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What standards should be non-negotiable in IVF labs?
In this week’s episode of Inside Reproductive Health, we’re joined by Dr. Sangita Jindal—lab director at five IVF centers and former SART president—to discuss the urgent need for standardized embryologist training, better oversight, and technologies that minimize catastrophic lab errors.
Tune in to hear Dr. Jindal’s insights on:
Why embryologists need national certification (and why ASRM should lead it)
The pros and cons of expanding training requirements for embryologists
The limits of automation without skilled human oversight
What she values most in the lab monitoring system Xiltrix (and why her other labs don’t have it)
Whether every IVF lab should be required to implement e-witnessing
This episode was recorded just after news broke of another embryo loss lawsuit—highlighting the real-world consequences of our field’s biggest vulnerabilities. Don’t miss Dr. Jindal’s thoughtful, candid perspective on what needs to change.
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Dr. Sangita Jindal gets 24/7 live assistance from XiltriX’s SafetyNet Team at three of her five IVF labs. Request your free demo to see if your IVF lab can benefit from the same advantages.
In your free demo, you’ll receive:
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Griffin Jones (00:04)
Dr. Jindal Sangita, thank you very much for joining me on the Inside Reproductive Health podcast. Welcome.
Sangita Jindal (00:11)
Thank you, Griffin. It's a pleasure to be here.
Griffin Jones (00:15)
What are you most concerned about in the IVF lab? know that incidents that happen in the lab are rare, but we don't want rare, we want zero. What are you paying attention to?
Sangita Jindal (00:27)
I think I agree with you, we want zero, but I think we also have to have reasonable expectations that we are human. Zero as aspirational, rare is probably more to be expected. So I think we should definitely adjust our expectations. ⁓ I think everybody knows, every lab director knows that they need to have a very robust quality management program.
quality control, they have to do audits to make sure things are being followed. But I must say, even with your best efforts, things can happen. Things can fail. We are human. We handle things. Things can be dropped. ⁓ know, there can be mislabeling issues. This is not to excuse it, but to say that it can happen. So those are things we definitely are monitoring. I will say, I think that automation coming into the lab will certainly assist.
in reducing some of the touch points that are misidentification risk points. ⁓ This can maybe reduce handling errors, improve safety, efficiency, workflow, maybe produce an audit trail. I think these are some of the things that we can look forward to when automation really starts to work into the laboratory.
Griffin Jones (01:49)
We are all human. Humans are always going to make mistakes. I see some solutions though that are not human. They're either robotic or they're operated by AI or at least a software or there's some sort of mechanism that should prevent some of these issues. And it seems to me like there's not a universal adoption in a different conversation that I had with Dr. Steve Katz, Dr. Eva Schenkman.
They both thought that everyone should have monitoring solution, everyone should have e-witnessing, everyone should have safe cryo storage system. Do you agree with, are all of those table stakes for an IVF lab in 2025 and beyond?
Sangita Jindal (02:36)
Well, I certainly don't disagree that these are the major third rails for IVF. It's cryo storage, it's ⁓ misidentification errors in embryos, in PGT. ⁓ Witnessing definitely is important. Now, having said that, to mandate ⁓ electronic witnessing, that's a lift for clinics financially. ⁓
we'd have to mandate that and make sure that everyone's following it. I think that might be a heavy lift. Having said that, we do require monitoring for cryo storage currently. ⁓ Things have to be, anything that's temperature sensitive has to be monitored 24 seven. That's a requirement and that includes cryo storage. But Griffin, honestly, even with all of the safeguards, the witnessing, the monitoring, it still can happen that systems fail.
It's only as good as the people using it and the training and the application of their training. In the absence of that, the system is only as good as the people using it.
Griffin Jones (03:47)
I wanted to ask about that and I am not talking ⁓ any details about a particular case or commenting on a particular case. You certainly are not because you don't even know which one I'm referring to, but just to give a situational viewpoint of this and then I want to see how you think we might approach it. In the news, there was recently reported a case of lost embryos.
