Clinicians’ and laboratory medicine specialists’ views on laboratory demand management: a survey in nine European countries

Diagnosis ◽  
2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Mercedes Ibarz ◽  
Janne Cadamuro ◽  
Zorica Sumarac ◽  
Joao Tiago Guimaraes ◽  
Svetlana Kovalevskaya ◽  
...  
Keyword(s):  
Health Care ◽  
Laboratory Tests ◽  
Demand Management ◽  
Health Care Expenditure ◽  
Management Strategies ◽  
Laboratory Medicine ◽  
Current Status ◽  
Small Scale ◽  
Appropriate Use ◽  
Inappropriate Use

AbstractBackgroundLaboratory tests are an essential aspect of current medical practice and their use has grown exponentially. Several studies however have demonstrated inappropriate use of laboratory testing. This inappropriateness can lead to delayed or wrong diagnosis, negatively impacting patient safety and an increase in health care expenditure. The aim of the present small-scale survey was to obtain information on the current status of demand management in European laboratories, as well as the opinions of laboratory and clinical professionals in this regard.MethodsTwo surveys were developed, one for laboratory specialists and one for clinicians, covering information on current use, knowledge and opinions on the possible impact of different demand management strategies on patient outcome and health care costs. Additionally, we asked for the current state and willingness on collaboration of laboratory specialists and clinicians.ResultsOne hundred and fifty responses, 72 laboratory specialists and 78 clinicians, from nine countries were received. Developing local ordering protocols/profiles in collaboration with clinicians was the most used strategy (80.3% of laboratories). Of clinicians, 85.6% considered measures to ensure appropriate use of tests necessary and 100% were interested in advice/information about their indication. Of the laboratory specialists 97.2% were either already participating or willing to participate in multidisciplinary groups on the appropriateness of test demand as were 60.3% of clinicians, and 85.9% of clinicians were interested in attending activities about laboratory test demand management.ConclusionsThe results of our survey show that tools to improve the appropriate use of laboratory tests are already regularly used today. Laboratory medicine specialists as well as clinicians are willing to undertake additional shared activities aimed at improving patient-centered laboratory diagnostic workup.

scholarly journals Laboratory medicine in central and eastern Europe: Can we catch up?

2004 ◽  
Vol 23 (3) ◽  
pp. 299-304 ◽  
Author(s):  
Gábor Kovács
Keyword(s):  
Health Care ◽  
Eastern Europe ◽  
Medical Training ◽  
Health Care Expenditure ◽  
Laboratory Medicine ◽  
European Countries ◽  
Medical Laboratories ◽  
Health And Disease ◽  
Catch Up ◽  
Central Eastern

Laboratory medicine, as defined by the IFCC and FESCC, is the application of chemical, molecular and cellular concepts and techniques to the understanding and evaluation of human health and disease. At the core of the discipline is the provision of results of measurements and observations relevant to the cause of disease, the maintenance of health and the conversion of these data into specific and general patient- and disease- related information at the laboratory-clinician interface. The discipline is committed to deepening the understanding of health and disease through fundamental and applied research. Furthermore, there are increasing health care expectations and consequently increasing demands of health care resources. Because of the increasing health costs, governments of many European countries have cut health care expenditure, often by decreasing the funding of acute care facilities, closing hospitals, outsourcing services or privatizing health care. Medical laboratories, highly dependent on rapidly changing, expensive and sophisticate technologies, have especially been affected by these policies. Several trends in medical laboratories are developing simultaneously: ? Centralization of diagnostic medical laboratories, rationalization of services, increased emphasis on cost-benefit analysis and cost-effective total patient care, linked to improving outcomes. ? Development of highly specialized laboratories at the interface with research. ? Implementation of point of care technology. ? Development of molecular biology procedures improving diagnosis of infections and inherited diseases. ? Computerization and telecommunication, which facilitates fast communication between laboratory and clinicians. ? Automation and robotics are changing the face of classic laboratories. ? A general trend towards accreditation or certification of laboratories in order to increase and recognize quality and excellence, including consultation services, pre -and post-analytical procedures. Medical laboratory specialists, whether of medical or non-medical training background, are responsible for comprehensive laboratory services including production of analytical results, consultation with clinicians, management, quality assurance, and computer technology. When possible, they conduct research and training in laboratory medicine. There are considerable differences among countries - in particular between highly developed countries of the European Union and countries of Central/Eastern Europe - in social, economical and health system developments, which affect the practice of medicine. The ultimate goal of laboratory specialists in the Central/Eastern European countries is to catch up with all these processes and also to reduce the gap between east and west in this respect. However, sufficient governmental financial resources are lacking as well. Thus, national laboratory societies bear a higher than ever responsibility in working out and implementing successful strategies, convincing public opinion, political opinion-leaders and the media about the importance of laboratory medicine, a discipline inevitable for successful predictive, preventive and clinical curative medicine.

