Three things are required for a result – Sample, Reagent, Instrument
    • Begin with sample (QC and calibrator are considered sample, it is the cheapest and easiest to begin with), then go to reagent, then to instrument
• EVALUATE THE PLAN (Review)
  • Was it successful? Yay! Make note for future instances.
  • Was it unsuccessful? Oh No, devise a new plan and change a different variable.

 

Beyond the systematic approach to troubleshooting, drafted above, the concept of common versus unique really seems to be the best way to examine a problem. Below are three scenarios that will, hopefully, explain the idea clearly.

 

• If you have CK-MB and Trop QC results in which level 1 is ok but level 3 is all out, what’s common? Reagent, Instrument. What’s unique? level 3 sample! Likely a bubble or wrong level poured.

 

• If you have a Na calibration pass but the CO2 calibration fails, what’s common? The instrument, the calibrator (sample). What’s unique? CO2 reagents. In this scenario we would begin with checking the CO2 reagents.

 

• If you have Multi-Qual QC levels 1 and 3 running but the lytes and glucose fail on both levels and everything else is fine, what’s common? sample, instrument (is it really? MC vs. CC) Instrument is unique! likely an MC error.

 

Apart from the instrumentation, we were engrossed in learning about Dr. Arnold Beckman and how he grew the company from such lowly beginnings to being a world leader in innovation and instrumentation. He was born in the year 1900, developed a small invention known as the pH meter, made a better and easier to use spectrophotometer, encountered famous names in history like Linus Pauling, William Shockley, and the Coulter brothers, and then lived until the age of 104! Our coach, Harry, recounted a story of meeting Dr. Beckman at his birthday party at the Brea Training Center in the year 2000; he was still sharp as a tack and witty at the age of 100. If you have some free time read this guy’s wikipedia.

 

Sadly he has passed away but he left us with a nugget of advice that we would each do well to follow. We close this letter with his seven rules in the hopes that we can internalize them which may, just may, make our lab that much better and the future brighter. Remember, we understand that our going on this trip constitutes our being a resource at your disposal when attending to the DxC600i systems.

 

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Dr. Beckman’s Seven Rules for Success:
1. Maintain absolute integrity at all times.
2. Always do your best; Never do anything half-heartedly.
(Either get into it, or get out of it)
3. Never do anything to harm others.
4. Never do anything for which you’ll be ashamed later.
(This is an important one!)
5. Always strive for excellence – there’s no substitute for it.
6. Practice moderation in all things – including moderation.
(There’s nothing wrong with a little excess once in a while)
7.Don’t take yourself too seriously.

Goodbye California

Time to go home! Making my way home through Dallas/Fort Worth with about a two hour layover. Another packed flight but not quite as long as Chicago to Santa Ana. Had fun on my layover riding the skylift around DFW. Made my way to the gate but in the time I was joyriding it had changed. Fixing to get on the flight to Nashville so I’ll go ahead and post this so I can spend my time with Sariah, Sophia, and Crystal when I land.

California Love

It’s a very bittersweet post I bring to you tonight. Training is over and it’s time to go back home. I know I can’t express how great of a time I had on this trip. That is not even close to being a statement about our extracurricular activities during the week, they were comparatively nonexistent to the training. Harry Whatley and Beckman Coulter made this training informative AND fun, an important factor that I am sure will aid in retention of the information.

Harry had a meeting during lunch so Christina, Kathy, and I went for a little walk and got the pictures below. A bocci ball area, a mini putt putt area, a walking track, many beautiful plots of plants and orange trees, and a large chess set. What we found out later was that we should not have been allowed to walk around that area as it is supposed to be employees only. Our little secret, okay? Thanks.

Dinner at the hotel restaurant and then off to the outlet stores to do a bit of shopping. Gotta get the goods to ensure I am welcomed home with open arms.

A bittersweet farewell to my friend Kathy as she leaves bright and early, she and Christina needing to leave the hotel at 6am. Thankfully I don’t have to check out until 9. Christina is on her way to Nashville the reverse of the way I came, through Chicago-O’Hare. While Kathy is making her way to Lexington through Dallas.

Californication

Another great day at the Beckman Training Center in Brea, CA! I didn’t mention the other members of our class yesterday but Christina, Kathy, and I are joined in the class by Marj from Medford, OR and Emily from Watsonville, CA. It’s so nice to discover that we can be from such different geographies and have such different work environments and yet we are all connected by our pull to science and the lab. Our labs may be but our problems are not unique. Harry swears it isn’t his quote but I’ll attribute it to him anyways:

If you find yourself in trouble or in doubt,
Run in circles, scream and shout.

