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Objective:To investigate the current situations and development requirements of emergency testing among secondary and tertiary hospitals in China.Methods:The data were collected from secondary and tertiary hospitals via online questionnaire across 31 provinces in China from February 1 to March 1, 2021. The questionnaire involves various aspects of emergency testing, including area of emergency laboratory, staffs and equipment configuration, inspection items, Turn-around time (TAT), reagents and consumables management, pre-analysis quality control, laboratory information system, critical values management and biosafety, etc.Results:A total of 2 187 questionnaires were obtained, and 1 503 valid questionnaires from 755 secondary hospitals and 748 tertiary hospitals were finally analyzed. The research data showed that daily average number of patients visiting emergency department exceeding 300 person-time in 29.41% (220/748) tertiary hospitals, but that number was less than 100 person-time in 76.69% (579/755) secondary hospitals; daily average emergency tests exceeding 5 000 was reported in 24.47% (183/748) tertiary hospitals, and less than 2 000 was reported in 93.51% (706/755) secondary hospitals; the area of emergency laboratory was less than 100 m 2 in 68.79% (238/346) tertiary hospitals with independent emergency testing laboratory; there were no fixed staffs of emergency testing in 56.02% (842/1 503) hospitals; the biochemical/immunoassay analyzer in 8.65% (130/1 503) hospitals did not have STAT position; one hundred and twenty-six hospitals (8.38%) did not have stock in and stock out record for reagents and consumes materials; the conventional statistical analysis of unqualified specimen was not carried out in 24.62% (370/1 503) hospitals; priority on emergent specimen was not set in 58.62% (881/1 503) hospitals; whole process monitoring function was not equipped in 48.64% (731/1 503) hospitals; there was no conventional communication working mechanism with clinicians on critical value in 7.32% (110/1 503) hospitals; overall, 50.23% (755/1 503) participants did not consider that biosafety risks exist in their emergency testing laboratory. Conclusions:This survey objectively presents the current situations and future development requirements of emergency testing among secondary and tertiary hospitals in China. The survey also reflects that some important process and concepts need to be improved, and extensive attention should be paid by laboratory and hospital administrator, in the area such as communication with clinician, site construction and staff configuration, administration on the priority of emergency testing, administration on the reagent and consumable materials, laboratory informatization construction, laboratory biosafety, and so on.
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RESUMEN Los países realizan muchos esfuerzos, para poder implementar los objetivos de desarrollo sostenible, en búsqueda de la cobertura universal de la salud. Sin embargo, el acceso o la oportunidad de los servicios de Patología Clínica de alta calidad y oportunos, son necesarios para respaldar los sistemas de atención médica que tienen la tarea de lograr estos objetivos. Este acceso es más difícil de lograr en los países de bajos y medianos ingresos. En este artículo especial, se realizó un análisis de la situación global y nacional de esta problemática, en esta especialidad médica. Se identifican las cuatro barreras clave para la provisión de servicios de calidad y óptimos: recursos humanos o capacidad de la fuerza laboral insuficiente, educación y capacitación inadecuada, infraestructura y equipamiento inadecuado, y calidad, normas y acreditación insuficientes.
ABSTRACT Countries do plenty of effort in order to implement the objectives for sustainable development, aiming to achieve universal health coverage. However, access or chances for having high quality Clinical Pathology services are both necessary for supporting medical care systems if such objectives are to be achieved. This access is much more difficult to achieve in low- and medium- income countries. This paper presents an analysis of both the global and local situation in this respect. Four key barriers for delivering high quality and optimal services were identified: insufficient human resources or limited capability of the working force, inadequate education and training, inadequate infrastructure and equipment, and insufficient quality, regulations, and accreditation strategies.