scholarly journals The role of evidence-based laboratory medicine in health service

2002 ◽  
Vol 21 (3) ◽  
pp. 245-254 ◽  
Author(s):  
Nada Majkic-Singh
Keyword(s):  
Health Care ◽  
Clinical Experience ◽  
Evidence Based Medicine ◽  
Laboratory Tests ◽  
Laboratory Medicine ◽  
Systematic Research ◽  
Evidence Based ◽  
External Evidence ◽  
Based Medicine ◽  
The Impact

Evidence-based laboratory medicine (EBLM) is the use of the current best evidence of the utility of laboratory tests in making decisions about the care of individual patients. This practice means integrating laboratory and clinical experience with the last available external evidence from systematic research. It means that the definition of EBLM focuses on two key elements: experience and evidence from systematic research. Although the term evidence-based medicine (EBM) was created in Canada at Mc Master University by a group lad by Dr Gard Guyatt, there are various claims as to the origin of its practice. Regardless of its origins, many factors have come together over the past 30 years to drive the movement to EBM. One factor is those individual physicians, faced with numerous medical informations; the second factor is the global phenomenon of increasing health care costs and third is that patients who have generally more education, want the best in diagnostics and therapies. It means that evidence-based medicine has been driven by the need to cape with information overload, by costcontrol, and by public impatient for the best in diagnostics and treatment. Clinical guidelines care maps, and outcome measures are quality improvement tools for the appropriateness, efficiency and effectiveness of health services. Laboratory professionals must direct more effort to demonstrating the impact of laboratory tests on a greater variety of clinical outcomes. Evidence-based laboratory medicine aims to advise clinical diagnosis and management of disease through systematic researching and disseminating generalisible new knowledge that meets the standard of critical review on clinically effective practice of laboratory investigations. In laboratory medicine, the use of tests increases; new tests are constantly introduced, but "old" tests are seldom removed from the repertoire. This, together with limited public funds for the health care should underline the challenge for laboratory professionals to provide evidence for the utility of different tests. This practice means integrating laboratory and clinical experience with the best available external evidence from systematic research therefore, it is important that advice given by laboratory medicine professionals are sound and based on evidence in the pre-analytical, analytical, and post-analytical phases of the diagnostic process. This paper provides an insight into the rationale, methodology and the phases of the EBLM.

scholarly journals Biomarkers for Diabetes Complications: The Results of Several Clinical Studies

2011 ◽  
Vol 30 (3) ◽  
pp. 207-212 ◽  
Author(s):  
Diler Aslan
Keyword(s):  
Public Health ◽  
Health Care ◽  
Clinical Studies ◽  
Diabetes Complications ◽  
Health Care Expenditure ◽  
Laboratory Medicine ◽  
National Health Care ◽  
The Public ◽  
Health Communities ◽  
Microvascular And Macrovascular Complications

Biomarkers for Diabetes Complications: The Results of Several Clinical StudiesDiabetes is a common metabolic disorder. Its microvascular and macrovascular complications contribute to death, disabilities, and reduction in life expectancy in diabetes. It is a costly disease, and affects not only the patient and family, but also the public health, communities and society. It takes an increasing proportion of the national health care expenditure. The prevention of the development of diabetes and its complications is a major concern. Biomarkers have been investigated for understanding the mechanisms of the development and progression of diabetic complications. In this paper, the biomarkers which are recommended in the clinical practice and laboratory medicine guidelines, and which have been investigated for prediction or diagnosis of diabetes complications, have been reviewed. The results of several clinical studies will be summarized.

scholarly journals A study on personal protective equipment use among health care providers, Tamil Nadu

2018 ◽  
Vol 5 (5) ◽  
pp. 1771 ◽  
Author(s):  
Archana Lakshmi P. A. ◽  
Gladius Jennifer H. ◽  
Meriton Stanly A. ◽  
Christina Mary Paul
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Personal Protective Equipment ◽  
Tamil Nadu ◽  
Cross Sectional Study ◽  
Protective Equipment ◽  
Care Providers ◽  
Appropriate Use ◽  
Cross Sectional ◽  
Inappropriate Use