And I don't know anything about what happened there. They might have had some of these cryo storage solutions in place. Can that only happen if solutions, if the best cryo storage solutions are not implemented or can a situation like that still happen even if they have the solutions from any of these like top three cryo storage companies?
Sangita Jindal (04:40)
No, I cannot say that it can never happen. Never is not a word I would use ever to say that errors, that should be the expectation. It cannot never happen. even with the best systems and audit trails, traceability, ⁓ training, constant monitoring, I'm sorry to say catastrophic events can still happen. ⁓
We are very cognizant. We monitor, we talk about it. I mean, this field with the self-regulation and the way that we examine how we work is, I think, unprecedented. I'm not sure that any other field of medicine looks at such a detailed level at what they do in their daily operations. It's incredible across the country, maybe globally. Everybody is looking at every granular aspect of how their laboratory runs.
And I think it's to our credit. And it could be that we're looking for something, we're always looking, we're going to find something that can be improved, that can be tightened up because we do have so much scrutiny on us and we apply that same scrutiny to our labs.
Griffin Jones (05:51)
You might know if you've listened to this show a bit that I have no scientific or clinical background. And so when I asked this question, I am not asking rhetorically. I'm actually asking you to explain it to me because one of the things that cryo storage talks about is you don't have to deal with this whole issue of the spreadsheets and this inventory nightmare. again, whatever happened in any clinic, I'm not really referring to them.
speaking very generally, how would that work if someone had a solution like that? How could they still lose embryos?
Sangita Jindal (06:34)
I think if people are still, there's still touch points that are human touch points. And if they are loading embryos into a vitrification device and they're literally, say they've done PGT and they've done biopsy and they have biopsy number embryo number three and number four, but instead of putting them into straws three and four, they reverse them and put them into four and three. That can happen. So it's still the same patient. It's still their embryos. They've still been biopsied.
They're still being frozen, but it can happen that they've reversed the tube. it, you know, without the witnessing, perhaps the witnessing doesn't work at the level of the tubing and of the vit device. It works for the patient. It works for that day. It works for that, you know, event, but it may not actually pick up that level of detail for witnessing. And so I think those are perhaps incidents where there's still an error that can be introduced into a robust system.
⁓ Just inadvertently that can happen because we are working with these invisible embryos under a microscope and you're doing many of them often for a patient. And I think it's probably more common that these errors happen within the patient rather than between patients.
Griffin Jones (07:47)
If you were called upon a governing body to put in some of the best practices, what would your advice be? What would you want to see implemented across the board to minimize incidents to whatever extent humanly possible?
Sangita Jindal (08:07)
I think we're partly there. think we do have accrediting agencies such as College of American Pathologists and the Joint Commission. They accredit embryology labs. They have requirements. I know for CAP, for example, they have multiple questions on the checklists that are to do with misidentification risk and monitoring of temperature sense of material. So there is accreditation requirements. So that's one.
I think number two, and we touched about earlier, was automation or semi-automation. I think that can also help to reduce risk. ⁓ Whether or not we should mandate these things in the laboratory, there are obviously big clinics, private equity, deep pockets, but that's not true for every clinic. And the cost will be passed on to the patients. We have to be mindful of that. I think traceability is important. If we have cryo storage systems,
We know that they're out there, one or two that are fantastic. ⁓ I know we have ⁓ e-witnessing systems. These are used but not mandated and not across the board. I think there's other ways to go instead of just ⁓ purchasing software or systems. ⁓ Perhaps we can create our own systems. We could have an internal reporting system, for example, of errors or near misses. Perhaps that's non-discoverable, similar to what hospitals have.
in their mortality and morbidity reporting. This is already, I believe, happening within these networks. ⁓ And there's data showing that when errors are reported, error rates go down. So I think ⁓ most errors are near misses or they get caught. And if we had an internal space to report them, this does occur in other countries, for example, that may be a way to go. It remains to be seen if we can do that within the US.
and the fact that we are a business as well as a medicine, I'm not sure that, ⁓ you know, reporting of errors will catch fire here, but I think it's one way to go. ⁓ I think another way to go options, as you know, there's an ISO standard. ⁓ That's also a heavy lift for labs, but maybe all the IVF labs could become ISO certified. ⁓ Maybe we should be standardizing training and credentialing of lab staff.