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Objective Quality control procedure based on the patient data in clinical chemistry was set up in laboratory information system (LIS). Methods Clinical chemistry tests results of outpatients and inpatients were collected from January 2016 to March 2017 in Zhejiang Provincial People's Hospital. Statistical results of daily patient data, including Xˉ, P2.5, P5, P10, P25, P50, P75, P90, P95 and P97.5 were calculated. Secondly, cumulative coefficients of variation (CV) of these statistical datawere calculated and compared to different criterions. Optimal analytes and related control concentrations were chosen. The minimum number of patient sample which use Xˉ as control point was calculated by PASS 11.0 software. Finally, the quality control procedure was set up base on the LIS and was verified by patient data. Results In outpatients, Xˉwas chosen as control point in AFU, APOA, APOB, CA, CL, HDL, K, MG, NA, NEFA, TP and URIC and the minimum number of sample needed were 23, 23, 30, 8, 10, 24, 34, 8, 8, 20, 13 and 22. P25 was chosen in ALP and TBIL. P50 was chosen in AST, GLU, GPDA and PHOS.P75 was chosen in ALB, CHE, CREA and DBIL. In inpatients, Xˉ was chosen as control point in AFU, ALB, APOA, APOB, CA, CL, HDL, K, Lpa, MG, NA, NEFA, TP and URIC and the minimum number of sample needed were 73, 19, 34, 18, 10, 30, 36, 21, 87, 12, 17, 51, 26 and 52;P25 was chosen in ALP, ALT, AST, CREA, DBIL, LDH, TBIL and TG. P50 in PHOS, P75 in GPDA, and P90 in CHE. 200 samples were needed in the tests which used percentiles as control points. Most CVs of these control points were higher than the commercial quality control used every day. Finally, a quality control procedure based on patient data were set up in LIS. L-J and Z score charts were used to find out systematic bias. Conclusion Patient data used in internal quality control was an economical and practical way, which can make up for the deficiency of traditional method.
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In pace with the progressing and strengthening of administration requirement in standardization, biosafety, and third party accreditation for medical laboratories, internal and external environment itself are becoming important elements for total quality control. Laboratory management starts at planning and design. Making the six conceptions (normalization, safety, practicability, convenience, environment-friendliness, and good-looking) as the forerunners, taking more attention to and perfecting most of the details in the phase of planning and designing of a medical laboratory are therefore offered. The aims of informatization, automation, intellectualization, and hommization would be materialized through normatively partitioning clean, buffer and polluted areas, reasonably arranging the passageways of staff, stuff, air and information, and centrally laying out the electric, water, gases, air-condition, and monitoring, which would lay the good foundation for afterwards use and management of the laboratory.
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Objective@#To develop autoverification rules to assistant the verification of biochemical results, based on laboratory information management system. @*Methods@#Designed six kinds of autoverification logic rules according to the guidelines of Clinical and Laboratory Standards Institute (CLSI) AUTO-10A and Accreditation Criteria for the Quality and Competence of Medical Laboratories(ISO15189: 2012), based on in-control of the Internal Quality Control. Those rules inculds: logic disorder rules, critical value rules, warning value rules, delta check rules, relevant contradictions rules, abnormal mode rules, etc. Those rules was setted up in laboratory information management system of Dian Diagnostics. From October 2016 to April 2017, The status of autoverification was checked according to the items and bar code, and compared with clinical diagnostic and manual review. @*Results@#The passing rate of autoverification is over 65% when counted according to tests and is 45% when counted according to sample code, the coincidence rate is 92% with clinical diagnosis.In passing results of autoverification, the coincidence rate is 97.48% to 100% when campared with manual verification, and in not-passing results, the coincidence rate is 82.98% to 85.21%. @*Conclusion@#(1)Autoverification can verify half of routine biochemical test results by setting intelligent logics and rules. (2)Autoverification rules must be verified by a certain amount of test results before they can be formally applied. (3)Autoverification could improve the speed and efficiency of post-test steps.(Chin J Lab Med, 2018, 41: 547-553)
