scholarly journals Use of The WISN Method to Assess the Health Workforce Requirements for the High-volume Clinical Biochemical Laboratories

2021 ◽  
Author(s):  
Sanja Stankovic ◽  
Milena Santric Milicevic
Keyword(s):  
Health Service ◽  
Clinical Laboratory ◽  
High Volume ◽  
Working Time ◽  
Medical Laboratory ◽  
Laboratory Diagnostics ◽  
Laboratory Staff ◽  
Service Activities ◽  
Laboratory Workers ◽  
Workforce Shortages

Abstract Background: The clinical laboratory services, as an essential part of health care, require appropriate staff capacity to assure satisfaction and improve outcomes for both patients and clinical staff. This study aimed to apply the Workload Indicators of Staffing Need (WISN) method for estimating required laboratory staff requirements for the high-volume clinical biochemical laboratories. Methods: In 2019, we applied the WISN method in all 13 laboratories within the Center for Medical Biochemistry of the University Clinical Centre of Serbia (CMB UCCS). A review of annual routinely collected statistics, laboratory processes observations, and structured interviews with lab staff helped identify their health service and additional activities and duration of these activities. The study outcomes were WISN based staff requirements, WISN ratio and difference, and a recommendation on the new staffing standards for two priority laboratory workers (medical biochemists and medical laboratory technicians).Results: Medical biochemists' and laboratory technicians' annual available working time in 2019 was 1508 and 1347 working hours, respectively, for the workload of 1,848,889 samples. In general, the staff has four health service, eight support, and 15 additional individual activities. Health service activities per sample can take from 1.2 to 12.6 min. Medical biochemists and medical laboratory technicians spend almost 70% and more than 80% of their available working time, undertaking health service activities. The WISN method revealed laboratory workforce shortages in the CMB (i.e., current 40 medical biochemists and 180 medical laboratory technicians as opposed to required 48 medical biochemists and 206 medical laboratory technicians). Workforce maldistribution regarding the laboratory workload contributes to a moderate-high workload pressure of medical biochemists in five and medical laboratory technicians in nine organizational units.Conclusions: The WISN method showed mainly a laboratory workforce shortages and workload pressure in the CMB UCCS. WISN is a simple, easy-to-use method that can help decision-makers and policymakers prioritize the recruitment and equitable allocation of laboratory workers, optimize their utilization, and develop normative guidelines in the field of clinical laboratory diagnostics. WISN estimates require periodic reviews.

scholarly journals THE PROFESSIONAL STANDARD OF A SPECIALIST IN CLINICAL LABORATORY MEDICINE AND ITS EVALUATION BY MEDICAL LABORATORY STAFF

2017 ◽  
Vol 25 (3) ◽  
pp. 63-68
Author(s):  
P. N. Zolotaryov
Keyword(s):  
Higher Education ◽  
Clinical Laboratory ◽  
Laboratory Medicine ◽  
Study Data ◽  
Medical Laboratory ◽  
Laboratory Research ◽  
Laboratory Diagnostics ◽  
Professional Standard ◽  
Laboratory Staff ◽  
Wide Range

The issue of improving the personnel service in clinical laboratory diagnostics is topical, since specialists, having modern knowledge in laboratory research, can not stay aside from active participation during their appointment and interpretation. Training of specialists of this level requires revision of the regulatory framework, namely, the development of professional standards for specialists in clinical laboratory medicine. The survey involved 83 specialists with higher education working in clinical diagnostic laboratories of various forms of ownership in the Samara Region (Russia). In the course of the study, data were obtained reflecting the readiness to perform a number of generalized labor functions of the professional standard. Prior to the evaluation of the criterion of attention paid to the labor function in each group of respondents, we expected to obtain values of 9-10 units. However, in the course of the study, we found that this indicator in various groups of respondents fluctuated in a wide range. We believe that the training of professional stuff with higher education in laboratory medicine should be implemented in parallel with the introduction of the professional standard.