This is done nationally in other countries, for example, HFEA in the UK. So I think we can have a standardized curriculum, hands-on training. This could be endorsed by our society, such as American Society for Reproductive Medicine. I think that could be very public facing. And to regulators and to the press and to business leaders, that we have standardized training and a curriculum that
ensures that these people have been trained properly. So I think there's a lot of things that can be done.
Griffin Jones (11:04)
With regard to monitoring, you use Ziltrix. What do you like about them specifically?
Sangita Jindal (11:10)
Yes, so I have a number of labs that I do direct, ⁓ actually five labs and three of the five have Ziltrix. And I chose Ziltrix, well, I don't know, seven years ago, well before the pandemic. And what I like about Ziltrix is several things. ⁓ I'm always nervous when everything is wifi and I know the wifi is a great systems or wireless, but I always get nervous in case there's a problem with the wifi and with the networks.
So Ziltrix actually has hard wiring to substations where the tanks are, where the fridge is, where the freezer is, where my incubators are, anything that's temperature sensitive. They have the substations. They do have capability for the wifi, the network, as well as the phone. And there's an online portal, which is terrific. And this allows for real time survey of equipment. You can obviously survey everything remotely.
Igor Brusil (11:52)
So.
Sangita Jindal (12:08)
It can generate reports. ⁓ It's able to be ⁓ filtered. So you can look at certain things in certain ways. It runs 24-7. The other thing I really like about it, the third thing is that their call center and their responses are terrific. We test our systems monthly, ⁓ all months of the year, over and over again. We have equipment that goes into an alarm when you're working with an incubator that's open or a cryo tank that's open.
Igor Brusil (12:15)
Thanks.
Sangita Jindal (12:37)
It will go into alarm and we have a response that's very robust. It's by text, it's by email, it's by phone, and they continue to ⁓ ping us until somebody responds. And ⁓ that has not failed yet in all the years we've used it. And I have to say also their customer service and replacement of probes or substations, all of these things are very good. And I do recommend Ziltrix.
Griffin Jones (13:06)
Why do you like those reports? What information do you find to be most important?
Sangita Jindal (13:12)
So the reports, so my pros are temperature. I do have one gas probe in one of my incubators, but everything else is temperature. And I run the temperatures between a tight range and I'm able to look at fluctuations over time for each piece of equipment. I can compare each piece of equipment and then I overlay ⁓ other metrics such as fertilization rate or blast development rate. So I can tell per incubator,
how ⁓ the embryos are developing to see if it anyway is associated with the temperatures that run ⁓ over time. And so during a series, for example, in my Miami lab, I will print out reports every month for those two weeks for the temperatures in the incubators and measure which embryos did best in which incubator to see if it matters if ever where there's a temperature. And for example, there is one.
catch we found where the temperatures were falling a little bit to the low end of the range and my blast development was not as robust as it should have been and we replaced the handle on the incubator to make it a tighter fit but I knew that because of Ziltrix.
Griffin Jones (14:26)
talked about different solutions that could be implemented like an internal reporting system, becoming ISO certified, having a standardized training and curriculum for embryologists. Which of those solutions or others would you put as number one?
Sangita Jindal (14:51)
I think.
I think it should be standardized training. think this is the ask. I am being told that that is what lab directors from large networks are being asked for. And if that's something we can do as a society, know, as around, for example, as a society provide to them, I think that would go a long way. So you mentioned some of these errors that happen. ⁓
In the networks, this can be very devastating. ⁓ We want to protect our embryologists. These are the boots on the ground in the lab doing the work manually, working tirelessly, very detailed. There's a lot of burnout. We want to make sure that these people are protected. And so I think starting there, starting with the people, making sure they're trained, making sure they're credentialed, there's a standardized curriculum that this is, you know, signed off so that networks
business leaders, ⁓ risk management, all of these parties within the networks, for example, understand that the embryologists have been trained to a certain standard. I think that would go a long way. And this is not like reinventing the wheel, Griffin. This has been done in other countries. This is done, for example, within ESHRA. And I think that that's something that we could do here in the US.