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Objective To improve the efficiency of result reporting and ensure the accuracy of the results by establishing autoverification system in Clinical Chemistry and Immunology Laboratory.Methods The study followed the requirements of the Clinical Laboratory Standards Institute(CLSI)AUTO-10A and ISO 15189:2012.In addition,seven categories of verification rules were encoded using the autoverification function of the CentraLink?Data Management System on the Aptio?Automation platform.These rules included Clinical Diagnostic Standard(CS), Sample Status(SS), Quality Control Severity(QS), Instrument Error Flags Severity(IS), Normal Severity(NS), Delta Check Severity(DS), and Logical Assessment Standard(LS).Various modules of Aptio Automation,laboratory information system(LIS)and hospital information system(HIS)were integrated using the CentraLink system to establish the autoverification system.Results The autoverification system was set up and tested from August 2015 to April 2016.In total, the system ran 4 496 425 tests on 366 180 chemistry specimens.The overall autoverification rate for tests performed increased from 53.4% to 87.0%.Glucose had the highest rate (98.3%)while CKMB had the lowest rate(63.6%).Average TAT for result verification decreased by 97.7%,from 46.3 minutes to 3.7 minutes.The system ran 410,040 tests on 160 119 chemiluminescence specimens.The autoverification rate for tests performed increased from 40.2%to 89%.C-P had the highest rate(98.4%)while A-TPO had the lowest rate(58.7%).Average TAT for result verification decreased by 77.4%,from 14.6 minutes to 3.3 minutes.From May 2016 to January 2017(when autoverification was employed),compared with the same period in 2014(when manual verification was employed),the following changes were observed with no increase in staff capacity:a)Volume of routine chemistry tests increased by 46.4%,and median TAT for tests decreased by 41.9%, from 118 minutes to 83 minutes; b)Volume of chemiluminescence tests increased by 24.5%and median median TAT for tests decreased by 52.4%, from 131 minutes to 86 minutes;c)Median TAT for critical values decreased by 50.5%; d)Rates of tests that did not go through autoverification were 88.2% for NS,6.05% for SS, 2.40% for DS,2.00% for LS, 0.97%for IS,and 0.43% for CS; e)Rates of abnormal specimen status identified by Aptio Automation were 7.13‰for jaundice,5.39‰ for blood lipids,2.20‰ for hemolysis,0.17‰ for barcode error, and 0.15‰ for insufficiency;f)Error rate decreased to 0.00%;and g)staff satisfaction increased from 85%to 100%.Conclusion Autoverification of results by using the CentraLink Data Management System can achieve quality control over the entire process of clinical laboratory testing, ensure accuracy of test results, improve work efficiency, decrease TAT, minimize the error rate, avoid skill variation of staff, reduce the pressure of performing manual verification,and improve medical security.
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Objective By analysis of the key performance indexes of the clinical laboratory automation system, to clarify the advantage and optimize the comprehensive performance of the laboratory automation system.Methods Key performance indexes were Collected from January 2017 to April 2017 in biochemistry and immunoassay group of Clinical Laboratory of Shanghai Tong Ren Hospital.(1)The data were collected and compared by the before-and-after method,the starting time of the automation system and initial sample test were analyzed.(2)Key performance indexes were analyzed for the time of specimen registration,inspection,and reporting.(3)The specimen turnaround time(TAT)was analyzed based on two months operation of the laboratory automation system.In view of disadvantage of infectious assays, setting up priority sample absorption, then TAT performance was re-evaluated.(4)By the assessment of total serum dosage required in the automation system, the number of blood vacuum tubes were reduced reasonably.The pros and cons of laboratory automation system were analyzed and the potential improvement were proposed.Results (1)According to the sample peak shift forward,the system start time could move forward 30 minutes earlier.(2)With the adopting of railway logistics,the specimens were sent to the lab and the registration time was at 7:25 am,and the time required for specimen delivery was greatly reduced which made specimen test,report and audit time all moved forward accordingly.(3)Data has shown that specimen TAT declined dramatically based on the performance of the first two month operation of the automation system,biochemical items were shortened 2 h,and the immunoassay shortened 4 h,respectively.Moreover the trend keeps better gradually.With setting up priority absorption infectious tests,the TAT was improved greatly,TAT reduced the average by 40 min.(4)500 μl(including the sample in dead space of vacuum tube)were needed for all the 65 biochemical items included in the system, and 1 495 μl serum were used for the 28 immunoassay.As a result, a total of 2 000 μl serum will be enough for sample analysis by the system, which provided the feasibility to reduce 3 vacuum tubes averagely.Considering the current automation system does not include all the analysis items in our lab directory, a few tests remain to be performed on offline instruments respectively.The methodology for some infectious agents are different from previous method, therefore some test results may need a period of time for comprehensive clinical appreciation.Furthermore,due to the parallel connection of multiple instruments included in the system, more rigorous and frequent quality control becomes a necessity,which may rely on more strict quality control procedure to guarantee the quality.Conclusions The application of the automation system significantly enhanced the efficiency of clinical laboratory all round.In addition, by the quantitative indicators, it is possible to monitor the system operation performance real time, which may feedback and facilitate the improvement constantly,and result in auto confirmation the majority results,eventually.
