Clinical laboratory management review : official publication of the Clinical Laboratory Management Association最新文献_第9页

Future directions for research in laboratory medicine: the findings of a Delphi survey of stakeholders. 检验医学研究的未来方向:利益相关者德尔菲调查的结果。

Clinical laboratory management review : official publication of the Clinical Laboratory Management Association Pub Date : 1998-07-01

H Maibach, R Keenlyside, D Fitzmaurice, D Brogan, J Essien

{"title":"Future directions for research in laboratory medicine: the findings of a Delphi survey of stakeholders.","authors":"H Maibach, R Keenlyside, D Fitzmaurice, D Brogan, J Essien","doi":"","DOIUrl":"","url":null,"abstract":"In July 1995, we asked 101 experts to anticipate future areas for research in clinical laboratory medicine using a modified Delphi survey approach. The panel included academicians, clinical laboratory professionals, laboratory managers, practicing physicians public health officials, hospital administrators, and representatives of manufacturing industries, managed care organizations, commercial laboratories, and government health agencies. The participants predicted fewer laboratories, more automation, and fewer skilled staff needed in the future. The consensus was that laboratory quality assurance will focus on patient outcomes and be benchmarked against peer groups. They agreed that quality assurance routinely will be integrated into testing kits. Measures derived from medical informatics, such as outcomes analysis and utilization statistics, will become a standard feature of health care. A major area of concern was the effect that reorganizing health care and striving for cost containment will have on laboratory services. These views were consistent with those expressed by participants at a CDC conference on the frontiers of laboratory medicine research held shortly after the study was completed. These topics by now are familiar to most laboratory professionals, and we urge them to explore the many research issues raised with their colleagues in their clinical laboratories, health-care organizations, and industry.","PeriodicalId":79576,"journal":{"name":"Clinical laboratory management review : official publication of the Clinical Laboratory Management Association","volume":"12 4","pages":"221-30; discussion 231"},"PeriodicalIF":0.0,"publicationDate":"1998-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21056684","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}

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As we see it. Hang together and you may not hang at all. 正如我们所看到的。团结在一起，你可能不会被绞死。

Clinical laboratory management review : official publication of the Clinical Laboratory Management Association Pub Date : 1998-07-01

P Labbe, R W Forsman, J Marchwinski, M Fluehr, N Greaves, E Cook, L Vallier, R Carpenter, S Deckard

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Do no harm versus the greatest good for the greatest number: health care and the clash of ethical imperatives. “不伤害”与“为最多数人带来最大好处”:医疗保健与伦理责任的冲突。

Clinical laboratory management review : official publication of the Clinical Laboratory Management Association Pub Date : 1998-07-01

W I Rosenblum

{"title":"Do no harm versus the greatest good for the greatest number: health care and the clash of ethical imperatives.","authors":"W I Rosenblum","doi":"","DOIUrl":"","url":null,"abstract":"For two millennia, more or less, doctors all over the world have taken the Hippocratic oath to \"do no harm.\" However, these words often have conflicted with social policy. Particularly in this century, some governments and other institutions have encouraged--or insisted on--placing the good of the state ahead of the duty to individual patients. Sterilizing \"handicapped\" and \"feebleminded\" persons in Germany long before the creation of the concentration camps is a prominent example of a program initiated under the guise of sacrificing few to improve the welfare of all. America likes to think it is fundamentally different from the Germany that carried out the sterilization program. However, the social and economic forces in Germany that placed national health above the principle of do no harm and encouraged doing the greatest good for the greatest number are similar to what is developing in America--a concordance between economic forces and a social philosophy that is willing to curtail access of some individuals to treatments that they need, want, and can pay for to achieve a hypothetical goal of better national health.","PeriodicalId":79576,"journal":{"name":"Clinical laboratory management review : official publication of the Clinical Laboratory Management Association","volume":"12 4","pages":"300, 295-9"},"PeriodicalIF":0.0,"publicationDate":"1998-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21056519","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}

引用次数: 0

Impact on human resources: Core Laboratory versus laboratory information system versus modular robotics. 对人力资源的影响:核心实验室、实验室信息系统、模块化机器人。

Clinical laboratory management review : official publication of the Clinical Laboratory Management Association Pub Date : 1998-07-01

R Dadoun

{"title":"Impact on human resources: Core Laboratory versus laboratory information system versus modular robotics.","authors":"R Dadoun","doi":"","DOIUrl":"","url":null,"abstract":"Technological advances in laboratory systems have had a great impact on human resources. Surviving the changes requires an in-depth understanding of the technology to implement the appropriate operational model. St. Mary's is a 414-bed, acute care hospital. For 18 months, the laboratories went through the process of moving from a noncomputerized traditional model laboratory (i.e., by discipline) to a fully computerized Core Lab. The Core Lab concept fully integrates biochemistry, hematology, blood bank, and microbiology into two sections (not physically separated): tests processed by automation and tests processed manually. This approach led to a 15% reduction in staff while the volume doubled. The transitions occurred sequentially: from traditional laboratory to Core Lab (noncomputerized), from manual Core Lab to fully computerized Core Lab, and ultimately from a simulation of manual preanalytical phase to automated preanalytical phase (modular robotics). The findings show that Core Lab and computerization have almost the same impact on human resources, 35% and 30% respectively, and modular robotics the least impact with 17%.","PeriodicalId":79576,"journal":{"name":"Clinical laboratory management review : official publication of the Clinical Laboratory Management Association","volume":"12 4","pages":"248-55"},"PeriodicalIF":0.0,"publicationDate":"1998-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21056685","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}