Organization of the work of the medical laboratory service in accordance with the requirements of the standard GOST ISO 15189–2015 «Medical laboratories. Particular requirements for quality and competence»

2020 ◽  
pp. 15-22
Author(s):  
Elena Vitalievna Perminova
Keyword(s):  
Clinical Laboratory ◽  
Medical Laboratory ◽  
Laboratory Research ◽  
Laboratory Diagnostics ◽  
Clinical Diagnostic Laboratory ◽  
Diagnostic Laboratory ◽  
Iso 15189 ◽  
Laboratory Service ◽  
Medical Laboratories

Clinical laboratory diagnostics is a medical specialty, which is based on in vitro diagnostic studies of biomaterial obtained from an individual. At the present stage, there are three main types of organization of the laboratory research process — a laboratory service as part of a medical and preventive institution, a centralized laboratory where biomaterials are delivered for research from various healthcare institutions, as well as mobile laboratories that allow conducting the research directly at the patient’s bedside. This discipline involves the use of a wide variety of diagnostic research methods and the use of a huge number of specific techniques. Their list should include carrying out hematological, microbiological, virological, immunological, serological, parasitic, and biochemical studies. Also, when organizing laboratory diagnostic activities, a number of other studies (cytological, histological, toxicological, genetic, molecular biological, etc.) are provided. A laboratory report is formulated after obtaining clinical data and comparing them with the obtained test results. The quality of laboratory tests is ensured through the systematic implementation of internal laboratory control, as well as participation in a national program for external quality assessment. The activities of the clinical diagnostic laboratory should be organized in accordance with the requirements of the standard GOST R ISO 15189–2015 «Medical laboratories. Particular requirements for quality and competence», which is based on the provisions of two more fundamental standards — ISO 9001 and ISO 17025, and adds a number of special requirements related to medical laboratories.

scholarly journals Inappropriate laboratory testing requests: perspectives of clinical laboratory professionals

2021 ◽  
Vol 3 (3) ◽  
pp. 249-256
Author(s):  
Sultan Alasmari ◽  
Keyword(s):  
Laboratory Testing ◽  
Clinical Laboratory ◽  
Educational Interventions ◽  
Cross Sectional Study ◽  
Medical Laboratory ◽  
Cross Sectional ◽  
Laboratory Staff ◽  
Level Of Satisfaction ◽  
Physician Awareness ◽  
Laboratory Examinations

Introduction: Laboratory examinations constitute a major factor in achieving the correct clinical diagnosis for patients. However, the ordering of unnecessary or inappropriate laboratory testing remains common, with consequent consumption of laboratory resources whether human or material. The present work evaluated the level of satisfaction of laboratory practitioners toward the appropriateness of laboratory tests ordered by physicians. Methods: This cross-sectional study involved a total of 256 medical laboratory practitioners representing different qualifications and health care sectors, who answered several questions concerning their knowledge and attitudes toward inappropriate laboratory testing ordered by physicians. Results: More than 85% of respondents agreed with the definition provided in the survey, which is substantially consistent with prior studies. More than 90% affirmed the associated drain on time and resources. However, discrepant responses were received concerning physician awareness of test availability, and participants reported laboratory staff arguments with physicians due to orders for unnecessary tests. Data showed that unnecessary orders were mainly requested by physicians of less experience. Conclusions: Ultimately, dissatisfaction was manifest among clinical laboratory professionals, and educational interventions are required to moderate request behaviors.

Laboratory services: regaining and maintaining control

2016 ◽  
Vol 29 (5) ◽  
pp. 507-522 ◽  
Author(s):  
Graham R. Lee ◽  
Maria C. Fitzgibbon ◽  
Paula O'Shea
Keyword(s):  
Test Performance ◽  
Best Practice ◽  
Performance Monitoring ◽  
Clinical Laboratory ◽  
Internal Quality ◽  
Laboratory Diagnostics ◽  
Analytical Control ◽  
Content Type ◽  
Laboratory Staff ◽  
Optimal Monitoring

Purpose – After implementing an internal quality control (IQC) programme, the purpose of this paper is to maintain the requisite analytical performance for clinical laboratory staff, thereby safeguarding patient test results for their intended medical purpose. Design/methodology/approach – The authors address how quality can be maintained and if lost, how it can be regained. The methodology is based on the experience working in clinical laboratory diagnostics and is in accord with both international accreditation requirements and laboratory best practice guidelines. Findings – Monitoring test performance usually involves both prospective and retrospective IQC data analysis. The authors present a number of different approaches together with software tools currently available and emerging, that permit performance monitoring at the level of the individual analyser, across analysers and laboratories (networks). The authors make recommendations on the appropriate response to IQC rule warnings, failures and metrics that indicate analytical control loss, that either precludes further analysis, or signifies deteriorating performance and eventual unsuitability. The authors provide guidance on systematic troubleshooting, to identify undesirable performance and consider risk assessment preventive measures and continuous quality improvement initiatives; e.g., material acceptance procedures, as tools to help regain and maintain analytical control and minimise potential for patient harm. Practical implications – The authors provide a template for use by laboratory scientific personnel that ensures the optimal monitoring of analytical test performance and response when it changes undesirably. Originality/value – The proposed template has been designed to meet the International Organisation for Standardisation for medical laboratories ISO15189:2012 requirements and therefore includes the use of External Quality Assessment and patient results data, as an adjunct to IQC data.