Griffin Jones (16:16)
For those listening, especially those on the business side, I have a feeling they might be thinking, we are training our embryologists to the highest standard, but if it isn't standardized, then that standard is different for different people. What might be included in that standardized curriculum that you feel is often missing?
Sangita Jindal (16:45)
I think lab directors do a great job organically training their staff. That's the way we've always trained them since the beginning of IVF. We bring trainees into the lab. We have a training program. It includes a certain number of ⁓ procedures they have to do each single thing. Dish prep, oocyte retrieval, embryo grading, vitrification, biopsy, all of the elements. And they have to do a certain number, ICSI of course.
They have to do a certain number, you know, up to a standard within the laboratory, and then they get signed off and then they can work independently. Now, we see over years, some labs take years to train somebody, some labs go faster, it depends on the trainer, it depends on the trainee, it's all over the place. And some people are really gifted in some things and not others, and they have to be remediated.
So it's variable and it always will be depending on the trainee. But if you have a standardized curriculum that has buy-in from most and all lab directors saying, yes, Sangeeta, I think they should all perform at least 20 egg retrievals without missing an egg, that's just a number I'm proposing, then we all agree that that is a standard. I think that that's very reasonable. And they can maybe do it within a certain timeframe as well. I think that's also something we can work on.
but I think it's important to have a standardized curriculum so that we also bring our people up. know, every lab works differently. Super busy labs have people doing the same thing every day because, you know, they can't train them to all the elements, so they do one thing they're really good at, but I'm not sure that's also the best way to retain people and have them reach their potential. I'm not sure that serves those people that are in the lab. So...
I think there could be a way to bring all of us to a higher level for all of the elements that is standardized across the country and understood and believed to be the gold standard. And so that way they are protected and recognized as a profession, as trained embryologists. Right now, I think everyone does a good faith effort to say seniors, mid-level, junior. We have these sort of internal titles. There's nothing that's really official.
And I think that could go a long way to making our field more attractive.
Griffin Jones (19:09)
Which society or which governing body in your view do you think is best suited to take on this standardized curriculum and training certification?
Sangita Jindal (19:23)
I think I've worked within several societies that we have. ⁓ Certainly, I would say ASRM. I think ASRM has the broadest impact across the field. And particularly within ASRM, there's five affiliate societies. There's one that's focused completely on laboratorians, that's SRBT. ⁓ And there's also SART, which
is focused on IVF labs, I'm sorry, IVF clinics and programs around the US. So I think SRBT, SART and ASRM are the three societies. And I think this brings up the whole issue of self-regulation in an era of regulation. think ASRM is the most poised to lead the way, particularly SART and SRBT with self-regulation.
Griffin Jones (20:16)
So among those three, sounds like they would have to all adopt the same guidelines in order for it to remain self-regulated, right? Because often you have different societies making different recommendations, and then a governing body is the one that says, here's what's actually the law or the requirements.
Sangita Jindal (20:42)
So I will clarify.
Griffin Jones (20:42)
Do you think these three
could come together to agree upon and adopt the same training requirements for all three?
Sangita Jindal (20:54)
Yeah, so I will say at the outset that SAR, SRM, SRBD, SRM is not a regulator. Yeah, so I just want to be clear about that.
Griffin Jones (21:01)
Right.
But that's what I mean, because if
you leave it to the societies to say, here's the certification, if they have any difference in their certification, then you don't really have a self-regulation because someone could say, well, I was following the SRBT guideline, even though the SART guidelines said that, or the SRM guidelines said that. And that's where regulators step in and say, OK, thank you very much for your guidelines. Here's the actual requirements. Do you think that these three could
agree upon a set of requirements for standardized training because if they could, to me, that would suggest effective self-regulation. don't know what the...