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ABSTRACT Introduction: Autoverification is the release of laboratory test results from clinical instruments to hospital interface, or to patients' records, with no human intervention. Verification rules are inserted in the middleware and/or in the laboratory information system (LIS), based on criteria established by the laboratory. As a result, it ensures that every result is consistently reviewed in the same way, improving the entire verification process and patient safety. Objective: Describe the implementation of autoverification of clinical chemistry tests results at the core laboratory of Hospital das Clínicas da Universidade Federal de Minas Gerais (HC/UFMG), Brazil. Material and methods: Twenty-six automated chemistry assays were chosen. They were fully automated including internal quality control, interfaced with LIS, available 24 hours a day, seven days a week. Rules were set up in the middleware and in the LIS. Instrument flags, evaluation of sample integrity, test linearity, delta check and critical values were used to construct the verification algorithms. Results: An autoverification algorithm was constructed; delta check values were calculated and defined, as well as automatic verification ranges. The results retained for manual verification followed a flowchart prepared for this purpose. Conclusion: Autoverification implementation led to a more consistent reviewing process of test results, efficiency and improved patient safety.
RESUMO Introdução: A verificação automática dos resultados consiste na liberação dos resultados dos exames diretamente do equipamento, sem intervenção humana. São inseridas regras para avaliar os resultados no middleware e/ou no sistema de informação laboratorial (SIL), com base em critérios estabelecidos pelo laboratório. A autoverificação uniformiza os critérios de liberação e melhora a eficiência no processo, garantindo a segurança do paciente. Objetivo: Descrever a implantação da autoverificação nos testes bioquímicos do menu de urgência no Serviço de Medicina Laboratorial (SML) do Hospital das Clínicas da Universidade Federal de Minas Gerais (HC/UFMG). Material e métodos: Foram configurados 26 testes bioquímicos disponíveis 24 horas por dia, plenamente interfaceados, inclusive o controle interno da qualidade. Definiram-se parâmetros e algoritmos usados para configuração do SIL e no middleware. No algoritmo elaborado para autoverificação, foram incluídos flags de equipamento, presença de interferentes na amostra, linearidade, delta check e valores críticos. Resultados O algoritmo de liberação automática de resultados, os valores de delta check, os intervalos de liberação automática e o fluxograma para liberação manual dos resultados retidos foram definidos e implantados. Conclusão: A implantação da autoverificação nos testes bioquímicos do menu de urgência no serviço possibilitou padronização e segurança na liberação dos resultados.
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To evaluate the items of critical values and alert limits of the test results , to optimize the critical values report procedure , to modify the laboratory information system ( LIS ) and the hospital information system ( HIS ) , the critical values monitoring platform was designed .Through the monitoring platform,the critical value report rate and critical value report timely rate could be calculated , so reduce medical risks and improve the level of hospital management .
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Los sistemas de información de laboratorio clínico, producen mejoras en la calidad de la información, la reducción de los costos del servicio, disminución de la espera para obtener resultados, entre otros. En el proceso de construcción de este sistema de información, el Instituto Nacional de Salud (INS) del Perú ha desarrollado e implementado un aplicativo a través de Internet basado en la web, para comunicar, al personal de salud (laboratoristas, epidemiólogos, gestores de estrategias sanitarias, médicos tratantes, etc.), los resultados de las pruebas de laboratorio que se realizan en el INS o en los laboratorios de la Red Nacional de Laboratorios de Salud Pública el cual es llamado NETLAB. Este artículo presenta la experiencia de la implementación de NETLAB, su situación actual y las perspectivas de su empleo, así como su contribución en la prevención y control de enfermedades en el Perú.
