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

The myths surrounding the licensure of clinical laboratory personnel are numerous, but many licensure detractors skew the facts in an attempt to convince both laboratorians and the general public that licensure of lab personnel is unnecessary. In her argument in favor of national licensure, longtime laboratory manager Diana Mass presents her case that debunks many of the so-called truths surrounding the negative impact of licensure.

This article describes the expansion and reorganization of a moderate-sized Canadian laboratory from Day One to "Live Day." The key factors to the success of this project were organized planning by the laboratory staff and the introduction of core lab theories, team building, and organized training sessions. The successful makeover resulted in improved turnaround time for STAT tests, especially those coming from the Emergency Unit. The efforts of the laboratory personnel toward the improvement of laboratory services, in spite of budget, human resources constraints, and resistance to change, are addressed.

Those who argue in favor of licensure for clinical laboratory scientists have their priorities in order, but fail to recognize the realities that would ensue were national licensure to be instituted. Higher health-care costs, elimination of rural facilities, and licensure board fraud are all unintended, yet dangerous, consequences that could occur. In his argument against national licensure, laboratory director Jack Garon summarizes some of the most salient research done regarding licensure and presents his case why it is unnecessary in the clinical laboratory.

Between 15 and 45 percent of a clinical laboratory's operating budget is spent on supplies. Given the size of this expenditure, laboratory managers must pay close attention to the supply chain and develop effective strategies to manage their inventory. Areas that need analysis include the carrying cost of supplies, the cost to generate a purchase order, methods to efficiently count supplies on hand, processes to ensure that lot number items are used before their expiration, and detailed analysis of the inventory. At the University of California-San Francisco Medical Center, we investigated options to manage our inventory and implemented a computerized system. The system required modifications to existing practices, which initially seemed unwieldy. However, after a relatively short learning curve, the improvement to operations has been significant, with a reduction in wasted reagents, fewer staff hours used to count supplies, and the ability to provide prompt analysis of the inventory for audits and discussions with administration. Focusing on the supply chain has allowed us to reduce inventory expenses by approximately 8 percent, reduce waste, given us a more focused understanding of our operations, and provided us with the ability to analyze our inventory easily.

Uncivil behavior in the laboratory can be crippling, damaging the morale of the department and overall attitude of employees. In this article, the author looks at data that indicates the importance of curtailing incivility as soon as possible and offers suggested ways for managers to deal with uncivil behavior.

Integration and standardization of laboratories throughout a medical system can increase the efficiency and effectiveness of laboratory operations. This task is challenging in most health-care systems, as no central governance exists to compel laboratories to standardize and integrate. We describe the initial collaborative efforts to integrate and standardize the laboratories of the Mayo Foundation, which includes more than 60 laboratories of different sizes in diverse locations. The goals and objectives of the group formed to develop this initiative--the Centralized Laboratory Purchasing Group--its origin, and lessons learned are described. Similar initiatives by other academic medical centers and community health-care systems to integrate and standardize their laboratories are discussed. Successful standardization and integration increases the value of the laboratory to the larger health-care system by demonstrating accountability, efficiency, and effectiveness, and can result in considerable cost savings to the entire health-care system.