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Biomedical subjects

J I Morrison

Publications and source records attributed to J I Morrison.

17 recordsLinked to original sources
PubMed1987

Managing bedside glucose testing in the hospital.

The scope and magnitude of bedside testing by personnel without formal laboratory training have recently increased. There has been some question about the reliability of bedside test results produced by nurses, physicians, and other ward staff that are used in clinical decisions. Glucose testing is currently the most widely performed bedside test. Because of the likelihood that the use of bedside testing will increase in the future, this article discusses various issues concerning bedside glucose analysis, including the scope of such testing, staff responsibilities, training and supervision, testing frequency, work flow and result reporting, and the reliability of bedside glucose results, in three institutions. We also suggest an approach to bedside testing quality management.

Blood Glucose↗
PubMed1985

Clinical laboratory--past, present, and future: an opinion.

In this review we have tried to identify some of the management issues affecting laboratories in the past, present, and future. In particular, we have focused on the increases in utilization and cost and have attempted to demonstrate some of the factors affecting the supply and demand sides of these issues. In the absence of a price mechanism to allocate resources, alternative strategies to evaluate and regulate laboratory use were discussed. Although promise is held out by some of these approaches, they are not, in our view, fully workable at this stage. We suggest that, in the interim, sound medical direction and management of the laboratory as a production function can be of benefit in inhibiting, if not actually controlling, cost increases. In particular, we recommend concentration on the management of technology because of its crucial role in laboratory costs and utilization. Emerging trends in clinical laboratory and monitoring technologies suggest that issues relating to decentralization, quality control, and funding will have to be addressed in the near future. The prime motivation for clinical laboratory use, i.e., the generation of answers to clinical questions, seems destined to continue and expand. The challenge for practitioners, researchers, and policy-makers is to harness, evaluate, and manage the technologies that can best contribute to both medical practice and health.

Forecasting↗
PubMed1983

Analyzing the factors contributing to rising laboratory costs.

A new method for analyzing factors that contribute to the rising costs of hospital laboratories was used to analyze data from a Canadian teaching hospital for the period of 1971 to 1981. Results indicated that real cost per acute care admission has doubled, primarily because more tests are performed and the factors of production in laboratories are costlier. Increasingly sophisticated technology in the laboratory has increased productivity, and thus reduced cost per test; however, increased intensity of testing apparently has not been accompanied by reduced length of stay.

British Columbia↗
PubMed1982

The cost of quality control procedures in the clinical laboratory.

The impact of quality control procedures on the workload and the cost of the clinical laboratory during the last decade is explored. Quality control procedures are shown to represent a relatively constant share of test procedures for acute care admissions. The effect of automation on quality control testing in the laboratory has been to reduce the workload units per quality control test and thus to reduce the relative share of total laboratory costs incurred by quality control. The need to assess changes in the cost of quality control testing against any change in quality of laboratory output is emphasized.

British Columbia↗
PubMed1982

Structuring complexity of testing: a process oriented approach to limiting unnecessary laboratory use.

The concept of structuring complexity is described as a process in which, during medical investigation, intensity of laboratory examination is escalated as the perceived complexity of diagnostic need increases. Application of this concept to laboratory controlled testing protocols is discussed. A clinical chemistry protocol for thyroid testing of ambulatory care patients in British Columbia resulted in a 15% reduction in test use and a 12% reduction in laboratory charges to the third party paying agent over a two-year period. The need to develop medically acceptable laboratory protocols that encourage selective test utilization and reduce cost is emphasized.

Clinical Laboratory Techniques↗
PubMed1981

Laboratory costs and utilization: a framework for analysis and policy design.

A conceptual framework is outlined as the basis for analysis and evaluation of laboratory test-ordering patterns. This framework highlights the input, process, and output phases of the laboratory inquiry system. Data are presented from a contemporary Canadian study to show that the cost of laboratory testing is escalating and represents a sizable proportion of hospital costs. Practical policy interventions intent on reducing the costs in this complex system will require thorough analysis within a conceptual framework such as is outlined here and will require ultimately sophisticated control programs at various levels in the laboratory inquiry system.

Clinical Laboratory Techniques↗
PubMedDate not supplied

Clinical chemistry equipment: a computerized system for cost evaluation.

A computerized decision-support system has been developed and implemented to assist in the economic evaluation of alternative clinical chemistry equipment configurations. The capabilities, structure, and relative merits of the system are discussed. This decision-support system is now being used extensively by hospitals in British Columbia. An alternative equipment configuration, identified with the aid of the system, resulted in one hospital alone saving an annual $200,000 in consumables and reagents costs. Further development of computerized economic evaluation systems is encouraged.

British Columbia↗
PubMedDate not supplied

Gastrointestinal disorders caused by medication and electrolyte solution osmolality during enteral nutrition.

Enteral feeding tubes represent convenient avenues for medication administration and electrolyte replacement. The frequent association of medication therapy with gastrointestinal disorders during enteral nutrition prompted this evaluation of medication and electrolyte solution osmolality. It is concluded that the hypertonicity of electrolyte replacement solutions and various medications may cause gastrointestinal intolerance in patients. Electrolyte supplementation by parenteral means or by appropriate dilution and mixture with an enteral formula is preferable to bolus administration of undiluted solutions via the feeding tube. Routine admixture of medications such as antibiotic suspensions to enteral formulas cannot be recommended at this time pending specific study of drug compatibility and availability from enteral tube feeding systems.

Anti-Bacterial Agents↗
PubMedDate not supplied

Railways of the nineties.

What killed the railways was that they were run by people who really liked choo-choos. This also is the Achilles' heel of hospitals. They are run by people fascinated with big white buildings and all they contain.

Bed Occupancy↗