Current status of US programs for training clinical laboratory scientists and anticipated impact of healthcare reform

1995 ◽  
Vol 41 (6) ◽  
pp. 934-941 ◽  
Author(s):  
M G Scott ◽  
D B Sacks
Keyword(s):  
Healthcare Reform ◽  
Clinical Laboratory ◽  
Clinical Chemistry ◽  
Clinical Pathology ◽  
University Hospital ◽  
Current Status ◽  
University Hospitals ◽  
Private Hospitals ◽  
Residency Programs ◽  
The Impact

Abstract We surveyed directors of medical technology (MT) and postdoctoral clinical chemistry (CC) training programs and of clinical pathology (CP) and combined anatomic/clinical pathology (AP/CP) residency programs regarding the number, quality, training emphasis, and job-placement experience of trainees for 1985-95 as well as the directors' opinions on the impact of "healthcare reform." Responses were received from directors of 94 of 249 (38%) MT programs, 14 of 15 (93%) CC programs, and 63 of 138 (46%) pathology residency programs. In all four categories the numbers of trainees have increased steadily over the last 5 to 7 years but are expected to remain stable or decrease slightly. Directors of MT and CC programs expect increasing difficulty placing their graduates; directors of AP/CP and CP residency programs do not. Although > 60% of MT graduates have entered private hospitals, this is anticipated to decrease, with a concomitant increase in university hospital placements. Of the AP/CP residents, > 60% and < 5% accepted service- and research-oriented positions, respectively. In contrast, 83% of CP residents entered university hospitals, with half of these taking research-oriented positions. Among CC graduates, 41% joined university hospitals and 10-15% accepted positions in each of either private hospitals or industry or reference laboratories. The emphasis of training varies, with clinical service and pathophysiology the major focus in AP/CP programs. CP and CC programs take two distinct approaches--some accentuating management, and others emphasizing research. Finally, MT program directors appear the most optimistic regarding the opportunities that healthcare reform may present.

Current status of pain medicine training in anesthesiology and pain medicine residency programs in university hospitals of Korea: a survey of residents’ opinions

2020 ◽  
Vol 45 (4) ◽  
pp. 283-286
Author(s):  
Jin Young Lee ◽  
Shin Hyung Kim ◽  
Yongjae Yoo ◽  
Seong Soo Choi ◽  
Sang Hun Kim ◽  
...  
Keyword(s):  
Survey Data ◽  
Training Programs ◽  
Training Period ◽  
Current Status ◽  
Pain Medicine ◽  
University Hospitals ◽  
Residency Programs ◽  
Level Of Satisfaction ◽  
Current Program ◽  
Second Year

BackgroundIn Korea, anesthesiologists are expected to be mainstream pain medicine (PM) practitioners. However, anesthesiology and pain medicine (APM) residency programs mostly emphasize anesthesia learning, leading to insufficient PM learning. Therefore, this study evaluated the current status of PM training in APM residency programs in 10 Korean university hospitals.MethodsOverall, 156 residents undergoing APM training participated anonymously in our survey, focusing on PM training. We assessed the aim, satisfaction status, duration, opinion on duration, desired duration, weaknesses of the training programs and plans of residents after graduating. We divided the residents into junior (first and second year) and senior (third and fourth year). Survey data were compared between groups.ResultsSenior showed significantly different level of satisfaction grade than did junior (p=0.026). Fifty-seven (81.4%) residents in junior and forty (46.5%) residents in senior underwent PM training for ≤2 months. Most (108; 69.2%) residents felt that the training period was too short for PM learning and 95 (60.9%) residents desired a training period of ≥6 months. The most commonly expressed weakness of the training was low interventional opportunity (29.7%), followed by short duration (26.6%). After residency, 80 (49.1%) residents planned to pursue a fellowship.ConclusionsDissatisfaction with PM training was probably due to a structural tendency of the current program towards anesthesia training and insufficient clinical experience, which needs to be rectified, with a change in PM curriculum.

scholarly journals Development and Implementation of Network-Resident Clinical Laboratory Tools in an Integrated Health Delivery System

