Volunteer Focus
Dennis Ernst, MT(ASCP), Director, Center for Phlebotomy Education

Dennis Ernst, MT(ASCP) is the founder and Director of the Center for Phlebotomy Education, Inc., which provides educational resources to all healthcare personnel who perform, teach and manage blood specimen collection procedures.  Ernst’s work—and the Center for Phlebotomy Education’s organizational mission—focuses upon the procurement of high-quality specimens for laboratory testing while emphasizing the safety of both healthcare worker and patient.   A highly recruited international speaker, Ernst conducts a number of workshops, inservices, and conferences each year—most recently in the USA, Canada, the United Kingdom, and New Zealand.  He is one of the most widely published authors on the subject of phlebotomy, with book credits including Applied Phlebotomy (Lippincott Williams & Wilkins, 2005) and Phlebotomy for Nurses and Nursing Personnel (HealthStar Press, 2001).  An active and dedicated CLSI volunteer who has served as a chairperson and participant on a number of CLSI specimen collection documents, in his own work, Ernst attests to the fundamental importance of CLSI standards and guidelines to the initial and ongoing education of the professional phlebotomist. 

Tell me a bit about your background and how you got started in the healthcare field.
I got started right out of college when I went to the School for Medical Technology in Saginaw, Michigan after graduating from Albion College, so I had my one-year internship there, and then I passed the board of registry, and then started working as a medical technologist, beginning in 1978.

At what stage did you become specifically interested in phlebotomy and the issues and problems facing that field?
In the 1990s, I began seeing, as everybody else did, how specimen collection responsibilities were being handed over to nonlaboratory personnel, and the problems from a specimen-quality perspective that this was having—as well as on a patient satisfaction perspective, and a patient-safety perspective.  And I became increasingly aware of permanently disabling injuries that patients were suffering at the hands of the unskilled, and I saw the phlebotomy community as being underserved from an educational perspective. 

And how did this awareness bridge into the formation of the Center for Phlebotomy Education?
Nobody was really providing the resources that a multidisciplinary specimen collection workforce required to perform the procedure correctly and safely for all involved—so, in 1998, I left the bench and I started the Center for Phlebotomy Education with the intent to provide educational materials and to be a resource to those who perform, teach, and manage specimen collection procedures.

What was the initial response from the phlebotomy field, and how has that evolved over the years?
The need that had gone unmet until the center opened was immediately obvious to me, and continues to grow.  There was a vacuum in the healthcare industry overall for a source of educational resources and highly accurate and researched information on specimen collection procedures, and the phlebotomy community embraced what I was offering immediately, and continues to do so today. 

How did Phlebotomy Today come into play?
One of the first things we did was to produce the Phlebotomy Today newsletter online, and we’re now in our sixth year, and we have about 6,000 subscribers, and about a dozen new ones every day.  So the hunger for information that’s readily accessible and easy to disseminate just continues to increase, and the more people that are aware of the free resources we have, as well as those that we develop and market, the more numbers that we’re reaching, and so the growth is still in an exponential stage for us.

Could you give me an overview of the resources and services that the Center for Phlebotomy Education provides?
Sure—we develop printed materials, online information.  We develop and market videos and download documents.  Again, the Phlebotomy Today newsletter is a free publication available to anyone; we do have artificial training models for educators and trainers who are teaching people how to draw blood specimens; we have a series of videos—these are the only videos on the market that are current with the CLSI standards and published guidelines.  And we continue to develop new products. 

What’s your newest product?
Our latest product is a blood collection site wall atlas.  Believe it or not, an illustration that showed where the nerves, the artery, and the veins pass through the anticubetal area did not exist in the literature until I commissioned a medical illustrator to draw a composite illustration based on the available diagrams from Gray’s Anatomy, Grant’s Anatomy, and every other illustration I could find. Then I sent the final illustration to a respected and well published physician who specializes in anatomy who gave our illustration his blessing.

Tell me about “Accurate Results Begin With Me."^TM
We’re expanding our “Accurate Results Begin With Me”^TM product line this month that includes items that recognize the role phlebotomists and testing personnel play in patient care and accurate results. Products that are imprinted with "Accurate Results Begin With Me" (TM) have always been available from us for phlebotomists, but now we have a new design for testing personnel. It’s a pretty jazzy design imprinted on travel mugs and polo shirts, sharpies, and buttons that we think people will really welcome in their workplace.