Clinical laboratory information systems produce improvements in the quality of information, reduce service costs, and diminish wait times for results, among other things. In the construction process of this information system, the National Institute of Health (NIH) of Peru has developed and implemented a web-based application to communicate to health personnel (laboratory workers, epidemiologists, health strategy managers, physicians, etc.) the results of laboratory tests performed at the Peruvian NIH or in the laboratories of the National Network of Public Health Laboratories which is called NETLAB. This article presents the experience of implementing NETLAB, its current situation, perspectives of its use, and its contribution to the prevention and control of diseases in Perú.
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Medical Informatics , Disease Prevention , Clinical Laboratory Information Systems , PeruABSTRACT
Objective To investigate the status of report appropriateness in Clinical Hematology and to identify its potential influence factors to improve the quality of laboratory reports.Methods 1 120 National External Quality Assessment ( EQA ) participants laboratories were enrolled in this study.The questionnaires were assigned to all the participants in both electronic and printed form.The participants were asked to retrospectively count the total reports and the affected reports while the following quality indicators occurred in 2012:report delay, inconformity of data between instrument and LIS as well as between report and request erroneous report transportation, report recall, and report modification.All quality indicators were evaluated in two ways:percentage and sigma (σ) scale.Mann-Whitney Test and Kruskal-Wallis Test were used to analyze the potential impacts of report appropriateness.Results Totally 609 (54.38%)laboratories submitted the survey results .The sigma metrics of six quality indicators on report appropriateness were more than 4.The main reason for report delay was equipment failure.Group comparison suggested that the report appropriateness of laboratories in tertiary-A hospitals and accredited by ISO 15189 werebetter.Report appropriateness with electronic request, electronic form and electronic transmission were superior than that inother ways. Conclusions Report appropriateness in China differs from laboratory to laboratory. Laboratories should develop emergency action plan in case the instrument breaks down and strengthen information technology .Long-term internal quality control and external quality assessment scheme are very meaningful to identify the insufficient performance and improve laboratory quality .(Chin J Lab Med, 2015,38:632-636)
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Objective To investigate the current application status of clinical laboratories in China, including:testing items, the testing amount of each item, total cost of each item and turnaround time ( TAT) of each item.The testing tem with larger proportion of testing amount required better quality control, more financial investment and policy making.Methods Except Tibet and Taiwan, 30 provinceswere included in this investigation.3 grade A tertiary hospitals, 3 tertiary hospitals and 3 secondary hospitals were randomly chosen from every province, and 270 hospitals were enrolled totally.The principals of clinical laboratories of chosen hospitals were contacted by each provincial center of clinical laboratories to complete the online questionnaire.The submitted data was checked by staff of our center and analyzed by Microsoft Excel 2007. The survey information included general information of the hospital, testing menu of the laboratory, test panels , annual test amount, cost, turnaround time, et al.Results All the hospitals enrolled in this investigation had submitted effective results (100%, 270/270).There were 628 single testing item collected in this survey:230 single items were in the field of clinical immunology, which made the biggest proportion (36.62%, 230/628 ); the total amount of testing of clinical chemistry had the biggest proportion (59.97%);the summary amount of the top 100 testing items exceeded 90% of the overall amount; the summary cost of the top 100 testing items exceeded 85% of the overall cost.Conclusions The information collected and analyzed after the survey of testing items of clinical laboratories in China could provide valuable reference information for quality control, financial investment and policy making.
