Variation in Laboratory Utilization and Correlation with Hospital Bed Utilization: Experience of a Trauma-Care Hospital during the COVID-19 Pandemic

Objectives The present study was planned with the following objectives: (i) to calculate the difference in frequency of laboratory test ordered and use of consumables between the prepandemic and pandemic phases, (ii) to determine and compare the monthly average number of tests ordered per patient between the prepandemic and pandemic phases, and (iii) to correlate the monthly test ordering frequency with the monthly bed occupancy rate in both phases. Materials and Methods Records of laboratory tests ordered and use of consumables were collected for the prepandemic phase (1.8.2019 to 31.3.2020) and the pandemic phase (1.4.2020 to 31.10.2020). The absolute and relative differences were calculated. Monthly average number of tests ordered per patient and bed occupancy rate between prepandemic and pandemic phases was determined, compared, and correlated. Statistical Analysis The absolute and the relative differences between the two periods were calculated. The continuous variables were analyzed between groups using Mann–Whitney U test. Spearman correlation was used to correlate the monthly test ordering frequency with the monthly bed occupancy rate in both phases. Results A total of 946,421 tests were ordered, of which 370,270 (39%) tests were ordered during the pandemic period. There was a decrease in the number of the overall laboratory tests ordered (12%), and in the use of blood collection tubes (34%), and an increase in the consumption of sanitizers (18%), disinfectants (3%), masks (1633%), and gloves (7011%) during the pandemic period. Also, the monthly average number of tests ordered per patients significantly reduced (p-value < 0.001). Test ordering frequency had strong positive correlation with bed occupancy rate during pandemic (Spearman co-efficient = 0.73, p-value = 0.03). Conclusions An overall decline in laboratory utilization during pandemic period was observed. Understanding and correlating the trends with hospital bed utilization can maximize the productivity of the laboratory and help in better preparedness for the challenges imposed during similar exigencies.

A Retrospective Review of the Effect of COVID-19 Pandemic on Laboratory Utilization

Introduction/Objective We performed a retrospective analysis of test volumes in clinical pathology prior to and during the COVID-19 pandemic to better understand the impact of the pandemic on our laboratory utilization. Methods/Case Report The laboratory information system was queried for test order volume in 2019 and 2020 using Discern Analytics 2.0. Representative tests including C-reactive protein (CRP), D-dimer, fibrinogen, ferritin, lactate dehydrogenase (LDH), procalcitonin, prothrombin time (PT), point of care iSTAT blood gas analysis, ABO and Rhesus typing (ABORh), antibody screening, flow cytometry, and serum protein electrophoresis (SPEP). Data was analyzed using Microsoft Excel 2013. Results (if a Case Study enter NA) The data showed an increase in the number of tests ordered and verified in the in-patient setting. The increase was most substantial for D-dimer, CRP and LDH with a percentage increase of approximately 200% on each test from year 2019 to 2020. An increase of 73% and 57% was noted for ferritin and fibrinogen respectively. A slight decrease in volume was noted for tests ordered in the out-patient setting including SPEPs during the pandemic. There was no significant change in the number of orders verified for point of care ISTAT blood gas testing between 2019 and 2020. Procalcitonin test volume increased steadily from its implementation in May 2020 with a steep rise in test volume in November and December. A total of 75,295 SARS-CoV-2 molecular tests were ordered between March and December 2020 with approximately 80% of the orders being performed as a send- out test. Conclusion The COVID-19 pandemic has had a substantial impact on laboratory utilization with significant volume increases in tests that guide the management of hospitalized COVID-19 patients and slight decrease in tests ordered mostly in the outpatient setting. These results may help guide current and future decisions relating to laboratory operations during pandemics.