Sangita Jindal (21:45)
Exactly,
exactly. No, you said it right. So SART and SRBT are affiliate societies within ASRM. So they, ASRM will rely on the content experts and thought leaders within SART and SRBT to put forth the standardized curriculum. And that's what they're doing now. And I think that is exactly what's happening and the minds are coming together and building this curriculum. Then ASRM will produce this for wide dissemination.
as something that ASRM is behind and backing and would like to see adopted across the field. So as you say, they set guidelines, they set guidance, they have practice guidelines, committee opinions, all of these things. This would be another one of those in the toolkit to say, hey, look, we are absolutely self-regulating as a field. We're even setting guidance and requirements for training for our staff, our most vulnerable people, which aside from the patients, I think are the laboratory staff.
This is the most risk, the most liability. They carry the most burden in terms of daily workload at a high, high level of detail. These are the people we need to make sure that we have clear requirements and guidance for their training and so that they can thrive in the field.
Griffin Jones (22:59)
You brought up something interesting about the breadth of training for embryologists because you might have a 2000 cycle IVF lab that has very different needs than a 200 cycle lab. And in the larger group, you might just train some embryologists to do certain things. In your view, doesn't sound like that might, that might not be the best for retention, but it sounds like you might also want a broader breadth.
for your embryologists, more cross training. What do you think is the minimum training? I could see there being a tension between needing that depth, even if it's stuff that they might not be working on today, because you don't know if they're going to be working on it tomorrow, and you don't always know how they're going to interrelate. And so people need to understand the bigger picture. I could also see that raising the barrier to entry of
let's just get these junior embryologists in, let's get them some embryology experience because we have a shortage of embryologists and we need more people that know how to do this. How do you balance those two? The minimum requirement to know the bigger picture and the barrier to entry.
Sangita Jindal (24:15)
I think you raised a good point with the word tension. I think there is a tension there. It's a balance. Maybe it's a more positive way to say it. think, ⁓ first of all, I don't think a laboratory needs to have 100 % senior embryologists. I think there is a place for a bit of a hierarchy where there are seniors, there are mid-levels, there are juniors. There are also going to be people who don't seek to be a senior. They're very happy doing
you know, some of the prep work or some of the mid-level work. And they may feel that they don't want to take on the extra burdens of the biopsy or the ICSI and doing that all over and over again. That may be those people. So I think it's good to have an aspirationally that everyone will be trained in everything. And I think that's wise, but it may not pan out that way in terms of workflow. Every day of the week, you can't have all seniors.
who want to do all the biopsies and the XEs and no one wants to do make the dishes. So on the other side, I think automation is also something that we have to factor in when we have ⁓ laboratories that have automation or semi automation. I know we're moving to more and more towards that. ⁓ There may be a drop off of skills and ⁓ sort of retaining your skills and your expertise in the face of automation. So if somebody is not trained on everything,
and the automated system goes down, what do you do then? I mean, how do you treat your patients? So I think there is a balance that has to be struck, but it's a very fluid situation. As you know, all the exciting innovations are within the lab and every year there's something new that we're having to sort of pivot and adopt and evolve. So I understand your question, but if you ask me two years from now, it'll be a different answer because I think the way we work in the lab will be totally different.
Griffin Jones (26:15)
You mentioned that e-witnessing can be very useful. It could also be very expensive for some people. And that might be part of the reason why it isn't mandated right now. If you were the czar of IVF, regardless of a practice's size and all of their financial background of if they can afford it or not, would you mandate e-witnessing?
Sangita Jindal (26:48)
Hmm.
I might, I might. I will say it's not error proof. There can still be errors, even with the e-witnessing. ⁓ It adds to the workflow. So there's pros and cons, like there is for everything. ⁓ If cost was not an issue, and by the way, we may be moving to this mandated state sooner rather than later. So yeah, I could see it happening as a reality.
I'm not rushing out to get e-witnessing for all my labs. It's on my wish list, but I have not implemented it yet for all my labs. you know, we function and it's fine. ⁓ But yeah, I could see in the near future that it would be mandated. I could understand that.
Griffin Jones (27:40)
What gives you pause? I think of the situation that happened a couple of months ago where there was an embryo mix-up and a woman gave birth to a different couple's child and that couple sued and gained custody of that child is just heartbreaking. All of us are gut-wrenching because of that. And I hear proponents of witnessing saying that we could have stopped that. That could have been prevented.