1997 ◽  
Vol 2 (3) ◽  
pp. 18-22
Author(s):  
Michael E. Sendek ◽  
Mohamed A. Virji
Keyword(s):  
Delivery System ◽  
Clinical Laboratory ◽  
Care Delivery ◽  
Clinical Chemistry ◽  
Point Of Care ◽  
Clinical Pathology ◽  
Current Data ◽  
Conceptual Approach ◽  
Pathology Laboratory ◽  
Integrated Health

The conceptual approach to a system of network resident-training tools for use in a clinical pathology laboratory is described and specific modules developed for use in an integrated health care delivery system. The modules have been developed to be accessible throughout an organization, are amenable to customization, are designed for use by personnel with varied knowledge of laboratory techniques, and can be updated readily. The modules designed are for dry slide clinical chemistry analyses, white blood cell maturation sequence, and flow cytometry. The concept can be applied to other laboratory functions including point-of-care testing service. The modules incorporate flexibility of integrating text with digital images, sound and animation. The core of the system is based on readily available software for Internet. Therefore, the system of laboratory tools can provide the means for rapidly accessible, current data resources for a variety of purposes for a laboratory to operate in an integrated delivery system.

scholarly journals Disaster preparedness level of university hospitals of Sousse -Tunisia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Lamine ◽  
M A Tlili ◽  
W Aouicha ◽  
E Taghouti ◽  
N Chebili ◽  
...  
Keyword(s):  
Disaster Management ◽  
Disaster Preparedness ◽  
Disaster Response ◽  
University Hospital ◽  
World Health ◽  
Structural Safety ◽  
Safety Index ◽  
University Hospitals ◽  
Hospital Safety ◽  
The Impact

Abstract Background Disasters, whether natural or man-made, are unpredictable. The health care systems, represented by hospitals, are on the front lines of the emergency and disaster response. Tunisian health structures, must be able to cope with a case of mass influx of victims following any disasters. Therefore, we conducted this study to describe the level of disaster preparedness of University Hospitals of Sousse - Tunisia. Methods A simple descriptive quote is the basis of a data collection, conducted between September and October 2019 and performed in both University Hospitals of Sousse - Tunisia (Farhat Hached and Sahloul). The measuring instrument used in this study is the 'Hospital Safety Index' designed by the World Health Organization in 2008. Data was analyzed using the 'Module and safety index calculator' which calculates a specific score for each module (structural safety, nonstructural safety and emergency and disaster management) and an overall score for hospital safety, and assigns an appropriate classification which can be “c/C” corresponds to a score from 0 to 0.35, “b/B” from 0.36 to 0.65, or “a/A” from 0.66 to 1. Results The overall safety index class of both hospitals was 'B'. Sahloul University Hospital was classified as 'a' in both structural and nonstructural safety modules and classified as 'c' in the emergency and disaster management module, in the other hand Farhat Hached University Hospital was classified as 'c' in structural safety module and classified as 'b' in both nonstructural safety and emergency and disaster management modules. Conclusions The hospitals' current levels of emergency and disaster management needs to be improved. Actually, both patients and staff safety as well as the hospital's ability to function during and after emergencies and disasters are potentially at risk. In both hospitals, intervention measures are needed in the short term. Key messages Appropriate disaster management should be based on a clear plan, preparedness and collaborative and effective efforts on the part of the community and the different organizations involved. A safe hospital needs to assure that its services remain accessible and functioning at maximum capacity, before, during and immediately after the impact of emergencies and disasters.

scholarly journals Improved Sample Quality and Decreased Turnaround Time When Using Plasma Blood Collection Tubes with a Mechanical Separator in a Large University Hospital

2020 ◽  
Author(s):  
Pierre-Olivier Hétu ◽  
Sacha Hobeila ◽  
François Larivière ◽  
Marie-Claire Bélanger
Keyword(s):  
Clinical Chemistry ◽  
Turnaround Time ◽  
Error Rates ◽  
University Hospital ◽  
Blood Collection ◽  
Sample Quality ◽  
Paired Samples ◽  
Deming Regression ◽  
Before And After ◽  
The Impact