Optimalisasi Fungsi Laboratorium IPAMelalui Kegiatan Praktikum Di SMP Negeri 4 Sinjai Timur Kabupaten Sinjai

ABSTRACK. This study aims to determine the optimization of the science laboratory function through practical activities for class VIII students of SMP Negeri 4 Sinjai Timur, Sinjai Regency. The type of research used in this research is descriptive qualitative research which will describe the results of measurements on the optimization of the functions of the science laboratory through practicum. The population of this study were all students of class VIII A of SMP Negeri 4 Sinjai Timur, Sinjai Regency, totaling 31 people with a distribution of 11 males and 20 females. The research instruments used were questionnaires, observations and document studies. The data obtained were then analyzed using data processing and data analysis. Based on data analysis that research on how to optimize the function of the science laboratory through student practicum activities, it was concluded that the implementation aspect of biology practicum learning showed that on average each questionnaire item given to students gave an answer category above 50% with categories strongly agree and agree and at aspects of laboratory utilization based on the questionnaires that researchers have distributed regarding optimizing the functions of the science laboratory through practical activities for class VIII students of SMP Negeri 4 Sinjai Timur on average give answers strongly agree and agree with a percentage above 50%.

Evaluasi Pemanfaatan Laboratorium Biologi SMAN/MAN se-kecamatan Godean

The laboratory has an important role in the implementation of learning, especially in the form of practicum. The use of school laboratories needs to be evaluated as a form of running school management. This study aims to determine: 1) the Principal's carrying capacity (contexts); 2) Resources support (input); 3) Laboratory utilization and constraints (process); 4) The percentage of students' interest in studying in the laboratory (product). This evaluation research uses the context, input, process, and product (CIPP) model. The research subjects were school principals, laboratory heads in SMA/MA Negeri in Godean sub-district, laboratory assistants at SMA N 1 Godean, two biology teachers from each school, and students SMA N 1 Godean 89 people and MAN 1 Sleman 80 people using proportionate stratified random sampling. The research object is the use of biological laboratories. Data collection techniques used are observation, interviews, questionnaires, and documentation. The data analysis technique used is in the form of qualitative and quantitative descriptive analysis. The evaluation results by CIPP obtained: 1) Context, the support capacity provided by the Principal by facilitating laboratory utilization activities; 2) Input, the availability of infrastructure suggestions is used to support learning through practicum and demonstrations. Management is carried out by laboratory personnel. Management includes planning, arrangement, arrangement, monitoring, and evaluation; 3) Process, the laboratory is used based on its function. The obstacles faced are infrastructure, limited time, and human resources; 4) Product, the percentage of student interest in learning in the laboratory of SMA N 1 Godean is 94.01% and MAN 1 Sleman is 91.39%.

Is It Time to Remove Total Calcium from the Basic and Comprehensive Metabolic Panels? Assessing the Effects of American Medical Association–Approved Chemical Test Panels on Laboratory Utilization

Background The necessity of individual tests within the most commonly used disease-oriented test panels has not been well established. We evaluated test-ordering practices for total calcium, both before and after implementation of American Medical Association (AMA)–approved panels (basic metabolic panel [BMP] and comprehensive metabolic panel [CMP]) in our electronic ordering system. Methods We performed a retrospective review of all total calcium orders placed during April and June 2018, before and after implementation of the panels. Orders from inpatient, outpatient, and emergency department (ED) care units were totaled, and the percentage of abnormal test results was calculated. We then queried institutional databases to determine the number of unique patients with calcium-related diagnoses and compared the rates from a 5-month period both before and after implementation of the panels. Results Total test volumes and tests per unique patient increased by more than 3-fold after implementation of calcium-containing AMA-approved panels, with the majority of those orders coming from BMPs and CMPs. The rate of low calcium values increased because of the shift toward more inpatient testing; however, the percentage of abnormal results within each patient population (inpatient, outpatient, ED) decreased. The prevalence of hypo- and hypercalcemia-related diagnoses among patients in the 5 months after implementation did not change significantly (1.29% before implementation vs 1.27% after implementation). Conclusions Implementation of BMPs and CMPs dramatically increased total calcium testing volumes without changing the rate of calcium-related diagnoses. The results suggest that the increase in total calcium orders associated with panel-based testing largely constitutes excess or unnecessary testing.