Fundamentals of Health Care Management Dr. Maisoun Al-Sharif Fall 2012 By Mustafa Malaka Abstract Our report will describe the clinical laboratory department, the services provided, and the different sections and functions in the department. We will highlight every important aspect related to the clinical laboratory department in detail as well as our suggestions and the areas that can be improved. Our conclusion will include a four minutes video that will summarize the points discussed in our research.
What is a clinical laboratory? Is a place equipped for making tests or doing experimental work for examination of materials derived from the human body (such as fluids, tissues, or cells) and for the purpose of providing information on diagnosis, prognosis, prevention, or treatment of disease. Is a laboratory in which tests directly related to the care of patients are performed. Such laboratories use material obtained from patients for testing, as compared with research laboratories, where animal and other sources of test material are also used.
A medical laboratory or clinical laboratory is a laboratory where tests are done on clinical specimens in order to get information about the health of a patient as pertaining to the diagnosis, treatment, and prevention of disease. What are the services provided by clinical laboratory? * Examining biopsy specimens. * Performing forensic and medicolegal autopsies. * Using living organisms as models to conduct experiments. * Weighing chemicals, filtering liquids, distilling ingredients, and growing cultures of microorganisms. Performs chemical, hematological, immunologic, microscopic, and bacteriological diagnostic analyses on body fluids such as blood, urine, sputum, stool, cerebrospinal fluid (CSF), peritoneal fluid, pericardial fluid, and synovial fluid, as well as other specimens. * Utilize pre-analytical systems in order for biomedical scientists. * Draw blood from a live person or animal for tests, transfusions, donations, or research. * Receive dictation from physicians and other healthcare professionals and transcribe them into different medical documents. Catalogues specimens for use by other health care workers, including laboratory technicians, nurses and physicians. Description of the different sections and the human resources working in these departments: * Hematology/Coagulation: Examines blood and blood components to determine if they are within normal limits. * Immunogenetics: Explores the relationship between the immune system and genetics. * Urology: Examines urine * Blood banking /storage of blood * Microbiology/Infectious diseases: The isolation and identification of pathogenic bacteria, yeast, fungi, parasites, and viruses. Toxicology (Drug Testing) * Cytology: The study of cells. * Forensic medicine: Investigation of crime. * Neuropathology: Concerned with diseases of the nervous system. * Pediatric pathology * Gynecologic pathology: Dealing with the health of the female reproductive system. The staff of clinical laboratories may include: -Pathologist: A doctor who specializes in the anatomic (structural) and chemical changes that occur with diseases. These doctors function in the laboratory, examining biopsy specimens, and regulating studies performed by the hospital laboratories (blood tests, urine tests, etc). Clinical Biochemist: Biochemists perform a number of tasks, such as weighing chemicals, filtering liquids, distilling ingredients, and growing cultures of microorganisms. -Pathologists’ assistant (PA): A physician extender whose expertise lies in gross examination of surgical specimens as well as performing forensic and medico legal autopsies. -Biomedical Scientist (BMS): Biomedical Scientists conduct research in a laboratory setting, using living organisms as models to conduct experiments.
These can include cultured human or animal cells grown outside of the whole organism, small animals such as flies, worms, fish, mice, and rats, or, rarely, larger animals and primates. -Medical Laboratory Scientist (MT, MLS or CLS): (also referred to as a medical technologist) is a healthcare professional who performs chemical, hematological, immunologic, microscopic, and bacteriological diagnostic analyses on body fluids such as blood, urine, sputum, stool, cerebrospinal fluid (CSF), peritoneal fluid, pericardial fluid, and synovial fluid, as well as other specimens.
Medical Laboratory Scientists work in clinical laboratories at hospitals, doctor’s offices, reference labs, and biotechnology labs. -Medical Laboratory Assistant (MLA): Prepare, and in some cases process samples within a pathology laboratory. They also utilize pre-analytical systems in order for biomedical scientists (BMS) or Medical Laboratory Scientific Officers to process the biochemical tests requested on the sample. The majority of an MLA’s time is spent in processing specimens. -Phlebotomist (PBT): Phlebotomists are people trained to draw blood from a live person or animal for tests, transfusions, donations, or research. Transcriptionist: Medical transcriptionists are formally trained to receive dictation from physicians and other healthcare professionals and transcribe them into different medical documents. Documents produced by medical transcriptionists include medical history and physical examination reports, consultation information, and autopsy reports.. etc . After physician approval, these documents become part of the patients’ permanent file. -Specimen processor: A laboratory professional who catalogues specimens for use by other health care workers, including laboratory technicians, nurses and physicians.
Specimens can include blood samples, bacteria cultures and even organs. The laboratory management often consists of: * Laboratory Medical Director * Laboratory Manager * Department/Technical Supervisor * Chief/Lead Technical Staff CLINICAL LABORATORY ADMINISTRATOR/Manager: assigned responsibilities for the overall management and supervision of a staff of technical and support personnel who perform clinical laboratory examinations or for directing the activities of a comprehensive statewide laboratory system providing diagnostic epidemiological and scientific services to state residents.