Abstract Background Serum is commonly used for clinical chemistry testing but many conditions can affect the clotting process, leading to poor sample quality and impaired workflow. With serum gel tubes, we found a high proportion of sample probe aspiration errors on our Beckman AU5800 analyzers. We decided to implement the BD Barricor™ plasma tubes, and we validated an off-specification centrifugation scheme and verified that results obtained for 65 chemistry and immunochemistry tests were comparable to those obtained in serum gel tubes. Finally, we evaluated the impact of this new tube on sample error rate and laboratory turnaround time. Methods To validate centrifugation settings, 50 paired samples were collected in Barricor tubes and centrifuged at 1912 × g for 10 min or 5 min (off-specification). To compare serum gel tubes with Barricor plasma tubes, 119 paired samples were collected from volunteers and results were analyzed using weighed Deming regression. Finally, the proportion of aspiration errors and laboratory TAT for potassium were measured before and after implementing Barricor tubes. Results Barricor tubes showed clinically acceptable equivalence to serum gel tubes for the studied analytes, and the off-specification centrifugation scheme did not affect the results. Implementing Barricor tubes improved the laboratory workflow by decreasing the aspiration error rates (2.01% to 0.77%, P < 0.001) and lowering hemolysis (P < 0.001). The laboratory TAT for potassium were also significantly lowered (P < 0.001). Conclusion Use of Barricor tubes instead of serum gel tubes leads to better sample quality, shorter more reproducible laboratory TAT, and decreases costs associated with error management.

Assuring the quality of interpretative comments in clinical chemistry

2016 ◽  
Vol 54 (12) ◽  
Author(s):  
Samuel Vasikaran ◽  
Kenneth Sikaris ◽  
Eric Kilpatrick ◽  
Jane French ◽  
Tony Badrick ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Clinical Chemistry ◽  
Continuing Professional Development ◽  
Laboratory Staff ◽  
Laboratory Services ◽  
Method Of Assessment ◽  
The Impact ◽  
Eqa Schemes ◽  
Interpretative Comments

AbstractThe provision of interpretative advice on laboratory results is a post-analytic activity and an integral part of clinical laboratory services. It is valued by healthcare workers and has the potential to prevent or reduce errors and improve patient outcomes. It is important to ensure that interpretative comments provided by laboratory personnel are of high quality: comments should be patient-focused and answer the implicit or explicit question raised by the requesting clinician. Comment providers need to be adequately trained and qualified and be able to demonstrate their proficiency to provide advice on laboratory reports. External quality assessment (EQA) schemes can play a part in assessing and demonstrating the competence of such laboratory staff and have an important role in their education and continuing professional development. A standard structure is proposed for EQA schemes for interpretative comments in clinical chemistry, which addresses the scope and method of assessment including nomenclature and marking scales. There is a need for evidence that participation in an EQA program for interpretative commenting facilitates improved quality of comments. It is proposed that standardizing goals and methods of assessment as well as nomenclature and marking scales may help accumulate evidence to demonstrate the impact of participation in EQA for interpretative commenting on patient outcome.

Clinical Pathology Testing Recommendations for Nonclinical Toxicity and Safety Studies

1992 ◽  
Vol 20 (3-2) ◽  
pp. 539-543 ◽  
Author(s):  
Kurt Weingand ◽  
John Bloom ◽  
Michael Carakostas ◽  
Robert Hall ◽  
Maria Helfrich ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Clinical Chemistry ◽  
Clinical Pathology ◽  
Regulatory Agencies ◽  
Blood Collection ◽  
Safety Studies ◽  
Safety Assessments ◽  
American Society ◽  
Clinical Laboratory Testing ◽  
Technical Recommendations

Clinical pathology testing in nonclinical toxicity and safety studies is an important part of safety assessment. In recent years, clinical laboratory testing has rapidly expanded and improved. Some government regulatory agencies provide guidelines for clinical pathology testing in nonclinical toxicity and safety studies. To improve these testing guidelines and the resultant safety assessments, the American Association for Clinical Chemistry's Division of Animal Clinical Chemistry and the American Society for Veterinary Clinical Pathology formed a joint committee to provide expert recommendations for clinical pathology testing of laboratory species involved in subchronic and chronic nonclinical toxicity and safety studies. These recommendations include technical recommendations on blood collection techniques and hematology, serum chemistry, and urinalysis tests.