I know that you also stay pretty busy out in the field, giving presentations to members of the phlebotomy community.  On the 5th of August, you gave a presentation at North Carolina Clinical Lab Tech Day in Raleigh, called “The New CLSI Standards: Important Changes Every Phlebotomist MUST Know.”  Which CLSI documents did the presentation involve?
The presentation given in Raleigh discussed the venipuncture standard, which is H3; we discussed H4, the skin puncture standard; H21, the coagulation guideline; and H18, the specimen processing and handling guideline.  And all these documents were recently revised—in the last 18 months or so.  We think it’s paramount that people are aware of the changes that have occurred, and in what areas they have been updated so that these changes can be reflected in their own policy and procedure manuals. 

Why is it important that phlebotomists stay updated on these standards?
One of the things I do in my capacity as Director of the Center for Phlebotomy Education is serve as an expert witness for attorneys representing patients or hospitals or healthcare facilities involved in phlebotomy-related litigation, and, I have to tell you, if a facility’s procedure manual is not reflecting the CLSI standards, then they are wide open for legal liability should an injury occur, and it can be found that it had occurred because of non-adherence to the standards and guidelines. 

It’s absolutely paramount from a risk-management standpoint that everyone is updated on what the current CLSI standards say, and that their procedure manuals and policies reflect those standards, because, if an attorney gets ahold of them, and can show that the facility is operating outside of the standards, then it’s very difficult to defend against liability.  So, not only is it in the best interest of the patient and the staff to have policies and procedures that reflect the current CLSI guidelines; it’s paramount for good risk management, and it’s the best way to reduce a facility’s risk of liability.

To what degree do you think the phlebotomy community is aware of this in advance of your presentations?
Well, everyone is aware of the CLSI standards, I’m finding.  What they’re not aware of are the very exact passages that their own policies and procedures may not be reflecting.  So I always recommend that every facility has a copy of the latest guidelines, and use it as a basis for their policies and procedures, and refer to that document frequently, not only in training their staff, but in evaluating their staff so that a lot of these things don’t get forgotten. 

The new venipuncture standard, for example, had some very critical passages inserted in this latest guideline, and, if a facility is not aware of what those passages are, and has not checked this latest version against their procedure manual, they may be operating beneath the standard of care, and may never know it.  When I give presentations and I discuss these revisions, for a lot of people, it’s a real “aha!” moment, and they see where they’re vulnerable, and they go back to their workplace, and close the cracks in the floor that they can fall through should a patient become injured.

Would you touch on some of the things you have coming up in the future?
Yes—some of the more interesting invitations I’m accepting are California Association for Medical Lab Technologists in September.  I’ll also be presenting to Alina Health Systems in Minneapolis, and the American Association of Bloodbanks, which will be held in Seattle.  I’ll also be providing inservice training to government healthcare facilities on the island of Aruba.

What has your role been in the CLSI consensus process?
I served as Chair of the working group that recently revised CLSI document H4, the capillary collection standard; I served as a member on the working group that recently revised H21, the coagulation guideline, and also on the venipuncture standard, and H18, the specimen processing and handling document, as well as H1-A5, Tubes and Additives for Venous Blood Specimen Collection.

Why is CLSI important to a phlebotomist’s ongoing education?
I have always firmly believed that, if an educational resource does not rely on CLSI documents as a basis for what they are teaching and putting forth in proper specimen collection procedures, they are doing a disservice to the healthcare community.  I’ve always found the standards and guidelines that CLSI produces to be of high quality, very well researched, and with very strict attention to detail.  It’s just not possible to produce quality educational materials unless they rely heavily on CLSI documents.  And our company is all about providing quality educational material, and we would not be as highly respected as a source of accurate information if we did not use CLSI documents as a basis for just about everything that we produce.

Dennis Ernst will be speaking at the California Association of Medical Laboratory Technologists (CAMLT) Annual Meeting, in Santa Clara, California, USA, on 24 September 2005.  For more information on the Center for Phlebotomy Education, or Mr. Ernst's speaking schedule, programs, and availability, visit www.phlebotomy.com.

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