Harry was on his game teaching coaching us to learn the best way to systematically troubleshoot; not just these instruments, nearly anything. Using a scientific method of identification and variable change to produce results. Off the top of my head the steps are as follows.

Identify the problem. Assess the severity. Take stock of what is involved in the process that failed. Think of anything that has changed recently either with the instrument or the environment. Identify what is not the problem. Formalize a plan of attack and begin with the easiest and most likely fix. If that doesn’t work just call service, they have trained much longer than we have.

I think my favorite thing from today that isn’t necessarily training related came from Dr. Beckman, posthumously of course. He is well known for living his life to his seven rules:

1. Maintain absolute integrity at all times.
2. Always do your best; never do anything half-heartedly.
3. Never do anything to harm others.
4. Never do anything for which you’ll be ashamed later.
5. Always strive for excellence-there’s no substitute for it.
6. Practice moderation in all things-including moderation.
7. Don’t take yourself too seriously.

A few bits of advice we would all be better off following that just may improve the world around us for our children and theirs and so on.

This afternoon we (Christina, Kathy, and I) plan on going to an Anaheim Ducks hockey game at the Honda Center. Can’t wait for that, it’s been quite a while since I’ve been to an NHL game. Sorry for the change in tense but I have a feeling I’ll be too worn out when we get back to make a post. Good night for now and enjoy the pics.

Add-on from after the game. Great show, Flyers scored to tie it up at 1.8 seconds left. Went to overtime, no score change, shootout went to the Ducks 3-2. Ducks won 5 to 4 over the Philadelphia Flyers! Go Mighty Ducks!

California Rain

Another day down. It’s a rainy day here in Cali, and apparently it’s like snow in Tennessee; craziness.

Met up with Christina and even made a friend at breakfast, Kathy from Mount Vernon, KY. I made sure to put on my name badge so anyone going to the classes could make contact, it worked. Breakfast at the Wyndham was a great selection of classics and a cool omelet bar.

We got to the Beckman training center through some more crazy traffic and found out our class was only five people. Different classes were going on for different specific products but thankfully Kathy was in ours.

Today was pretty basic information but our trainer coach (he doesn’t want to be called a trainer or instructor), Harry, made it fun and interesting. This place is super nice, see the pics below. Lunch was provided at the training center and then we got back to work.

I know I learned a little bit, pretty sure everyone did, even on this introductory day so I’m very excited to get back in to it tomorrow. Finally made it home after some insane traffic of California mixed with the inane driving in the rain. Dinner with Christina and Kathy at Outback. See you guys tomorrow, it’s been a long few days.

California Dreamin

It’s finally here. My training trip for work. For the next week I am in Anaheim, CA for training on advanced maintenance for our Chemistry analyzers. I truly feel special to have been chosen to go, I guess they really do like me. This is a post made on my iPad so it may not be formatted very well, sorry about that.

I don’t know if I’ll get a post together everyday, don’t know if there’ll be enough to be worth it but I’m taking pictures and videos and want to share my experience.

This isn’t my first time flying, nor is it my first work trip, but it is my first solo flight. I’ve been to Europe, twice, but I was still nervous when I got to BNA (Nashville Airport) this morning. Oh, special thanks and shout out to my sis for dropping off! The nerves were from ignorance of what to do, not so much about the flying. I’ve always had an older, experienced, person leading a group of people, not this time.

Check in went well, thankfully it was just crowded enough that I could watch a couple of people and figure out the motions but not crowded enough for bad moods.

Had a bit of a wait due to crazy brain making me think my flight was the time I was supposed to plan on being there so a couple of extra hours in the airport, but I’m no worse for wear. Got on the plane headed for Chicago about 1030. Got a cool video of take off out the window and a couple of pics from the plane below. Got to help a family with their kid by playing peek-a-boo for a while, that was fun.

An hour and a half in the sky and we disembarked to a chilly Chi-town, 22 degrees! It was quite a shock to us all. Very short layover later I made my way to a much larger plane to fly out to Santa Ana, CA. Landing video and a few more pics. Each seat had a small touch screen monitor for movies and what not but the best part for me was the flight information, see the pics below to see some cool stuff, altitude, speed, and outside air temp.

Made it John Wayne Airport safe and sound about 5 o’clock. Took a while to get a shuttle and make it through traffic but finally made it to the Wyndham Anaheim Garden Grove. I must make it a point to tell you all that this is a great chain of hotels; nice rooms, friendly staff, and free wifi.

That’s about all for today. Very long day since three am being woken up by Bebe whimpering because I was apparently in his spot.