The functions within this job family will vary by level, but may include the following: * Plans, organizes, directs and coordinates a statewide clinical laboratory service. * Develops and establishes laboratory goals, policies, programs and plans. * Appraises needs for laboratory services; develops new, additional or different laboratory service programs. * Coordinates and integrates laboratory activities with those of other subdivisions and with other state agencies conducting programs that require support from the clinical laboratories. Participates in the development of new programs, methodologies, tests and products necessary to further the department’s commitment to prevention and control of disease. * Supervises the preparation and maintenance of laboratory records and reports; summarizes laboratory activities, accomplishments and needs. * Develops and implements policies, procedures and performance standards designed to ensure efficient laboratory operation. * Interprets or verifies difficult or unusual analyses; plans and supervises the performance of special tests and projects. Consults with physicians, hospital personnel and independent and hospital laboratory personnel regarding common laboratory problems. * Plans new laboratory facilities; requisitions new equipment and laboratory supplies; determines and recommends laboratory support for departmental programs and activities. * Represents the department in court or at hearings as an expert witness and public contacts, reviews, comments, and interprets federal, state legislation and local laws, objective, rules and procedures affecting the operation of laboratories. Cooperates with local, state and national agencies and organizations for the improvement of laboratory services particularly in reference to public health and medical services. What are their qualifications and competencies? Qualifications as being substantially equivalent to the Bachelor of Medical Laboratory Science degree providing they are equivalent to a 4-year course of study, the content of which covers most of the health service categories within the profession of medical laboratory science.
Or, a degree in medicine is not considered equivalent to a medical laboratory science qualification for the purpose of registration as a medical laboratory scientist. TECHNOLOGY LAB PROCEDURES AND POLICIES – Computer Resources & Facilities Usage Guidelines 1. All computer software and/or documents developed by students, faculty, staff, or others on college time and/or equipment becomes the property of the hospital. Computing documents may be examined or disclosed by this hospital if there is reason to suspect violation of hospital policies. 2.
Purchase of all computer hardware or software by any department must be approved by the Associate Vice President for Information Technology. 3. The computer labs are open to all the faculty, students and staff on a first-come first-served basis during open periods. Students in scheduled classes have first priority on the equipment during their assigned lab periods. 4. All systems to be written by Information Technology personnel must be planned and requested through the office of the Associate Vice President for Information Technology before the fiscal year in which work is to begin.
Work requiring minimal programming effort should be requested directly through the Associate Vice President for Information Technology via proper form with required signatures. 5. Access to the computer room is restricted and any entry must be accompanied by an Information Technology staff member. 6. Tours of the computer room are conducted with advance notice and only under the supervision of the Associate Vice President for Information Technology or designated Information Technology staff member. 7. Computer facilities may be used for college educational and administrative purposes only. Education Cooperative Network 1. Focuses on higher layer networking 2. Addresses the latest trends and research results 3. Covers fundamental concepts, models, advanced topics and performance issues in cooperative networking 4. Contains contributions from leading experts in the field 5. Provides an insight into the future direction of cooperative networking – Multipurpose Computer Lab Usage Guidelines Materials are used in the department Beaker – a liquid-measuring container Burette – measures volume of solution
Clay triangle – a wire frame with porcelain used to support a crucible Wire gauze – used to spread heat of a burner flame Test tube – used as holder of small amount of solution Forceps – holds or pick up small objects Graduated cylinder – measures approximate volume of liquids Graduated pipette – measures solution volumes Condenser – used in distillation Crucible – used to heat a small amount of a solid substance at a very high temperature Funnel – used to transfer solids and liquids without spilling Thermometer – measures temperature Balance – measures mass of material
PH meter – measures acidity of solutions Centrifuge – separates materials of varying density Pipette – used to transfer measured substances into another vessel Droppers – for addition of liquids, drop by drop Glass funnels – for funneling liquids from one container to another, or for filtering when equipped with filter paper. Graduated cylinders – for measurement of an amount of liquid. The volume of liquid can be estimated to the nearest 0. 1 mL with practice. Ring stand (with rings or clamps) – for holding pieces of glassware in place.