Background: Personal protective equipment (PPE) limits the health care workers contact with all secretions or biological products. This study was planned to find gaps between use of PPE among the health care providers (HCPs). The objective of the study was to evaluate appropriate use of PPE among health care providers in tertiary centres Tamil Nadu.Methods: A cross sectional study was done during November 2014 to October 2015 in two tertiary health care institutions. All health care providers (Doctors, nurses and technicians) who had more than one year experience and gave informed consent were included. Data collected by pretested structured questionnaire. Data analysis was done using SPSS 20v and summarized by descriptive statistics. Proportion and Chi-square was calculated at 5% α.Results: HCPs included in the study were 1060. Among them, there were 412(38.9%) doctors, 550 (51.9%) nurses and 98 (9.2%) technicians. Among 862 HCPs who work outside the operation theatre (OT) and ICU, appropriate uses of PPE were only 156 (18.1%). It was high among doctors 109 (31.5%) followed by nurses 39 (9.3%) and technicians 8 (8.2%) which was statistically significant p=0.0001. HCPs working in OT and ICU were 423 and 183 respectively. Among HCPs working in OT, appropriate use of gloves, mask, apron, gown and hair cover was 100%. But the use of goggles and shoe cover was very low. The reasons for inappropriate use of PPE was non availability 562 (78%) followed by not aware of the importance 77 (11%).Conclusions: The study showed inappropriate use and lack of adequate knowledge on infection control practices emphasizing that periodic re-training is needed. 

160: Cost-Effectiveness of Medical Management Strategies of Nephrolithiasis in Different Health Care Systems

2004 ◽  
Vol 171 (4S) ◽  
pp. 42-43 ◽  
Author(s):  
Yair Latan ◽  
David M. Wilhelm ◽  
David A. Duchene ◽  
Margaret S. Pearle
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Medical Management ◽  
Health Care Systems ◽  
Management Strategies ◽  
Care Systems

Health Informatics: Handle with Caution

1997 ◽  
Vol 36 (02) ◽  
pp. 79-81
Author(s):  
V. Leroy ◽  
S. Maurice-Tison ◽  
B. Le Blanc ◽  
R. Salamon
Keyword(s):  
Health Care ◽  
Data Management ◽  
Medical Informatics ◽  
Health Care Professionals ◽  
Data Security ◽  
Health Informatics ◽  
The Other ◽  
Inappropriate Use

Abstract:The increased use of computers is a response to the considerable growth in information in all fields of activities. Related to this, in the field of medicine a new component appeared about 40 years ago: Medical Informatics. Its goals are to assist health care professionals in the choice of data to manage and in the choice of applications of such data. These possibilities for data management must be well understood and, related to this, two major dangers must be emphasized. One concerns data security, and the other concerns the processing of these data. This paper discusses these items and warns of the inappropriate use of medical informatics.

Institutional Repositories in Swaziland: An Exploratory Study

Mousaion ◽  
2019 ◽  
Vol 36 (2) ◽  
Author(s):  
Ncamsile Nombulelo Dlamini ◽  
Maritha Snyman
Keyword(s):  
Open Access ◽  
Exploratory Study ◽  
Management Strategies ◽  
Current Status ◽  
Academic Institutions ◽  
African Countries ◽  
Institutional Repositories ◽  
Limited Knowledge ◽  
Advocacy Strategies ◽  
Awareness Level

The purpose of this paper is to assess the current status of institutional repositories (IRs) in Swaziland’s academic institutions. The factors under discussion are the number of IRs in Swaziland, their usage, the level of awareness of these IRs, and the challenges that prevent the implementation of IRs in Swaziland’s academic institutions. A webometric approach, interviews and semi-structured questionnaires completed by IR managers or librarians working for the Swaziland’s academic institutions were used to collect data for this study. Responses were received from 11 respondents. The findings indicated that there is one IR in Swaziland that is accessible to the institution’s community via the intranet. This IR was, at the time when this study took place, not registered in any of the international registries of repositories, such as the Registry of Open Access Repositories (ROAR) and the Directory of Open Access Repositories (OpenDOAR). Currently, this IR faces problems of insufficient content, a low level of IR awareness, limited knowledge of effective and appropriate IR advocacy strategies and limited knowledge of effective IR implementation and management strategies. Based on the findings and information gained from a literature review of IRs, the paper recommends strategies to academic institutions in Swaziland that may enable them to increase their number of IRs, the awareness level of IRs and consequently the use of IRs. The findings and recommendations may also benefit other African countries in similar situations.  

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