Is that true? It sounds like you have some reservation about that.
Sangita Jindal (28:12)
It's not that it's not true. It's just, it's only as good as the people using it, Griffin. mean, if people don't, there's workarounds, there's hacks, there's, you know, there's error points where a supervisor has to come in and unlock the system again to make sure that they're back on track for that patient. It can happen. No system is foolproof. And so to say that would have prevented it, maybe yes, possibly in that case, absolutely. And as I say, we're probably moving to that system being mandated.
okay, we'll deal with it, it'll be fine, it'll be great, but I'm not sure that it is the answer and the only answer. I think there's a lot of other things that can be done around that. And as we move to automation, things will be witnessed, you know, automatically. And so we may not even need a separate e-witnessing system 10 years from now.
Griffin Jones (29:05)
Again, my ignorance, how does it add to the workflow?
Sangita Jindal (29:10)
I think you have to have readers in the laboratory. have to be placed, you know, around the lab, in the hoods, on heated surfaces, wherever you're working with dishes. You have to have the labels. You have to have barcoded labels. They have to be working within your EMR. You have to have these scanners that are available at the time you're working. I you cannot just use a heated surface.
do the work, move it back into the incubator, you have to work with the system. And it's a learning curve. I'm sure it's not onerous at all, but it is part of the workflow that has to be sort of integrated into your workflow. So eventually it'll be done and we'll get used to it at a broad scale. But the systems also may or not work for every step. It may not be something you can check at every single
point, for example, tubing and biopsy, I think this has newly come about, but this has also been evolving to provide more sort of security for the embryologists. It didn't come out fully formed when it started. It's been getting better and better over time. So I think at some point when it's at that point, you know, where it's really robust and every single possible point has been identified as a risk point that can be mitigated, perhaps then we can go to mandate it.
Griffin Jones (30:37)
Umbrologists need a lot of support and from their lab directors, from the solutions, maybe from other folks as well. I don't know if you use the word call center for Ziltrix, but something about that support of how they alert you. Can you tell me more about that?
Sangita Jindal (30:54)
⁓ You're talking about Ziltrix call center? ⁓ So, right. So when we, for example, get an alarm, we will get a text, we'll get an email, failing that within a few minutes, we get a call. The call identifies that there's ⁓ an inconsistency in a temperature measurement. It's fallen out of range. They can tell us which piece of equipment it is, what has happened, has it spiked or has it dropped. ⁓
Griffin Jones (30:56)
Yeah.
Sangita Jindal (31:22)
or there's a power interruption, for example, that's another reason that the system would go to an alarm. So all of these things are detailed to us verbally within minutes of the alarm happening. And it goes through a phone tree. if it doesn't reach the first person on the list, it keeps going, and it keeps going in a circle around the list until somebody answers the alarm, which of course it never takes that long because embryologists don't do that. We all have our phones with us and we all
you know, communicate with each other. And then the alarm is answered either physically in person or it is through the portal that you indicate it's been answered and everybody's aware. So that call service to me is key because if it's just by text, for example, and you're, know, it's two in the morning and your phone is not set for notifications, you're not, you it doesn't ring. You've got to ring her off something, something you don't get the alarm. So by having the phone,
going all through a circle of response team, I think that's the best way to mitigate the error, or not the error, sorry, the alarm going unanswered.
Griffin Jones (32:29)
Yeah, even in an age where we're all glued to our phones, there's still plenty of exception. You're in the shower, ⁓ you're trying to spend time with your family or whatever it might be or something else is going on. ⁓ How does that normally look? Like in the absence of a system like Ziltrix, how does alerting normally look or finding out about this information typically look in the absence of something like Ziltrix?
Sangita Jindal (32:36)
Sadly.
Well, mean, other alarm systems also, they will have visual alarm. You have changes of colors, for example, on your portal that shows that the tank, for example, a cryo tank, is warming or cooling in a way that it shouldn't be, usually warming, obviously. And ⁓ you will have text messages. You can have ⁓ emails. You can have phone calls. If it's wireless, you know,
I think the wireless systems out there are great. ⁓ I think that they have their own mitigation, but I do have two labs that have a different system out of my five. And ⁓ I have to say maybe the hardware is antiquated, but I find that the substations go down. They're not answering the alarms, queries when we have questions about why the substations go down. The alarms, they send us a text.
