Clinical leadership & management review : the journal of CLMA最新文献

The purpose of a utilization or test management program is to identify for the clinician the most frequently ordered and useful laboratory tests relevant to the diagnosis, prognosis, treatment, and management of the patient. As such, a test management program must be carefully constructed to provide appropriate and effective utilization of laboratory services by incorporating and promoting the highest quality and best practice standards for patient care.1 At the same time, a test management program must not hinder the clinician's ability to properly care for the patient by ordering the right test at the right time for the right reason. Too often, utilization strategies solely focus on cost reduction without regard for clinical impact.

In early 2001, a small group of hospital lab administrators, educators, and hospital council and health occupations leaders in the South San Francisco Bay Area, seeing no end to the area's laboratory workforce shortage, developed an ambitious plan to increase the number of clinical laboratory scientists (CLSs). Here is how they convinced administrators from 15 area hospitals to fund it.

The National Center for Health Workforce Analysis of the Health Resources and Services Administration (HRSA), Bureau of Health Professions contracted with the University of California at San Francisco Center for the Health Professions to conduct a study of the clinical laboratory workforce. The study utilized existing and new survey data, in collaboration with the American Society for Clinical Pathology (ASCP), as well as interviews with experts in the field. This paper will describe the demographic characteristics, roles, and scope of practice of this workforce, as well as identify factors that influence the current and future demand for and supply of workers. There is ample evidence of a shortage of workers over the past few years, indicated by double-digit vacancy rates, increasing salaries, and the use of other incentives to fill positions. Recent data show a reduction in vacancy rates, although an increase in per diem and contract workers may mask a continuing shortage. There is recent growing interest in the profession, as evidenced by an increase of applicants to educational programs. Several factors make it difficult to predict the future need for and role of clinical laboratory workers, including an aging population and the demand for increased services, the possible retirement of many current workers, automation, new technology and tests, and public health challenges.

This article describes our journey for quality in the Department of Laboratory Medicine and Pathology (DLMP) at Mayo Clinic. It provides the background of the department and the process for the development and implementation of the quality program. In addition, a quality conference and the development of a quality school are outlined. Throughout the course of this process, valuable lessons were learned and are discussed. We are pleased with the success of the quality journey. However, we realize that the quest has just begun. We look forward to the future and the challenges that lie ahead.

The outcome for the patient in the study could have become a serious issue for this facility. The patient was still in the facility and was able to provide another sample. As it turned out, the patient had not taken any medication that could have interfered with the culture and sensitivity testing. As we have discussed, patient safety issues are part of the laboratorian's and health-care professional's daily routine. Errors and incidents can be reduced by having clear and simple communication between patients and staff. In addition, open, honest, and direct quality communication without judgment or blame between each person involved in the patient service system is the key to guaranteeing patient safety issues won't occur in your patient practice.