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Objective To explore the factors influencing the intra-laboratory turnaround time ( ILTAT) and establish a COX regression model.Methods Data of 5 weeks with a total of 904 cases from the samples of blood routine examinations from January 2014 to June 2014 in The Third Hospital of Xingtai were randomly collected.The records of the samples included test dates , times of arrival , times of test , sample statuses, time consumption, time duration, operators, project portfolios, delay, PLT counts, results of 30-minute treatment and test weeks.Based on SPSS 17.0, the above indicators were analyzed by COX single factor analysis and then COX mutiple-factor regression analysis.Results Within the prescribed time , 421 cases were sent taking up 46.6%of the total samples.The ratios of sent cases in 10, 20, 30, 40 and 50 minutes are 10.4%, 24.7%, 46.6%, 58.7% and 82.1% respectively.The results of COX single factor analysis showed that times of arrival , sample statuses, times of examination, operators, project portfolios and delay had statistical significance for ILTAT ( P0.05).Conclusions Times of arrival, times of test, operators, project portfolios and delay were the independent risk factors leading to the delay in ILTAT.Other laboratories could determine the variable number of proportional hazards models based on their sample transport , test procedures and principal influence factors , and carry out quantitative evaluation on the factors in sample processing for improvement.Thus, significant decrease on ILTAT would be achieved.
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Critical value report procedures need to be improved rationally by urban space saving, post setting, and monitoring and analysis of historical data of critical value.Laboratory is required to develop and put into practice critical value policies and procedures by numerous regulatory agency standards, such as, International Standard Organization ( ISO 15189) , College of American Pathologists.Laboratories should implement and continuously improve quality management system for achieving the quality goals set by Laboratory and International Standard Organization.
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Objective Using the frozen human-pooled serum samples,with values assigned by the enzyme reference procedure in laboratory network to explore the way of quantity value transfer from enzyme reference measurement system to routine ones.Methods The study is about quantity value transfer.The frozen human-pooled serum sample was assigned by the enzyme reference laboratory network including six domestic reference procedure laboratories,namely Beijing Chaoyang Hospital affiliate of Capital University of Medical Sciences,Beijing Aerospace general Hospital,Beijing Shijitan Hospital affiliate of Capital University of Medical Sciences,Peking Union Medical College Hospital,Beijing Leadman Biochemistry Co.,Ltd.and Sichuan Maker Biotechnology Co.,Ltd.,which used the reference measurement procedures of creatine kinase (CK) and lactate dehydrogenase (LDH) from the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC).First,the assigned serum was used to calibrate or verify trueness of routine measurement systems from the 49 laboratories of tertiary hospitals in Beijing in Feb,2013 by Beijing Centerfor Clinical Laboratories.Second,the assigned serum and two levels of patient samples were tested in duplicate by laboratory 's measurement systems after calibration with manufacturer's calibrator and with assigned serum.During this procedure,all laboratories data were collected.Harmonization of results was observed after calibration with the assigned serum according to the statistics.Results After calibration,the interlaboratory coefficients of variation (CVs) of two patient samples were decreased from 4.67％ and 5.96％ to 1.86％ and 1.47％ for CK and from 5.72％ and 5.04％ to 3.67％ and 3.62％ for LDH.For peer group of A and B instrument,after calibration,both CVs of the assigned serum and two patient samples were less than 2％ for CK,and less than 4％ for LDH ; For C instrument group,which was not calibrated with the assigned serum,the biases were-4.75％ for CK and-13.1％ for LDH,while the biggest CVs were 3.64％ for CK and 7.57％ for LDH.For peer group of reagents,after calibration,the CVs were decreased from 1.60％-4.44％ to 0.23％-1.62％ for CK and from 0.93％-6.07％ to 1.06％-2.72％ for LDH.Conclusions It is one of the feasible ways for quantity value transfer by using the frozen human-pooled serum samples,which were assigned by the enzyme reference laboratory network for calibration or verification.It can effectively solve the problem of trueness and harmonization of enzyme testing results.In addition,for those measurement systems which are not applicable for this calibration.
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O Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) é um estudo de coorte multicêntrico com o objetivo de identificar os fatores de risco associados ao diabetes tipo 2 e à doença cardiovascular na população brasileira. O artigo descreve as estratégias de coleta, processamento, transporte e de controle de qualidade dos exames de sangue e urina no ELSA. O estudo optou pela centralização dos exames em um único laboratório. O processamento das amostras foi realizado nos laboratórios locais, reduzindo o peso do material a ser transportado e diminuindo os custos do transporte para o laboratório central no Hospital da Universidade de São Paulo. O estudo incluiu exames para avaliação de diabetes, resistência à insulina, dislipidemias, alterações eletrolíticas, hormônios tireoidianos, ácido úrico, alterações de enzimas hepáticas, inflamação e hemograma completo. Além desses exames, foram estocados DNA de leucócitos, amostras de urina, plasma e soro. O laboratório central realizou aproximadamente 375.000 exames.