They don't really follow it up with phone call. It can be a little bit more variable. I'm saying that just because I think that that system may be a little more antiquated and it might be to be upgraded. But I think there are other great systems out there. There are some that are just cryo. Ziltrix is nice because it does incubators, does fridges, it does freezers and it does cryo. So I don't have to have two systems for alarms monitoring. I can just have one.
Griffin Jones (34:18)
With regard to cryo storage, what do cryo storage solutions have to have in place for you? What's the standard that you think everyone should have? What do you pay attention to?
Sangita Jindal (34:32)
⁓ For cryo monitoring, think that has to be done daily. I think we look at our tanks daily. check for ⁓ sweating on the tank, showing excess evaporation and gas formation that the liquid is starting to go down. We look for puddling. ⁓ We measure the actual liquid in the tanks. you know, several times a week we fill. ⁓
have the alarm monitoring. I mean, this just goes on and on. And then when there's an alarm that happens, we have a whole response that has to be, ⁓ you know, followed. We also have training for alarm response. It's a whole workflow around cryo storage from when you enter the lab to, you know, when you're fully trained and you're now responding to alarms. There's a whole decision tree that has to happen and constant monitoring. I don't know.
how else to get around it except constant monitoring, and visual monitoring as well as electronic.
Griffin Jones (35:36)
It sounds like there are some attributes of vigilance that just come with embryologists as part of their personality type. If you're not somebody who's going to be constantly on the watch, this probably isn't the job for you. But even with selecting for that personality type, you want to turn some of those traits into behaviors.
How do see that going into the training curriculum? How do you train people to pay attention for the variables that you might not have counted for or the surprises or other things that they have to use their head a little bit to see, oh, this isn't right. How do you train somebody on that?
Sangita Jindal (36:27)
I really like to set people up for success. So I am a big believer in checklists. think checklists are the way to go. You know, just having that safety net that catch mentally so that you are actually having to check off every single, I'm exaggerating every single, but you know, every single box of all the things that you should not be missing because it can happen. You get comfortable.
You just glance at it, you get busy, you don't have time. Oh, it was fine yesterday. I'm sure it'll be fine. We all do that. And so a way to sort of come away from protocol drift and to stay on message and to use these checklists, I think that sets everyone else up for success, whether you're a newbie or whether you've been doing this for 20 years, follow the checklist. I think, again, I come back to the...
constant monitoring. And as you say, the level of detail that embryologists have to think about every single minute, I think the checklists help with that. Why do they have to carry every single detail in their head every minute of every day? Have a checklist. So it's the support that you need to make sure you don't miss anything.
Griffin Jones (37:43)
for the business executives listening that I think many of your lab directors are listening, shaking their heads and they're nodding their heads, I should say. And ⁓ what you're saying is resonating with them. And sometimes they feel like they're not always getting the support from the business side. We want the business side to think about of here's what our people need. Here's the level of support. What advice would you give them?
Sangita Jindal (38:13)
I think businesses are there to run businesses and make profit and to ⁓ serve the patients that their physicians are treating. think a way to do that is to take care of your people and to invest in the lab. To me, the lab is...
It's the engine that drives the entire program. It is the revenue generator. It's again, where all the liability is where there is not all a lot of the liability is where the risk is your Your currency there is your is your staff. It's your embryologists and those are people that need to be compensated appropriately. They need to have ⁓ Abilities to work with automation semi automation. They have to have enough staffing to prevent burnout ⁓
I would say it's really of value to the program to invest in your lab and in your people because they are the ones who will revenue generate for you and they will mitigate your risk if you take care of.
Griffin Jones (39:22)
Dr. Sangeeta Jindal, you've given us some wisdom today that the systems are only as good as the people behind them. Thank you very much for joining me on the Inside Reproductive Health podcast. I look forward to having you back for a future interview.
Sangita Jindal (39:37)
it's been a pleasure Griffin. Thank you so much for all you do.
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