{"title":"Optimizing point-of-care testing in clinical systems management.","authors":"G J Kost","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The goal of improving medical and economic outcomes calls for leadership based on fundamental principles. The manager of clinical systems works collaboratively within the acute care center to optimize point-of-care testing through systematic approaches such as integrative strategies, algorithms, and performance maps. These approaches are effective and efficacious for critically ill patients. Optimizing point-of-care testing throughout the entire health-care system is inherently more difficult. There is potential to achieve high-quality testing, integrated disease management, and equitable health-care delivery. Despite rapid change and economic uncertainty, a macro-strategic, information-integrated, feedback-systems, outcomes-oriented approach is timely, challenging, effective, and uplifting to the creative human spirit.</p>","PeriodicalId":79576,"journal":{"name":"Clinical laboratory management review : official publication of the Clinical Laboratory Management Association","volume":"12 5","pages":"353-63"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21056284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Wisdom circles.","authors":"C Garfield","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>King Arthur had the right idea all along--to get the key stakeholders around a table and address the vital issues. The author describes his concept of a \"wisdom circle,\" a gathering of people who speak candidly and from the heart, listen intently to the wisdom of other people, and honor the wisdom and intelligence we all possess to meet both individual and collective needs.</p>","PeriodicalId":79576,"journal":{"name":"Clinical laboratory management review : official publication of the Clinical Laboratory Management Association","volume":"12 5","pages":"401, 400"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21056287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Standardization across multiple sites.","authors":"C Diehl","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Standardizing products, procedures, and processes in clinical departments across multiple sites has significant potential for improving clinical outcomes, enhancing financial savings, and simplifying management processes. This is true whether a network of owned hospitals is working toward a full-scale clinical integration or a group of community hospitals is collaborating to gain cost efficiencies. By developing a functional team and designing a relatively simple program, the results can be very rewarding. The author describes some of the basic principles in designing a standardization program and cites some examples of successful programs as well as listing some pitfalls to be avoided along the way.</p>","PeriodicalId":79576,"journal":{"name":"Clinical laboratory management review : official publication of the Clinical Laboratory Management Association","volume":"12 5","pages":"347-52"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21056291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Telemedicine: emerging opportunities and future trends.","authors":"A S Kurec","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Remote location, lack of specialty services, or managed care capitation contribute to limited access to health care. As reimbursement rates decline, availability to expert or high-tech care is affected. The need to \"make do\" with available personnel, existing technologies, or dated facilities is not uncommon and affects the quality of health care. Telemedicine accounts for these issues and serves as an alternative to providing interactive evaluation and management of patients. As computer hardware and software improve and become less costly, access to this technology will be more commonplace and establish itself as an acceptable standard of practice. The Internet may serve as a highway to resources that currently are not available in rural areas or in third-world countries. Access to Web sites that provide comprehensive and instructive material is just one part of a complex, developing area of health care.</p>","PeriodicalId":79576,"journal":{"name":"Clinical laboratory management review : official publication of the Clinical Laboratory Management Association","volume":"12 5","pages":"364-74"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21056293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical integration: one health-care system's experience.","authors":"S Croushore","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Clinical integration is occurring continuously in most health-care environments. Depending on the process and model used, outcomes have varied. Success depends on strong leadership, careful planning, and continuous communication. Within health-care systems, further integration is occurring with service consolidation among hospitals in geographic proximity. Such consolidation is financially driven. These various changes reflect the new \"quantum mechanics\" of health-care management. In quantum thinking, the management process involves viewing systems as a large set of relationships, interdependent and interrelated. It is a new age of increasing complexity.</p>","PeriodicalId":79576,"journal":{"name":"Clinical laboratory management review : official publication of the Clinical Laboratory Management Association","volume":"12 5","pages":"314-6"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21056279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Robotics, automation, and the new role of process control.","authors":"R A McPherson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The natural progression of automation in the clinical laboratory next will lead to robotic devices to perform many of the manual tasks still remaining. To date, most efforts of laboratory automation have been directed at the analytic phase. New targets for automation will be at the preanalytic and postanalytic phases where many of the bottlenecks in specimen flow now occur in highly repetitive manual tasks. Laboratory professionals will have a unique opportunity to incorporate new concepts of robotics in their facilities to improve error rates and to use massive laboratory databases to improve medical and public health services.</p>","PeriodicalId":79576,"journal":{"name":"Clinical laboratory management review : official publication of the Clinical Laboratory Management Association","volume":"12 5","pages":"339-46"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21056281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Proactive management in the managed care era.","authors":"J S Parrott","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Preparing for the future impact of managed care on clinical laboratories remains a complex challenge as the corporate strategies of health maintenance organizations (HMOs) and managed care contracting continue to evolve. Employers often fail to use data or quality measures to select an HMO, preventing a clinical laboratory from competing on patient care issues. Developing analysis skills and knowledge concerning physician ordering data, HMO information, costs, and capitation rate corridors prepares the enterprise and managers for a successful future.</p>","PeriodicalId":79576,"journal":{"name":"Clinical laboratory management review : official publication of the Clinical Laboratory Management Association","volume":"12 5","pages":"310-3"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21056525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Legal basis and interpretations of medical necessity.","authors":"P M Kazon","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article examines the legal issues surrounding medical necessity in Medicare reimbursement. The author reviews how the Health Care Financing Administration has defined medical necessity for laboratory testing and the role of the laboratory and the laboratory manager in ensuring medical necessity.</p>","PeriodicalId":79576,"journal":{"name":"Clinical laboratory management review : official publication of the Clinical Laboratory Management Association","volume":"12 5","pages":"375-82; discussion 382-3"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21056282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Integrated ethics for the clinical systems manager.","authors":"L J Weber","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article describes how clinical systems managers can integrate clinical ethics, management ethics, and the social responsibility of business or organizational leaders (business ethics) to resolve ethical dilemmas they may encounter. Three examples are discussed: policy on use of resources, personnel issues, and managed care and the current backlash against it.</p>","PeriodicalId":79576,"journal":{"name":"Clinical laboratory management review : official publication of the Clinical Laboratory Management Association","volume":"12 5","pages":"384-8"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21056292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Key performance indicators to assess laboratory operations. Action-packed benchmarking with HBSI (HBS International Inc.).","authors":"S S Heatherley","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The first article of this series highlighted the five most widely used performance measurement systems for comparing laboratory and clinical department operations. This column has since taken an in-depth tour of two of the systems, the MECON PEERx and the Laboratory Management Index Program. We also have taken a slight detour to discuss the ORYX initiative, which has been mandated for certain types of health-care organizations accredited by the Joint Commission. In this issue we return to a more detailed analysis of one of the five most commonly used benchmarking systems for clinical services, HBS International, Inc.</p>","PeriodicalId":79576,"journal":{"name":"Clinical laboratory management review : official publication of the Clinical Laboratory Management Association","volume":"12 4","pages":"261-6"},"PeriodicalIF":0.0,"publicationDate":"1998-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21056516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}