引用次数: 0

The role of reflexive (algorithmic) testing in laboratory medicine: adapting to the new era. 反思(算法)检测在检验医学中的作用:适应新时代。

Clinical laboratory management review : official publication of the Clinical Laboratory Management Association Pub Date : 1998-07-01

E S Pearlman, R Miele, S Swiss, L Bilello, J Stauffer

引用次数: 0

Enhancing decision-making effectiveness in problem-solving teams. 提高解决问题团队的决策效率。

Clinical laboratory management review : official publication of the Clinical Laboratory Management Association Pub Date : 1998-07-01

S Bazan

{"title":"Enhancing decision-making effectiveness in problem-solving teams.","authors":"S Bazan","doi":"","DOIUrl":"","url":null,"abstract":"Active participation by all group members as well as the generation, presentation, and critical evaluation of a wide range of perspectives and alternatives are hallmarks of effective problem-solving teams. Diverse groups with an odd number of participants (five to seven members are generally best) are manageable and provide an adequate range of perspectives and alternatives. Several problems limit the effectiveness of problem-solving teams. Dysfunctional concurrence or \"groupthink\" occurs when concurrence seeking in cohesive groups overrides the realistic appraisal of alternative courses of action. Managers initially should withhold their own opinions, assign members the role of critical evaluators, and bring in people from outside the initial group to minimize this problem. Domination by a select few is also a problem because it can squelch the presentation of diverse opinions. Brainstorming and nominal group technique can mitigate this problem. In nominal group technique, a manager guides the group through steps involving brainstorming, recording, and voting on the merits of various alternatives before open discussion is allowed. Decision-making dropouts are group members who withdraw from active participation in the group. Managers can reduce this problem by emphasizing the importance of active participation and by monitoring performance.","PeriodicalId":79576,"journal":{"name":"Clinical laboratory management review : official publication of the Clinical Laboratory Management Association","volume":"12 4","pages":"272-6"},"PeriodicalIF":0.0,"publicationDate":"1998-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21056523","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}

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CLMA research initiative: moving into the 21st century with leadership in knowledge. CLMA Research Advisory Committee. CLMA研究计划:以领先的知识进入21世纪。CLMA研究咨询委员会。

Clinical laboratory management review : official publication of the Clinical Laboratory Management Association Pub Date : 1998-07-01

M G Bissell, J S Barr, D J Boone, J Counts, E Jenkins, C D Jones, A Kurec, K M Peddecord, M Silverstein, J Yost, J Zinn, C A Steward

引用次数: 0

Retaining key staff, Part I. 留住关键员工，第一部分。

Clinical laboratory management review : official publication of the Clinical Laboratory Management Association Pub Date : 1998-07-01

M M Kennedy, R B Pickett

引用次数: 0

Using the absolute neutrophil count as a stand-alone test in a hematology/oncology clinic: an abbreviated test can be preferable. 使用绝对中性粒细胞计数作为血液学/肿瘤学临床的独立测试:一个简短的测试是可取的。

Clinical laboratory management review : official publication of the Clinical Laboratory Management Association Pub Date : 1998-07-01

A Jatoi, R Jaromin, L Jennings, P L Nguyen

{"title":"Using the absolute neutrophil count as a stand-alone test in a hematology/oncology clinic: an abbreviated test can be preferable.","authors":"A Jatoi, R Jaromin, L Jennings, P L Nguyen","doi":"","DOIUrl":"","url":null,"abstract":"More is not always better. We hypothesized that clinicians prefer an abbreviated but focused test to one that provides more--but not totally essential--information. We performed a retrospective analysis of physicians' ordering practices after introducing the absolute neutrophil count (ANC) as a stand-alone test in a hematology/oncology clinic. Previous studies have demonstrated a strong correlation between the ANC, as determined by the Coulter STKS instrument, and the manual neutrophil count. In contrast to the more extensive five-part differential the ANC is a one-part differential that focuses exclusively on the neutrophil count and provides abbreviated information. The hematology laboratory's records from 2 months before and 4 months after introducing this new test were analyzed. Total numbers of ANCs, automated complete differentials, and manual complete differentials performed were tabulated. After its introduction, the ANC comprised more than 75% of differentials performed in this clinic. Manual complete differentials dropped from 69.4% to 18.8%. The turnaround time (TAT) for all differentials taken together dropped by 75% (p = 0.042). We conclude that the ANC can be used widely in the hematology/oncology clinic as a separate, stand-alone test. For clinicians, its popularity over the five-part differential may be based on the fact that the ANC is a focused test with a relatively short TAT. Our experience suggests that it is the test result's relevance and not the volume of information provided that determines clinicians' use.","PeriodicalId":79576,"journal":{"name":"Clinical laboratory management review : official publication of the Clinical Laboratory Management Association","volume":"12 4","pages":"256-60"},"PeriodicalIF":0.0,"publicationDate":"1998-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21056686","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}

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The gray zone. 灰色地带。

Clinical laboratory management review : official publication of the Clinical Laboratory Management Association Pub Date : 1998-07-01

H J Kisner

引用次数: 0