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Role of external quality assurance schemes in assessing and improving quality in medical laboratories.

Medical laboratories have a long tradition of external quality assessment. Starting from pure quality control of laboratory performances, most external quality schemes in Europe evolved into a powerful tool for improving quality of clinical outcome of results. External quality assurance in medical laboratories not only includes laboratory performance evaluation, but also evaluation of method performance, post-market vigilance, training and help. In the future, the quality of programmes will further be improved by accreditation of schemes international collaboration and by using IT applications.

Accreditation↗

Experiences with extended-duration medical laboratory support in deployable medical systems.

Medical laboratory services in an echelon-II Deployable Medical Systems environment were examined after a 6-month deployment in Guatemala-Fuertes Caminos 94 (N). The limitations in preparing and executing laboratory operations by U.S. Army Reserve units using Minimal Essential Equipment for Training components were identified. Corrective actions for planning future operations requiring laboratory support were addressed. Despite significant limitations, 353 laboratory procedures were conducted to standard. Additionally, laboratory procedures supporting blood-transfusion activities was successfully undertaken. Employment of laboratory services in remote environments for extended durations requires special attention and complete planning to ensure that all elements of care are in place to support medical operations.

Blood Banks↗

Tele-education: the virtual medical laboratory.

The virtual medical laboratory (VML) was conceived to provide an Internet-accessible resource, offering access for clinicians and scientists to an invaluable data archive at the institute of Laryngology and Otology, London. The Institute is home to the largest collection of temporal bone, laryngeal, skull and sinus sections in Europe. The skull and sinus collections include an extensive section consisting of animal material. These were contributions from zoos around the world. Over the last 50 years, samples have been carefully sectioned and stained by specialized technicians to produce histology slices of most regions of the head and neck. The aim of the project is to create a virtual medical laboratory, which will provide access to archived histological material as well as computerized tomography and magnetic resonance data. Central to this aim is the reconstruction of the internal anatomy of the temporal bone from two-dimensional histology slices, to create three-dimensional views that can be used for anatomical simulation and surgical training in otolaryngology. State-of-the-art three-dimensional reconstruction and rendering technology allows us to develop such a model. Computer-generated simulation could be made available to all hospitals in which otolaryngology is practised, via digital communication networks. We aim to develop core technology in our own specialty that is applicable to other fields of higher education, which have not been exposed to such modern teaching modalities. This has the potential to become an invaluable teaching resource for anatomists, surgeons and other scientists.

Computer Communication Networks↗

Medical laboratory workforce trends and projections: what is past is prologue.

During the last several decades, supply and demand trends for clinical laboratory personnel have been cyclical. Factors such as quantity of graduates from accredited training programs, quality and quantity of career recruitment, growth of new technologies, automation, downsizing, and consolidation of services have affected the balance of workers needed to meet demand. More recently, several additional forces led to a potential long-term shortage of clinical laboratory personnel. This article reviews major studies of staffing strategies and outlines strategies of the American Hospital Association to ease the current shortage crisis.

American Hospital Association↗

Is New Zealand's recent increase in campylobacteriosis due to changes in laboratory procedures? A survey of 69 medical laboratories.

AIMS: To evaluate the contribution of changing procedures in microbiology laboratories over the previous 5 years to the increase in campylobacteriosis notifications. To assess whether regional differences in notification rates are due to variations in laboratory procedures. METHODS: A questionnaire was sent to 69 New Zealand medical laboratories, requesting data on their identification procedures for enteric pathogens, including campylobacter. RESULTS: Changes over the last 5 years in laboratory techniques were insufficient to account for a marked increase in campylobacter isolations. On the basis of data provided by 12 laboratories, the number of specimens that grew campylobacter increased by 49% between 1992 and 1993. Differences in laboratory methods do not explain regional differences in campylobacter notification rates. CONCLUSION: Changes in laboratory methodologies over the last 5 years do not appear to account for the recent national increase in campylobacteriosis notifications.

Campylobacter↗