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PubMedDate not supplied

Timeliness and best demonstrated practices.

Significant changes have occurred in many hospital-based laboratories over the past few years. The demands from the medical staff to deliver the highest quality test results in the shortest possible time coupled with the mandates from hospital administration to become cost efficient have given laboratory managers many challenging opportunities. Information management is a basic component of the process required to meet the timeliness goal. Best demonstrated practices for the various sections within our laboratory resulted when combining five components of daily management. These are instrument automation, using a laboratory information system to auto-merge and auto-release tests, consolidating workstations, redistributing work among the technical and nontechnical personnel, and implementing key indicators to follow improvement.

Benchmarking↗
PubMed1988

Automated sample handling in a clinical laboratory.

Bar codes have received wide acceptance and have permeated many industries since their early days in the railroad industry. They offer a simple and cost-effective approach to a variety of operational situations. Clinical labs are especially well-suited for this technology.

Chicago↗
PubMed1991

[Developments of automated cell counter and its clinical laboratory application].

A rapid development has taken place in recent years in the field of automatic cell counting and automatic differential machine for miscellaneous blood cells. In the present paper we concisely summarized the history on the development of these machines, then reported the results obtained using STKS-VCS (automatic blood cell counter and cell analyzer based on flow system). 1. The precision of the STKS was established as follows using the coefficient of variation, 0.39-3.96% for 5 CBC parameters. WBC differentials; under 1% for neutrophils and lymphocytes, 6 to 9% for monocytes and eosinophils, approximately 18% for basophils. 2. Time profile of CBC and WBC differential data by same machine, was almost unchanged until 24 hours from blood taking using both glass and plastic vials. 3. Good correlation was obtained as for white cell differential between data from VCS and by manual ones with 4 skilled technicians according to NCCLS method. 4. Predictive value of tests applied to normal and abnormal population, high true positive and negative ratio and low false positive and negative ratio, which results helped us, to share more times to observe abnormal samples more carefully. 5. So called "flags" which predicts presence of abnormal cells (e.g. immature granulocytes, atypical lymphocytes) was useful to screen abnormal cell population in VCS system.

Blood Cell Count↗
PubMed1987

A novel device for the automated administration of test compounds to laboratory animals.

A prototype instrument is described that permits efficient administration of test compounds to laboratory animals by intubation. The system integrates a balance, a computer and a volumetric dispenser. Complete animal identification, weight and dose records are kept and may be interfaced with mainframe computers. A range of doses may be delivered from a single stock solution. No carryover is evident between doses. The system is accurate, precise and rugged. The system is cost effective relative to current manual gavage techniques and offers added safety for investigators handling toxic materials.

Administration, Oral↗
PubMed1983

Cost analysis and cost justification of automated data processing in the clinical laboratory.

Prospective cost analysis of alternative data processing systems can be facilitated by proper selection of the costs to be analyzed and realistic appraisal of the effect on staffing. When comparing projects with dissimilar cash flows, techniques such as analysis of net present value can be helpful in identifying financial benefits. Confidence and accuracy in prospective analyses will increase as more retrospective studies are published. Several accounts now in the literature describe long-term experience with turnkey laboratory information systems. Acknowledging the difficulty in longitudinal studies, they all report favorable effects on labor costs and recovery of lost charges. Enthusiasm is also expressed for the many intangible benefits of the systems. Several trends suggest that cost justification and cost effectiveness will be more easily demonstrated in the future. These are the rapidly decreasing cost of hardware (with corresponding reduction in service costs) and the entry into the market of additional systems designed for medium to small hospitals. The effect of broadening the sales base may be lower software prices. Finally, operational and executive data management and reporting are destined to become the premier extensions of the LIS for cost justification. Aptly applied, these facilities can promote understanding of costs, control of costs, and greater efficiency in providing laboratory services.

Computers↗
PubMed1991

[Automation of hematologic studies in a clinical-diagnostic laboratory in a multi-profile hospital].

The authors share their experience gained with automation of hematologic investigations at a clinical diagnosis laboratory. A CDL information system, basing on personal computers, has been created, functioning in complex with hematologic autoanalyzers. The reports on the laboratory's activity are made automatically, as is the laboratory register and processing of applications for tests.

Clinical Laboratory Information Systems↗
PubMed2007

Increasing patient safety and efficiency in transfusion therapy using formal process definitions.

The administration of blood products is a common, resource-intensive, and potentially problem-prone area that may place patients at elevated risk in the clinical setting. Much of the emphasis in transfusion safety has been targeted toward quality control measures in laboratory settings where blood products are prepared for administration as well as in automation of certain laboratory processes. In contrast, the process of transfusing blood in the clinical setting (ie, at the point of care) has essentially remained unchanged over the past several decades. Many of the currently available methods for improving the quality and safety of blood transfusions in the clinical setting rely on informal process descriptions, such as flow charts and medical algorithms, to describe medical processes. These informal descriptions, although useful in presenting an overview of standard processes, can be ambiguous or incomplete. For example, they often describe only the standard process and leave out how to handle possible failures or exceptions. One alternative to these informal descriptions is to use formal process definitions, which can serve as the basis for a variety of analyses because these formal definitions offer precision in the representation of all possible ways that a process can be carried out in both standard and exceptional situations. Formal process definitions have not previously been used to describe and improve medical processes. The use of such formal definitions to prospectively identify potential error and improve the transfusion process has not previously been reported. The purpose of this article is to introduce the concept of formally defining processes and to describe how formal definitions of blood transfusion processes can be used to detect and correct transfusion process errors in ways not currently possible using existing quality improvement methods.

Blood Group Incompatibility↗
PubMed1991

Modification of an automated method for determining plasma and erythrocyte cholinesterase activity in laboratory animals.

By altering the analytical parameters on an automated analyzer, analytical precision for measuring cholinesterase (ChE) activity in hemolysates was markedly improved in samples from several species. Manual and automated spectrophotometric analyses of plasma and erythrocyte ChE activity were optimized for use in rats, mice and dogs. Replicate ChE analyses were performed on plasma samples and on hemolysates made from whole blood or packed erythrocytes to determine the precision of the manual ChE method and 4 modifications of the automated method. Large method-related differences in precision were observed for the erythrocyte assay, but not the plasma assay. The addition of a nonionic detergent to make hemolysates was beneficial in determining erythrocyte ChE activity in the rat, but not in the mouse or dog. Species specific temperature conversion factors were necessary for comparing results from methods using different analytical temperatures. Analysis of whole blood hemolysates provided similar or better precision for determining erythrocyte ChE activity compared to using hemolysates made from packed erythrocytes. Comparisons of erythrocyte ChE results obtained from assays with even minor methodological differences should be approached with caution because of the many analytical factors which can affect results.

Animals↗