It’s a tradition to come up with New Year’s resolution in order to improve ourselves. How about some resolutions to improve our labs?

1. Review and update the procedure manual

When was the last time you reviewed your procedure manual? Procedure manuals should be reviewed by the lab manager and medical director annually. It’s time to re-read the ATS/ERS guidelines and then review and update your procedure manual. Both your old staff and your new staff need to know what to do and how to do it. Your procedure manual is also going to be the first thing that anybody looks at if your lab is ever inspected.

2. Biological QC

Daily calibrations (and you’re doing daily calibrations and keeping a log of them, aren’t you?) are not enough to make sure our test systems are operating correctly. Regular (weekly, bi-weekly or monthly) biological quality control on ourselves with a Levey-Jennings chart is still the best way to do this. Don’t put it off. Biological QC is not an option; it’s a minimum requirement for any medical lab.

3. Staff certification

The staff certification requirements differ widely from state to state. Regardless of what your state mandates it is time for all PFT labs to require CPFT certification as a minimum for all staff members and RPFT certification for supervisors. In the same manner the staff in medical offices and clinics that only perform spirometry should be required to get an AARC spirometry certificate or a NIOSH certificate. Respect is not a given; it has to be earned. Nobody is going to help the PFT profession but us and it’s time to pull ourselves up by our own bootstraps.

4. Make better use of what you already have

We all want new equipment but aren’t likely to get it anytime soon. Make better use of what you already have by performing simple tests that improve patient diagnostics. Upright & Supine spirometry only needs a place for a patient to lie down. Hypoxic Altitude Simulation Tests (HAST) only needs a tank of 15% O2, some disposable supplies and a pulse oximeter. Perform SVC as well as FVC testing during routine spirometry to get the highest VC. 6-minute walk testing only needs corridor space, a stopwatch and a pulse oximeter.  Waste not, want not.  Your patients and physicians will thank you.

5. Update your reference equations

The ATS/ERS specifically recommends reviewing and updating your reference equations at least every 10 years. How many labs are still using outdated reference equations from the 1970’s and 1980’s like Morris, Knudson or Crapo? It’s time to bite the bullet and update to NHANESIII or GLI. The fact that there will be discrepancies between the old and the new percent predicteds and that the interpreting physicians will have to re-learn what’s normal is not a valid excuse. You’re not helping your patients if you continue to use obsolete equations. Deal with it and move on.

Don’t break these resolutions. Make 2017 the year you’re going to keep them.

PFT Blog by Richard Johnston is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License