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The merging of two medical technology programs.

The merging of two medical technology programs

For years, the two hospitals in Sioux City operated their own medical technology programs, each graduating about 10 students annually. Then, in the wake of prospective payment, several trends threatened the schools.

To start with, staff reductions made fewer technologists available to teach students. The tight job situation also forced graduates to look elsewhere for work. St. Luke's Regional Medical Center, a 356-bed hospital, stopped taking on new medical technologists on the day shift-five years have passed since the last one was hired. Neighboring 484-bed Marian Health Center had openings for part-time technologists only.

In addition, there was the question of financial support for the programs. Each hospital sought to cut costs because of a lower patient census.

Our MT programs have had a long tradition of service to the metropolitan Sioux City area, and we were anxious to keep them active. Joining forces gave us a way to do that. Last June, the first group of 12 students graduated from a combined MT program.

The idea for a merger of the programs originated with the education coordinator and the director of the laboratory at Marian Health. They approached the education program coordinators at St. Luke's, and soon both laboratories were abuzz with talk about the possible consolidation, a lot of it skeptical.

A friendly rivalry exists between the two hospitals. They refer testing to each other's labs, and their technologists know one another, having attended workshops and seminars together. Nonetheless, many technologists doubted a program merger would work. Among the comments heard: "I can't work with her on lectures.' . . . "He's bull-headed and won't stand for change.' . . . "They do things weird over there.'

Overpowering these sensitivities was the main impetus for merger: a desire to eliminate the extra cost of maintaining separate programs. With the support of their administrations, the hospitals' education coordinators, laboratory managers, and pathologists engaged in almost a year of discussions to produce a plan for the 1985-86 school term.

The first decision involved appointment of a single program coordinator. Because the education coordinator at St. Luke's was already full-time, she became overall program coordinator with two part-time assistants, one from each hospital. The hospitals share her salary but individually pay their own assistants since these staff members also work part-time as bench technologists. The assistants oversee the student clinical rotation and maintain student schedules.

Enrollment was limited to 12 students overall, down from the previous 10 at each school. Six students take part in the clinical rotation at either hospital-- through urinalysis, hematology, chemistry, microbiology, blood bank, serology, Stat lab, and evening shift.

In the didactic portion of the program, the 12 students come together for lectures covering phlebotomy, urinalysis, hematology/ coagulation, chemistry, microbiology /mycology/parasitology, immunohematology, and immunology /serology. There are also seminars in management education, research and development, and quality control.

Here the program planners faced their toughest task: deciding which lectures would be handled by St. Luke's, which by Marian Health. It came down to acknowledging that each hospital had its own areas of expertise. The one better qualified in a subject area was assigned the lecture.

St. Luke's, for example, provides most of the teachers for microbiology because its laboratory is an Extent 4 facility in College of American Pathologists surveys and does extensive mycobacterial identification. On the other hand, Marian Health handles the lectures on anaerobes and viral diseases because it does more work in these areas.

Generally, lectures are assigned to staff members with specialty certification. For example, two St. Luke's technologists certified in hematology teach the bulk of that subject. The 26 lectures in blood banking are evenly divided. But 9 of the 13 sessions assigned to Marian Health are taught by a technologist with a blood bank specialist certification.

Urinalysis and chemistry are taught primarily by St. Luke's, immunology and serology and most of coagulation by Marian Health. The hospitals split administrative seminars on purchasing, research and development, quality control, and workload recording.

In subject areas where the departments are equally qualified, the education coordinator asks for volunteers to fill lecture assignments. She has no problem in this regard because technologists now look forward to teaching the lightened lecture load. In most cases, they can work in their own particular areas of interest. When the programs were separate, the heavier workload made it necessary for the education coordinator to "strongly request' that technologists accept teaching duties.

While the bulk of the savings result from having a single lecturer in place of two, the consolidation has also reduced reagent and supply costs. Whichever hospital teaches a subject provides materials if the lecture requires a student lab. The merger has been especially cost-effective in microbiology because in previous years both laboratories had to order all the tube media for the identification of unknowns. St. Luke's spent more than $200 a year for microbiology lecture materials before the merger. Now the outlay is less than $100.

With a smaller enrollment, there have been cost savings for materials in the clinical portion of the program, too. St. Luke's used to spend $260 for blood bank training supplies when it had 10 students. The cost is half that for six students. In the microbiology clinical rotation at St. Luke's, supplies for 10 students ran about $350. For six students, the cost is just under $200.

As one would probably imagine, there are some problems when a teaching program is held at two hospitals. The main adjustment that students and technologists have had to make is remembering where they're supposed to be. The hospitals are two miles apart, and most travel the distance by car. Since the majority of lectures given by personnel of either hospital are held at St. Luke's, because of its better classroom facilities, students and some of the teachers from Marian Health have had to do most of the traveling.

Another problem is that technologists in the classroom are not familiar with all the students because they see only half of them during the clinical rotation. This has caused some difficulty in gauging how much of the lecture material each student will comprehend. I have learned as a lecturer not to assume that all students have covered the material during the clinical portion. Usually, I begin my lectures with a brief summary of the material the students should have covered up to that point. We do strive, of course, to keep the rotations similar and follow a common curriculum and set of objectives.

The program will not become so fused in the future that students won't be able to identify with either hospital. At present, St. Luke's and Marian Health students pay a $1,000 tuition fee to their respective hospitals and at graduation receive certificates from each institution.

Students benefit from exposure to two laboratory organizations. When they tell us, "We do it differently at our place,' we explain that methods may differ but the principle is the same, and that it is good experience to get a different approach to the same clinical situation.

At the end of our second year of co-operative teaching, we think none of the problems are insuperable. The important thing is that we have kept medical technology education alive in Sioux City.
COPYRIGHT 1987 Nelson Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1987 Gale, Cengage Learning. All rights reserved.

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Title Annotation:interhospital cooperation in training medical technologists
Author:Kirwan, Erna
Publication:Medical Laboratory Observer
Date:Jun 1, 1987
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