The ELSA (Estudo Longitudinal de Saúde do Adulto - Brazilian Longitudinal Study for Adult Health) is a multicenter cohort study which aims at the identification of risk factors associated with type 2 diabetes and cardiovascular diseases in the Brazilian population. The paper describes the strategies for the collection, processing, transportation, and quality control of blood and urine tests in the ELSA. The study decided to centralize the tests at one single laboratory. The processing of the samples was performed at the local laboratories, reducing the weight of the material to be transported, and diminishing the costs of transportation to the central laboratory at the Universidade de São Paulo Hospital. The study included tests for the evaluation of diabetes, insulin resistance, dyslipidemia, electrolyte abnormalities, thyroid hormones, uric acid, hepatic enzyme abnormalities, inflammation, and total blood cell count. In addition, leukocyte DNA, urine, plasma and serum samples were stored. The central laboratory performed approximately 375,000 tests.
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Adult , Humans , Laboratories/organization & administration , Specimen Handling/methods , Transportation/methods , Brazil , Cardiovascular Diseases/diagnosis , /diagnosis , Longitudinal Studies , Multicenter Studies as TopicABSTRACT
The development of clinical microbiology laboratory is an essential part in promoting the development of clinical microbiology and the basis rational use of antimicrobial agents.Under the circumstances of national specific rectification of antimicrobials,clinical microbiology laboratory should focus on self-buildup and improvement.The development of clinical microbiology laboratory should focus on development of both software and hardware capabilities for lab examination and diagnosis in an all-round way,enhance the antimicrobial susceptibility surveillance,and emphasize and communication and cooperation between laboratory and other departments e.g.clinical departments,pharmacy department and nosocomial surveillance and control office,making concept translation from past ‘paramedical department' to a ‘platform department',contribute its due share to the rational uses of antimicrobial agents.
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With the rapid development of clinical laboratory technology and clinical improvement,the discordance between department of microbiology and clinical departments got more and more.Based on the analysis of interface issues existed between them,we discussed and explored how to do a wonderful job to communicate with each other.(Chin J Lab Med,2013,36:375-376)
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Clinical laboratory information system is the key to the realization of total laboratory automation,standardization,intelligent and digitization.In recent years,with the establishment,application,popularization and upgrading of clinical laboratory information system,it is very important to establish the construction criterion of clinical laboratory as soon as possible.Now according to the requirements of construction and management of modern clinical laboratory and combining with the practical application of clinical laboratory information system in our hospital at domestic settings,the standardization construction of clinical laboratory information system was discussed in this article.
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Point-of-care (POC) testing is desirable because of both the ease with which it can be administered and its short turnaround time. However, because standard POC devices cannot transmit test results automatically to a laboratory information system (LIS), each result must be recorded by hand. This inconvenience not only increases the possibility of clerical errors, but also limits the proper use of test results. If POC test results are not saved in the LIS, it is hard to either monitor patients' health trends or to quality control (QC) the test results. In this paper, we describe how we have solved these problems by connecting 250 POC blood glucose test devices to the LIS via a local area network (LAN). After connecting the POC devices (we used the Accu-Chek Inform II; Roche Diagnostics, Germany) to a manufacturer-provided POC data management system (Roche's Cobas IT 1000; Roche Diagnostics), we developed our own interface program for delivering data from the Cobas IT 1000 system to the LIS. By installing a program to scan the identification barcode worn by patients on their wrists, network-connected POC devices enable users to omit extra ordering, receiving, and recording processes, and they also reduce the possibility of patient misidentification. Such a system also provides an effective way for physicians to follow both the current and accumulated test results of patients. We note that performing QC on glucometers and the sending of data via LAN to the LIS are necessary steps to monitor both patients' results and the QC of those results.