Research Investigating Medical Laboratory Examinations: Quality and Timelessness

International Journal of Business Society, Vol. 5, Issue 10
Qi WeiqiangTan Suyono*Fioni
Clinical/Biomedical analysisBioanalytical methodsLaboratory medicineMedical laboratory testingPoint-of-care testing
PDFSpecial IssueDOI: 10.30566/ijo-bs/2021.special.06
5Volume
10Issue

Abstract

Modern laboratory medicine can be categorised into two key types, namely central laboratory testing and point-of-care testing (POCT). Typically, centralized laboratory medicine offers high-quality results that can be ensured using effective management programs and training staff. It is the clinical staff who carry out POCT, which enables tests to take place closer to the patient. The key benefit of POCT is that it significantly reduces turnaround time, which is a great benefit to the patient. Nonetheless, the key drawback is that clinical laboratory testing requires staff to have expert skills. Thus, the following factors must be considered when deciding which laboratory testing components will be carried out in central laboratories and which ones will be performed as POCT (in relation to quality and timeliness): medical necessity, medical utility, technological capabilities and costs. POCT is usually the preferable option as long as adequate quality can be guaranteed. This is because it is quick to perform, which is essential when measuring vital parameters. Additionally, POCT is generally preferred in cases where the central laboratory is unable to guarantee that results will be delivered quickly (i.e., within 30-60 minutes).

References

[1]

M. R. Chassin and R. W. Galvin, "The urgent need to improve health care quality: Institute of Medicine National Roundtable on Health Care Quality," Jama, vol. 280, no. 11, pp. 1000 -1005, 1998.

[2]

P. H. Mitchell and N. M. Lang, "Framing the problem of meas uring and improving healthcare quality: has the Quality Health Outcomes Model been useful?," Medical Care, vol. 42, no. 2, pp. II -4-II-11, 2004.

[3]

A. Mourtzikou and M. Stamouli, "An update on best practices and regulatory requirements for the improvement of clinical laboratory services through quality," International Journal of Reliable and Quality E-Healthcare (IJRQEH), vol. 6, no. 1, pp. 1 -17, 2017.

[4]

R. B. Haynes, Clinical epidemiology: how to do clinical practice research . Lippincott williams & wilkins, 2012.

[5]

E. Vavoulidis et al., "Transition to ISO 15189: 2012 for Cytopathology Laboratories Part 2: Technical Requirements," International Journal of Reliable and Quality E-Healthcare (IJRQEH), vol. 5, no. 3, pp. 22 -41, 2016.

[6]

A. V. Chobanian et al., "Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure," hypertension, vol. 42, no. 6, pp. 1206 -1252, 2003.

[7]

S. L. Clark, M. A. Belfort, S. L. Byrum, J. A. Meyers, and J. B. Perlin, "Improved outcomes, fewer cesarean deliveries, and reduced litigation: results of a new paradigm in patient safety," American journal of obstetrics and gynecology, vol. 199, no. 2, pp. 105. e1 -105. e7, 2008.

[8]

M. Plebani, M. Laposata, and G. D. Lundberg, "The brain -to-brain loop concept for laboratory testing 40 years after its introduction," American journal of clinical pathology, vol. 136, no. 6, pp. 829 -833, 2011.

[9]

M. Plebani, "Errors in clinical laboratories or errors in laboratory medicine?"," Clinical Chemistry and Laboratory Medicine (CCLM), vol. 44, no. 6, pp. 750 -759, 2006.

[10]

M. Plebani, F. Ceriotti, G. Messeri, C. Ottomano, N. Pansini, and P. Bonini, "Laboratory network of excellence: enhancing patient safety and service effectiveness," Clinical Chemistry and Laboratory Medicine (CCLM), vol. 44, no. 2, pp. 150 -160, 2006.

[11]

G. Lima-Oliveira, W. Volanski, G. Lippi, G. Picheth, and G. C. Guidi, "Pre-analytical phase management: a review of the procedures from patient preparation to laboratory analysis," Scandinavian journal of clinical and laboratory investigation, vol. 77, no. 3, pp. 153 -163, 2017.

[12]

J. A. Ombewa, "Total Quality Management in Iso 15189 Accredited Medical Laboratories in Kenya," university of nairobi, 2018.

[13]

C. Seidl et al., "Levels of quality management of blood transfusion services in Europe," ISBT Science Series, vol. 3, no. 1, pp. 54 -62, 2008.

[14]

I. Schimke, "Quality and timeliness in medical laboratory testing," Analytical and bioanalytical chemistry, vol. 393, no. 5, pp. 1499 -1504, 2009.

[15]

A. W. Wong, J. M. Lanyon, H. L. Sneath, G. R. Leggatt, and L. Woolford, "Comparison of i -STAT® with traditional laboratory analysers in the measurement of blood analytes from field captured dugongs (Dugong dugon)," Aquatic Mammals, vol. 44, no. 1, pp. 19 -31, 2018.

[16]

M. Fleisher and M. K. Schwartz, "Strategies of organization and service for the critical-care laboratory," Clinical chemistry, vol. 36, no. 8, pp. 1557 -1561, 1990.

[17]

P. St -Louis, "Status of point -of-care testing: promise, realities, and possibilities," Clinical biochemistry, vol. 33, no. 6, pp. 427 -440, 2000.