scholarly journals Assessment of biosafety measures in clinical laboratories of Al-Madinah city, Saudi Arabia

2018 ◽  
Vol 12 (09) ◽  
pp. 755-761
Author(s):  
Omar Falah Khabour ◽  
Khalil H. Al Ali ◽  
Jamal N. Aljuhani ◽  
Mousa A. Alrashedi ◽  
Fuaad H. Alharbe ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Clinical Laboratory ◽  
Health And Safety ◽  
Daily Basis ◽  
Safety Measures ◽  
Public And Private ◽  
Laboratory Staff ◽  
The Public ◽  
Clinical Laboratories ◽  
Laboratory Workers

Introduction: Workers in clinical laboratories are exposed to occupational hazards on a daily basis and their health and safety may be threatened if appropriate protective standards are not implemented. The aim of this study was to assess the knowledge and practices of clinical laboratory workers towards biosafety measures, in Al-Madinah city, Saudi Arabia. Methodology: Clinical laboratory staff was recruited from both the public and private sectors. A structured self-administered questionnaire was used to achieve the aim of the study. Results: A total of 208 workers participated in the study (64% were males, 57% were from the public sector and 71% held a BSc degree). About 68% of the workers were trained in laboratory safety. The majority (> 80%) followed guidelines for disposing medical wastes, decontamination of sample spills, and use of protective lab coats, gloves, etc. However, among participants, 24.2% used to eat, drink or use gum, 18.3% used cosmetics and 24.6% used the mobile phone in the lab. About 18.4% reported that they continued working with a finger cut, whereas 67% reported that they used to recap needles after blood withdrawal. These unacceptable behaviors were associated with lack of lab safety training (P < 0.05), biology degree holders (P < 0.05), and low experience (3 years and less, P < 0.01). With respect to facilities, most of the laboratories complied with standard safety measures. Conclusion: The majority of the sample showed good laboratory practices with respect to safety measures. However, some behaviors are not accepted and need interventions

scholarly journals Electronic tools in clinical laboratory diagnostics: key examples, limitations, and value in laboratory medicine

2021 ◽  
Vol 45 (6) ◽  
pp. 319-324
Author(s):  
Mary Kathryn Bohn ◽  
Giulia F. Fabiano ◽  
Khosrow Adeli
Keyword(s):  
Clinical Laboratory ◽  
Laboratory Data ◽  
Reference Intervals ◽  
Medical Laboratory ◽  
Laboratory Diagnostics ◽  
Evidence Based ◽  
Complex Data ◽  
Clinical Implementation ◽  
Patient Centered ◽  
Diagnostic Management

Abstract Electronic tools in clinical laboratory diagnostics can assist laboratory professionals, clinicians, and patients in medical diagnostic management and laboratory test interpretation. With increasing implementation of electronic health records (EHRs) and laboratory information systems worldwide, there is increasing demand for well-designed and evidence-based electronic resources. Both complex data-driven and simple interpretative electronic healthcare tools are currently available to improve the integration of clinical and laboratory information towards a more patient-centered approach to medicine. Several studies have reported positive clinical impact of electronic healthcare tool implementation in clinical laboratory diagnostics, including in the management of neonatal bilirubinemia, cardiac disease, and nutritional status. As patients have increasing access to their medical laboratory data, it is essential that accessible electronic healthcare tools are evidence-based and user-friendly for individuals of varying digital and medical literacy. Indeed, studies suggest electronic healthcare tool development processes significantly lack the involvement of relevant healthcare professionals and often present misinformation, including erroneous calculation algorithms or inappropriate interpretative recommendations. The current review provides an overview of the utility of available electronic healthcare tools in clinical laboratory diagnostics and critically reviews potential limitations and benefits of their clinical implementation. The Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) online database is also detailed as an example of a pediatric diagnostic tool with widespread global impact.

scholarly journals The interface between clinicians and laboratory staff: A field study in northern Tanzania