Test tubes – for holding small samples or for containing small-scale reactions Test-tube holders – for holding test tubes when tubes should not be touched Tongs – similar function to forceps, but are useful for larger items Volumetric flasks – to measure precise volumes of liquid or to make precise dilutions. Wash bottles – for dispensing small quantities of distilled water. Watch glasses – for holding small samples or for covering beakers or evaporating dishes. Wire gauze on a ring – supports beakers to be heated by Bunsen burners
The risks related to the technology and materials used Improper maintenance of the machines can cause inaccurate results which leads to medical errors. -Most common mistakes 1. Performing the wrong test, or having the wrong sample 2. Patient not prepared properly 3. Equipment or software errors 4. Training deficiency 5. Mislabeling the samples 6. Collection and preparation errors OVERALL OBJECTIVES AND GOALS OF A MEDICAL LABORATORY OBJECTIVES| GOALS| Audit management| To fully track and audit trail. |
Barcode handling| Assign one or more data point to a barcode format; read and extract information from a barcode. | Inventory and equipment management| Measuring and recording inventories of vital supplies and laboratory equipments. | Document management| Process and convert data to certain formats; manage how documents are accessed and distributed. | Compliance| Follow regulatory standards that affect the laboratory. | Instrument calibration and maintenance| Schedule important maintenance and calibration of lab instruments and keep detailed records of such activities. Manual and electronic data entry| Provide fast and reliable interfaces for data to be entered by a human or electronic device. | Time tracking| Calculate and maintain processing and handling times on chemical reactions, workflows, etc. | Quality assurance and control| Gauge and control sample quality, data entry standards and workflow. | Chain of custody| Assign roles and groups that dictate access to specific data records and who is managing them. | Reports| Create and schedule reports in a specific format; schedule and distribute reports to designated parties. | TASKS PERFORMED IN A MEDICAL LABORATORY
Laboratory scientists carry out the following tasks in the lab: * Clinical Biochemist: analyses body samples (of blood, urine, faeces and tissue) for diseases such as diabetes and renal failure. * Clinical Immunologist: studies the body’s immune system to test for diseases such as allergies and HIV infection. * Cytogeneticist: investigates genetic disease and how chromosomes are affected by disease. * Haematologist: analyses blood samples for diseases such as anaemia and cancer. * Histologist: prepares tissue samples for investigation by a pathologist. * Medical Cytologist: test cell samples for cancer. Medical Microbiologist: detects, cultivates and tests bacteria and fungi. * Transfusion Scientist: prepares blood and blood products for transfusion. As a Lab Monitor, you have the following responsibilities: 1. Monitor computer users to ensure that they are authorized for access. 2. Helping students by answering their questions to the best of your ability 3. Maintaining the Lab – Checking lab supplies (printer toner, ribbons, ink cartridges, paper) – Reporting problems or lack of supplies – Checking for damaged or faulty equipment, vandalism and theft – Housekeeping (paper in bins, chairs under desks) Cleaning the equipment (monitors, computers, desks, and whiteboards) – Checking for rules violations – Resetting equipment to established Columbia State defaults 4. Keeping current on software used in the lab – Maintaining familiarity with the list of software used in the lab – Attending training sessions and meetings for Lab Monitors held by Information Technology (This counts as work time. If these conflict with classes, notify the supervisor prior to the meeting time. ) 5. Being prompt and responsible 6. Maintaining a professional presence Improvement:
Many of lab workers fall into the trap of trying to be all things to all people in an effort to get everything done just so, and end up burning out in the process. Here are three ideas for achieving the outcomes you desire and keeping your sanity simultaneously. First, examine your beliefs and mindsets around how work gets done; second, shift the paradigm; and third, walk your talk. Example: Wright Medical Center in Clarion, Iowa, was ASCP’s North Central Region winner. Its clinical laboratory consistently sustained a 92% score for outpatient services on the Press Ganey patient survey during the years 2002 and 2005.
Laboratory Leader Rayne Premo said the lab team, however, wanted to raise the bar and improve “things on our score that were consistently less than stellar. ” An analysis of patient satisfaction survey responses revealed that the medical laboratory’s two weakest areas were: 1) explaining lab tests or lab test procedures to patients; and, 2) addressing the patient level of comfort or pain. The improvement team at Wright’s laboratory developed protocols for patient contact aimed at improving patient satisfaction in these two areas. Once changes were implemented, Premo noted that the laboratory’s Press Ganey score shot up to 95%. Following a laboratory procedure on a patient, we now go over what the physician has ordered, give a layman explanation of what each test is used for, ask if the patient has any questions, and take the time—to do our best—to answer their questions fully,” said Premo. Use of scripted interaction with patients now helps patients clearly understand that minimal pain is unavoidable and, importantly, that the phlebotomists and lab employees do care and are sorry to have to inflict pain. ” In conclusion, to sum up everything we talked about, we would like you to watch this video: http://www. youtube. com/watch? =Cha5prMMIgM&feature=related Listen to Lorraine Frierson, Clinical Lab Manager at AHEC South Arkansas, talk about the life of a Medical Lab Technician. As she sees it, the lab tech is a critical piece of the health care puzzle, providing important information to doctors about the condition of their patients. References www. web. columbiastate. edu/IT/Labs/LabMonJobDescPrt. htm www. indeed. com/me/william_davisBIT www. fml-dubai. com/ www. dohms. gov. ae/… /. http://www. youtube. com/watch? v=Cha5prMMIgM&feature=related www. Hoovers. com http://www. ehow. com/info_8566803_list-clinical-laboratory-set-up. html
