Behind-The-Scenes Medical Work Provides Critical Component for Wuesthoff Patients and Beyond

Labs in today’s hospitals play a considerable role in pinpointing medical issues, conducting research and even doing forensic work to assist law enforcement. Take away the activities of the modern hospital lab and even the basic work of diagnosing a patient’s condition would be seriously hampered.

“Doctors would have great difficulty making an accurate diagnosis without the work of our lab staff,” said Andy Romine, interim chief executive officer at Wuesthoff Medical Center—Rockledge. “Patients may not be aware of how much their healthcare depends on all the behind-the-scenes work in those labs, but it’s considerable.”

Romine added that they play a critical role in preparing a patient for surgery – for example, testing to ensure the patient has a sufficient clotting factor before entering the operating room. The lab staff’s often-invisible presence pervades much of the healthcare process.

In recent months, the labs at both Wuesthoff Medical Center— Rockledge and Wuesthoff Medical Center—Melbourne have received accreditation from the Joint Commission, an independent, not-for-profit organization. Widely regarded as the gold standard in health care accreditation, the Joint Commission has been setting standards for the healthcare industry for 60 years.

In addition to the Joint Commission accreditation of the hospital labs, the College of American Pathologists newly certified the Wuesthoff Reference Laboratory in January.

All of this means that the Wuesthoff laboratories are recognized by independent bodies as adhering to the most stringent standards of performance.

The various labs in the Wuesthoff system fulfill different roles. They all play a part in the diagnosis, prevention and treatment of illness, but they also have areas of specialization. The six lab draw stations, situated throughout Brevard County, are conveniently located centers where patients can have specimens taken and then analyzed at the reference laboratory. These can include a wide range of tests: thyroid, cholesterol, triglycerides, hormones, anemia, kidney function and many others.

The lab in the Rockledge hospital has approximately 40 on staff, including the phlebotomists who draw blood from patients, cytologists (cell specialists) and technologists. Its work spans a broad array that includes surgical pathology, the analysis of tissues taken from biopsies and other procedures.

The reference lab’s activities include about 50 percent forensic services. Situated near Spyglass Hill Road in Suntree/Viera, the 22,000-square-foot facility does work for the Florida medical examiner and various law enforcement agencies around the state. The lab also performs esoteric testing of samples from Wuesthoff Medical Center—Rockledge, Wuesthoff Medical Center—Melbourne, Sebastian River Medical Center and St. Cloud Medical Center. Esoteric testing includes microbiology, virology and immunology, along with other sophisticated tests, such as cancer markers and hepatitis.


“Along with seeing 250 outpatients per day at the lab draw stations, we also see detectives, FBI, the border patrol and attorneys,” said Janet Smith, director of the reference lab and its staff of 40. Other high-profile clients include Kennedy Space Center and Orange County.

Among the lab’s services to law enforcement is toxicology work, such as determining levels of alcohol in a person’s blood. “They’re always looking for a quick turnaround time and that’s really our market niche,” Smith said.

Smith said the lab is sometimes called upon to check street drugs for adulterants – extra substances added during the manufacturing process that can make them far more dangerous to the user. “When we see an alarming number of deaths due to the adulterants, we report that to the state of Florida,” Smith said. “They then alert the schools about a dangerous drug being on the streets.”

The lab’s processes are highly automated and state-of-the-art. Improvements in efficiency have led to better diagnosis and treatment, Smith said. For example, it was once necessary to grow bacteria on a media plate to determine the nature of an infection. But with swiftly spreading diseases like meningitis, there was no time to wait for bacteria to grow – doctors were forced to do a certain amount of guesswork with regard to treatment.

A new lab process that diagnoses disease by extracting DNA and RNA has eliminated much of that uncertainty. While a diagnosis may have taken 48 hours at one time, it’s now a matter of two hours. “The treatments are now targeted to exactly what the infection is,” Smith said. “We’re able to eliminate the guessing.”

Among the most obvious differences between hospital labs decades ago and today are the quantum-leap advances in technology and the automation of processes. “I have seen so many changes in the field of lab medicine, the testing methodology, and it’s still changing,” said Susan Hultenius, laboratory director at Wuesthoff Medical Center—Melbourne. “That’s one of the things that keeps me engaged in this work.”

A veteran of 40 years in the field, Hultenius remembers well the days of paper documentation with its three-part forms, hands-on work with test tubes and other practices that have since faded away. “We don’t have that manual chemistry part anymore,” she said. “But back then, we couldn’t get our hands on the kind of data mining we have today.”

Along with all the advanced technologies and procedures comes another crucial part of the lab’s work: staying current with a flurry of regulations from the United States Congress, OSHA, the Environmental Protection Agency, the Centers for Disease Control and other regulatory bodies. It’s all part of the ongoing challenge that exists at all levels of healthcare. “We have to stay in touch with it all,” she said.

While patients rarely see the lab, Hultenius tries to get out and visit them as she has opportunity. She spends the rest of her time overseeing a department that’s often in a state of transformation, requiring the staff of 20 to adapt. “It’s challenging and exciting because of the new technology, new instruments, new testing coming out,” she said. “We are committed to working together and assisting other departments to provide the best care possible for our patients.”

“We are committed to working together and assisting other departments to provide the best care possible for our patients.”
– Susan Hultenius, Laboratory Director