[18]

S. E. Juul et al., "Effect of high-dose erythropoietin on blood transfusions in extremely low gestational age neonates: post hoc analysis of a randomized clinical trial," JAMA pediatrics, vol. 174, no. 10, pp. 933 -943, 2020.

[19]

F. J. Bednarek et al., "Variations in blood transfusions among newborn intensive care units," The Journal of pediatrics, vol. 133, no. 5, pp. 601-607, 1998.

[20]

G. J. Fermann and J. Suyama, "Point of care testing in the emergency department," The Journal of emergency medicine, vol. 22, no. 4, pp. 393-404, 2002.

[21]

U. Jahn and H. Van Aken, "Editorial I: Near‐patient testing —point‐of‐care or point of costs and convenience?"," ed: Oxford University Press, 2003, pp. 425 -427.

[22]

J. A. Sergeant, "Modeling attention -deficit/hyperactivity disorder: a critical appraisal of the cognitive -energetic model," Biological psychiatry, vol. 57, no. 11, pp. 1248 -1255, 2005.

[23]

P. R. Sackett, N. Schmitt, J. E. Ellingson, and M. B. Kabin, "High -stakes testing in employment, credentialing, and higher education: Prospects in a post -affirmative -action world," American Psychologist, vol. 56, no. 4, p. 302, 2001.

[24]

J. H. Andrews, L. C. Briand, and Y. Labiche, "Is mutation an appropriate tool for testing experiments?," in Proceedings of the 27th international conf erence on Software engineering , 2005, pp. 402 -411.

[25]

S. L. Gutierres and T. E. Welty, "Point-of-care testing: an introduction," Annals of Pharmacotherapy, vol. 38, no. 1, pp. 119 -125, 2004.

[26]

D. A. Novis, B. A. Jones, J. C. Dale, and M. K. Walsh, "Biochemical markers of myocardial injury test turnaround time: a College of American Pathologists Q-Probes study of 7020 troponin and 4368 creatine kinase –MB determinations in 159 institutions," Archives of pathology & laboratory medicine, vol. 128, no. 2, pp. 158 -164, 2004.

[27]

P. J. Howanitz, "Errors in laboratory medicine: practical lessons to improve patient safety," Archives of Pathology and Laboratory Medicine, vol. 129, no. 10, pp. 1252 -1261, 2005.

[28]

S. J. Steindel, B. A. Jones, and P. J. Howanitz, "Timeliness of automated routine laboratory tests: a College of American Pathologists Q-Probes study of 653 institutions," Clinica chimica acta, vol. 251, no. 1, pp. 25 -40, 1996.

[29]

R. C. Becker, J. Cyr, J. M. Corrao, and S. P. Ball, "Bedside coagulation monitoring in heparin-treated patients with active thromboembolic disease: a coronary care unit experience," American heart journal, vol. 128, no. 4, pp. 719 -723, 1994.

[30]

A. J. McIntyre, "Blood transfusion and haemostatic management in the perioperative period," Canadian journal of anaesthesia, vol. 39, no. 1, pp. R101 -R114, 1992.

[31]

J. McCord et al., "Ninety-minute exclusion of acute myocardial infarction by use of quantitative point-of-care testing of myoglobin and troponin I," Circulation, vol. 104, no. 13, pp. 1483 -1488, 2001.

[32]

F. Di Serio, G. Antonelli, P. Trerotoli, M. Tampoia, A. Matarrese, and N. Pansini, "Appropriateness of point-of-care testing (POCT) in an emergency department," Clinica chimica acta, vol. 333, no. 2, pp. 185 -189, 2003.

[33]

C. A. Parvin, S. F. Lo, S. M. Desuser, L. G. Weaver, L. M. Lewis, and M. G. Scott, "Impact of point-of-care testing on patients' length of stay in a large emergency department," Clinical chemistry, vol. 42, no. 5, pp. 711 -717, 1996.

[34]

J. H. Nichols et al., "Clinical outcomes of point-of-care testing in the interventional radiology and invasive cardiology setting," Clinical chemistry, vol. 46, no. 4, pp. 543 -550, 2000.

[35]

G. Despotis et al., "Prospective evaluation and clinical utility of on-site monitoring of coagulation in patients undergoing cardiac operation," The Journal of Thoracic and Cardiovascular Surgery, vol. 107, no. 1, pp. 271 -279, 1994.

[36]

L. Shore-Lesserson, H. E. Manspeizer, M. DePerio, S. Francis, F. Vela-Cantos, and M. A. Ergin, "Thromboelastography-guided transfusion algorithm reduces transfusions in complex cardiac surgery," Anesthesia & Analgesia, vol. 88, no. 2, pp. 312 -319, 1999.

[37]

A. Annibaldi, "Tumor sensitizing function and mechanism of action of a RasGAP derived peptide," Université de Lausanne, Faculte de biologie et médecine, 2012.

[38]

G. Fabris, "Role of microRNAs and their machinery in hepatocytes and pancreatic beta cells," COMUE Université Côte d'Azur (2015-2019), 2019.

Article Information

Article Details
Volume & IssueVol. 5, Iss. 10
Publication DateDec 1, 2021
Authors
Qi Weiqiang
Tan Suyono*
Fioni
DOI
10.30566/ijo-bs/2021.special.06
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