Brian Dukek
Mayo Clinic Labs @ Work
Thousands of people in hundreds of different roles work at Mayo Clinic Laboratories. Mayo Clinic Labs @Work offers a glimpse behind the scenes into this busy reference laboratory, featuring staff from throughout the organization talking about what they do and why they do it.
My wife and I graduated from college in St. Paul in 1996. She had a degree in nursing, and I had a degree in molecular biology. We both began looking for work in our respective fields but were stuck in the “it takes experience to get experience” trap. This was difficult for us as a couple because a hospital had just closed and laid off all its nurses, which contributed to a nursing glut in the Twin Cities. My wife had participated in a nursing internship program at Mayo Clinic the summer before we graduated, so she quickly found a job there and the two of us moved to Rochester.
Brian Dukek
When in college, I wanted to work in the genetic research field. When I also got a job at Mayo, my first role was working as a research technologist in a clinical lab. In that position, I worked side-by-side with clinical staff and learned more about clinical diagnostic testing. I decided my dream job wasn’t in research after all, but in developing clinical tests and workflows. I moved to a new lab as a developer in 1999 (I placed the stickers on the lab’s computers that prevented them from having Y2K problems), and except for one brief foray back into research, I’ve worked in clinical diagnostics or workflow development ever since.
I am a senior principal developer and work with the automation team in the Process Innovation Through Automation (PITA) Lab in One Discovery Square. This exciting lab is so new that carpet from the former tenants will be removed and replaced with lab-appropriate vinyl tile. Our lab and team serve as a resource for the Department of Laboratory Medicine and and Pathology (DLMP) with two main purposes. First, we provide staff and space to evaluate new automation tools in clinical testing meant to improve quality, safety, and capacity. We do this while reducing workload, turnaround time, and environmental impact. Projects are started through a request for application (RFA) process, scored by a leadership team, and awarded competitively. The most recent RFA window just closed, and projects are currently being scored, but future opportunities will be available.
Throughout the year and without the need for an RFA, our team also performs “house calls” to host labs. We do consultations to streamline automation workflows or determine where they would have the most impact. Additionally, we program liquid handlers (currently specializing in Hamilton and Perkin Elmer product lines) to help in clinical testing. If your clinical lab needs automation help, requests can be submitted through the REDCap tool.
My team and I are helping to bring automation tools to labs throughout DLMP. These tools are largely invisible to the patient but help clinical labs do their jobs better. As a metaphor, when you take your car in to have the tires replaced, you as the customer don’t know if the mechanic used a tire iron or a pneumatic impact wrench to remove and replace the lug nuts. Both will work, but if they use an impact wrench, they can do the job faster and can set the torque to the right level every time. As a result, your cost as a consumer should be lower, and the chances that your car and its wheels part ways on the freeway go down.
In the same way, automation in laboratory testing benefits patients and providers indirectly but improves quality, access, and cost. Automation tools help clinical labs reduce errors, increase throughput, improve technologist safety, and lower FTE needs. As an example, I know of a test that had so many complicated steps with risk of tech error that the lab didn’t feel comfortable offering it clinically until it could be automated. In another case, capacity limits for a new test performed manually allowed it to be offered internally to Mayo patients, but Mayo Clinic Laboratories clients were turned away. When the test was later automated, Mayo Clinic Laboratories was then able to offer the same testing to its clients.
I think we all owe a large part of who we are today to our parents and how we grew up. My love for science dates to elementary school when I got chicken pox and had to stay home from school for what seemed like forever. To keep me occupied while isolated in bed, my mom bought me science encyclopedias from the Peanuts gang (Charlie Brown, Snoopy, Lucy, etc.). I read those over and over, and by the time I started high school I knew I wanted to work in a laboratory.
My love for knowing how things work likely comes from my dad and my many uncles who were auto mechanics. From them I learned how to take things apart, put them back together, and to understand the “why” of what made things work or how they could go wrong. When something broke and money was tight, we found creative workarounds to make it work again.
PITA leadership uses the phrase “we don’t know what we don’t know,” and this perfectly expresses our challenge. A big part of the PITA Lab’s role is to find solutions to ongoing problems in automation, either in topics that seemingly can’t be automated or aren’t automated well. When we do find a solution, we need to consider why a tool isn’t used. Is this a new tool? Is this something used elsewhere in the enterprise but overlooked by DLMP? Was there an earlier business relationship with the company that didn’t go well? This work is almost as important as finding new tools to help us do our work better. We need to understand what obstacles prevented the use and how to best move past them.
There is no greater joy in work than to be part of a close team with a common goal to solve together. I am thankful to upper leadership for their vision and investment in the PITA Lab as a means of bringing innovative solutions to automation. I am thankful to my direct manager who recognized my need to be technically involved in development and helped me get my shovel and bucket back into the sandbox. Finally, I am thankful to the automation team I get to work with every day for their talent, passion, and humor as we find solutions to thorny automation issues together.
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