Adequacy of Pathology Resident Training for Employment: A Survey Report From the Future of Pathology Task Group

2007 ◽  
Vol 131 (4) ◽  
pp. 545-555 ◽  
Author(s):  
Mary E. Kass ◽  
James M. Crawford ◽  
Betsy Bennett ◽  
Teresa M. Cox ◽  
Margaret M. Grimes ◽  
...  
Keyword(s):  
Residency Training ◽  
Clinical Laboratory ◽  
Medical Knowledge ◽  
Clinical Pathology ◽  
Resident Training ◽  
Recent Change ◽  
Subspecialty Training ◽  
Residency Programs ◽  
Anatomic Pathology ◽  
Recent Graduates

Abstract Context.—The recent change in accreditation requirements for anatomic pathology and clinical pathology residency training from 5 to 4 years and the rapid advances in technologies for pathology services have sparked a renewed debate over the adequacy of pathology residency training. In particular, perceived deficiencies in training have been declared from a variety of sources, both in the form of recent editorial opinions and from surveys of community hospital pathologist employers in 1998, 2003, and 2005 by Dr Richard Horowitz. Objective.—To obtain more comprehensive data on the perceptions of strengths and weaknesses in pathology residency training. Design.—The College of American Pathologists conducted a survey of potential pathology employers (senior College of American Pathologists members, members designated as head of group, and members of the Association of Directors of Anatomic and Surgical Pathology). Also surveyed were recent graduates of pathology residency programs, who were identified as being junior members of the College of American Pathologists, were recent recipients of certification from the American Board of Pathology, or were contacted through their directors of pathology residency programs. Results.—There were 559 employer respondents, of whom 384 were responsible for hiring and/or supervising new pathologists. There were 247 recent graduates of pathology residency training programs who responded. From the employers' standpoint, the majority expressed overall satisfaction with recent graduates, but almost one third of employers indicated that new hires had a major deficiency in a critical area. Specific areas of deficiency were clinical laboratory management and judgment in ordering special stains and studies. In addition, one half of employers agreed that more guidance and support for newly trained pathologists is needed now than was required 10 years ago. Academic employers generally were more satisfied than private sector employers. Newly trained pathologists did not appear to be inappropriately overconfident in their abilities. In addition, their perceptions of those specific areas in which they are most and least prepared are very similar to the ratings provided by employers. On average, newly trained pathologists' ratings of their own preparedness are highest for specific aspects of general pathology and anatomic pathology, and lowest for specific aspects of clinical pathology and administration. In selecting new pathologists, employers perceived medical knowledge and interpersonal skills as the most important discriminating applicant characteristics. When new employees were asked why they thought they were offered their position, the discriminating qualifications cited most often were academic background and training, as well as completion of a fellowship and subspecialty training. Conclusions.—It is our hope that the results of this survey can be used as input for further discussions and recommendations for training of pathology residents so as to further advance the ability of pathologists to provide quality patient care upon their graduation from training.

scholarly journals 1235. A Survey of Surgical Site Infection (SSI) Surveillance Practices in US Hospitals, and their Association with SSI Rates

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S445-S445
Author(s):  
Aurora E Pop-Vicas ◽  
Fay Osman ◽  
Nasia Safdar
Keyword(s):  
Colon Surgery ◽  
Data Sources ◽  
University Hospital ◽  
Bivariate Analysis ◽  
Full Time ◽  
Critical Access Hospitals ◽  
University Hospitals ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Impact