2014 ◽  
Vol 3 (1) ◽  
Author(s):  
Coosje J. Tuijn ◽  
Elizabeth Msoka ◽  
Declare L. Mushi ◽  
Marion Sumari-de Boer ◽  
Jaffu Chilongola ◽  
...  
Keyword(s):  
Qualitative Data ◽  
Geographical Area ◽  
Field Application ◽  
Laboratory Diagnostics ◽  
Laboratory Staff ◽  
Individual Interviews ◽  
Northern Tanzania ◽  
Laboratory Test Results ◽  
Education Levels ◽  
Laboratory Workers

Background: Strengthening the communication and professional relationships between clinicians and laboratory workers is essential in order to positively change clinicians’ attitudes about the reliability of diagnostic tests, enhancing the use of laboratory diagnostics and, ultimately, improving patient care. We developed an analytical framework to gain insight into the factors that influence communication amongst health professionals.Objective: To explore whether the interaction between clinicians and laboratory workers influences the use of laboratory test results in clinical decision making.Methods: Four health facilities in northern Tanzania were selected using convenience sampling, whereas study participants were selected using purposive sampling. The quantitative and qualitative data collection methods included self-administered questionnaires; semistructured, individual interviews; in-depth, individual interviews; and/or focus group discussions with clinicians and laboratory workers. Thematic content analyses were performedon qualitative data based on the framework. Descriptive statistical analyses of quantitative data were conducted using Microsoft Excel.Results: Contact between clinicians and laboratory professionals is seldom institutionalised and collaboration is rare. The clinicians believe collaboration with laboratory staff is a challenge because of the gap in education levels. Laboratory workers’ education levels areoften lower than their positions require, leading to clinicians’ lack of respect for and confidencein laboratory professionals, which compromises the laboratory staff’s motivation.Conclusions: Hospital managers, clinicians and laboratory workers need to recognise the critical and complementary roles each professional plays and the importance of addressing the gap between them. Field application of the framework proved successful, justifying the expansion of this study to a larger geographical area to include additional healthcare institutions

scholarly journals Inter-rater Variability in Malaria Microscopy at the LEKMA Hospital, Ghana

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Andrew Nii Adzei Bekoe ◽  
Emmanuel Alote Allotey ◽  
Elliot Elikplim Akorsu ◽  
Albert Abaka-Yawson ◽  
Samuel Adusei ◽  
...  
Keyword(s):  
Sub Saharan Africa ◽  
Medical Laboratory ◽  
Rater Agreement ◽  
Laboratory Personnel ◽  
Parasite Count ◽  
Laboratory Staff ◽  
Significant Difference ◽  
Expected Outcome ◽  
Sub Saharan ◽  
Group B

Background. Malaria remains a major cause of morbidity and mortality worldwide and particularly in sub-Saharan Africa where it is endemic. As such, it is important that a proper diagnosis is made before treatment is initiated. Malaria parasite count plays a key role in the diagnosis and management of malaria. Variations in ratings by laboratory personnel can impact negatively on the treatment regimen for malaria-infected patients. The study is thus aimed at evaluating and comparing the proficiency and parasitaemia counts by two different categories of laboratory staff at the LEKMA Hospital, Ghana. Materials and Methods. A total of 200 confirmed malaria-positive samples were used in the study. Six thick and thin films were prepared from each sample and uniquely labelled. Two of the six slides were given to two WHO-accredited malaria microscopists to examine and report their respective parasite count/μl ( parasite   count / WBC × 8000 ). These were used as the reference for the two categories of laboratory staffs: rater A being diploma holders (Technical Officers referred to as untrained rater) and rater B being degree holders (Medical Laboratory Scientist referred to as trained rater) at the LEKMA Hospital. Results. In comparison to the expected outcome, the parasite count by the rater group A (190 (151-239)]) and the rater group B (177 (140-224)) demonstrated significant positive correlation ( r = 0.995 , p < 0.0001 vs. r = 0.995 , p < 0.0001 , respectively) with the expected outcome in the cases of heavy parasitaemia. A statistically significant difference ( p < 0.05 ) between counts by the different raters in low parasitemia was observed in this study. A persistent nosedive inter-rater agreement from k = 0.82 to k = 0.40 with increasing density cutoff was observed in this study. Conclusion. The study observed that the degree of inter-rater agreement of parasite density count by various categories of laboratory personnel is almost perfect. However, the parasite count between raters varied significantly with very low levels of parasitemia but better correlated with heavy parasitemia.

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