Abstract Background Current US hospital reimbursement models rely on self-reported SSI rates. The impact of variability in SSI surveillance on publicly reported SSI rates is unknown. Methods Cross-sectional survey to US hospitals administered during November 18 – 2/19 through the Association for Professionals in Infection Control. We assessed SSI surveillance practices, and asked for self-reported facility standardized infection ratios (SIR) for hysterectomy and colon surgeries. We performed bivariate analysis and used Kendall’s ranks correlation for trend analysis. Results Of the 2,851 hospitals surveyed, 491 (17.2%) responded. Table 1 shows facility descriptors. Critical Access Hospitals (OR 6.11 [3.12 – 11.750, P < 0.005) and Ambulatory Surgical Centers (OR 3.92 [1.68 – 8.64], P < 0.001) were more likely to have less than one full-time ICP. University Hospitals were more likely to have ≥4 ICPs (OR 12.15 [6.73 – 22.04, P < 0.001). The majority (83%) of the 477 respondents reported electronic software for SSI surveillance, with Epic (23%), Theradoc (22%), and Cerner (11%) as the most common packages used. Manual surveillance was more likely for Critical Access Hospitals (OR 2.80 [1.47 – 5.19], P < 0.001). University Hospitals were more likely to have higher rates in 2016 for colon surgery (P = 0.02) and hysterectomy (P = 0.002). Table 2 shows characteristics of SSI surveillance practices reported by study participants. Ambulatory Surgical Center ICPs were more likely to use reports from surgeons and/or surgical staff as the initial trigger for SSI surveillance. University Hospital ICPs were significantly more likely to spend increased time (mean hours/month 69.77 vs. 28.99, P < 0.001), and to use more data sources for SSI review (mean 4.58 vs. 3.99, P = 0.001). In our trend analyses, we found the number of data sources used for SSI surveillance to be positively associated with higher SSI rates: (KT =0.14, P = 0.028 for colon SIR in 2017; KT = 0.20, P = 0.009; KT = 0.25, P = 0.001 for hysterectomy SIR in 2016 and 2017, respectively). Conclusion SSI surveillance practices across US hospitals vary significantly, and rigorous surveillance methods are associated with higher SSI rates. Standardizing SSI surveillance is necessary to accurately capture SSI burden of disease. Disclosures All authors: No reported disclosures.

Impact of Financial Management on Improving Quality at Jordanian Public University Hospitals

2020 ◽  
Vol 19 (03) ◽  
pp. 2050025
Author(s):  
Atef T. Al Raoush ◽  
Ashraf A’aqoulah ◽  
Samir Albalas ◽  
Seif Athamneh
Keyword(s):  
Financial Management ◽  
Linear Regression Analysis ◽  
Hospital Staff ◽  
Public University ◽  
University Hospital ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
University Hospitals ◽  
Financial Management System ◽  
The Impact

The main purpose of this study was to investigate the impact of financial management on improving quality at the public university hospitals in Jordan. We used a quantitative method with a sample of 220 public university hospital staff. Using simple linear regression analysis, we showed via our findings a significant impact of the financial management dimension on the quality management dimension. These findings emphasise that using a proficient financial management system would improve the quality of services and overall organisational performance in the Jordanian public healthcare sector.

scholarly journals The roadmap for implementing value based healthcare in European university hospitals - consensus report and recommendations

2021 ◽  
Author(s):  
Yolima Cossio-Gil ◽  
Tanja Stamm ◽  
Maisa Omara ◽  
Carolina Watson ◽  
Joseph Casey ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Performance Indicators ◽  
Medical Personnel ◽  
University Hospital ◽  
Current Status ◽  
University Hospitals ◽  
Patient Pathways ◽  
Barriers To Implementation ◽  
European University ◽  
Consensus Report

Value based healthcare (VBHC) aims at improving patient outcomes while optimizing the use of hospitals' resources among medical personnel, administrations and support services through an evidence-based, collaborative approach. In this paper, we present a blueprint for the implementation of VBHC in hospitals, based on our experience as members of the European University Hospital Alliance (EUHA). The EUHA is a consortium of nine large hospitals in Europe and aims at increasing quality and efficiency of care to ultimately drive better outcomes for patients. The blueprint describes how to prepare hospitals for VBHC implementation, analyses gaps, barriers and facilitators and explores the most effective ways to turn patient pathways to a process that results in high value care. Using a patient centric approach, we identified four core minimum components that must be established as cornerstones and seven organisational enablers to waive the barriers to implementation and ensure sustainability. The blueprint guides through pathway implementation and establishment of key performance indicators in six phases, which hospitals can tailor to their current status on their way to implement VBHC.

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