[email protected] || 1 st semester, AY 2011-2012 1 – Introduction to Clinical Pathology Clinical Laboratory • Plays a central role in health care • 70% of all medical decisions are based on laboratory results (Silverstein, 2003) • Philippines: Low national budget for healthcare = Limited funds for government hospital laboratories • A facility where tests are done on specimens from the human body to obtain information about the health status of a patient for the prevention, diagnosis and treatment of diseases. This tests include, but are not limited to, the following disciplines: clinical chemistry, hematology, immunohematology, microbiology, immunology, clinical microscopy, histopathology, cytology, toxicology, endocrinology, molecular pathology and cytogenetics. Purpose of the Laboratory (Kurec, 2000) • To provide clinicians and other healthcare professionals with information to: – Detect disease or predisposition to disease – Confirm or reject a diagnosis – Establish prognosis – Guide patient management – Monitor efficacy of therapy Indications for Ordering Laboratory Examinations • To confirm a clinical impression or to establish a diagnosis • To rule out a diagnosis • To monitor therapy (management guide) • To establish prognosis • To screen for or to detect disease Clinical Laboratory Management • Effective leadership provides the direction of where the organization is going, whereas management provides the “road” to get there (to get things done) Leader versus Manager Traits Leader Manager Administrator Implementer Organizer and developer Maintains control Risk-taker Thinks short term Inspiration Asks how and when Thinks long term Watches bottom line Asks what and why Accepts status quo Challenges status quo Is good soldier Does the right thing Does things right Basic Management Responsibilities Operations Management Human Resource Management Quality assurance Job descriptions Policies and procedures Recruitment and staffing Strategic planning Orientation Benchmarking Competency assessment Productivity assessment Personnel records Legislation/regulations/HPP A compliance Performance evaluation/appraisals Medicolegal concerns Discipline and dismissal Continuing eduction Staff meeting Financial Management Marketing Management Department budgets Customer service Billing Outreach marketing CPT coding Advertising ICD-9 coding Website development Compliance regulations Client education Test cost analysis Fee schedule maintenance Government (DOH) Rules & Regulations • Republic Act No. 4688 s. 1966, “An Act Regulating the Operation and Maintenance of Clinical Laboratories and Requiring the Registration of the Same with the Department of Health, Providing Penalty for the Violation Thereof, and for Other Purposes” • Administrative Order No. 59 s. 2001, “Rules and Regulations Governing the Establishment, Operation and Maintenance of Clinical Laboratories in the Philippines • Administrative No.0027 s. 2007 Revised Rules and Regulations Governing the Licensure and Regulation of Clinical Laboratories in the Philippines Classification of Clinical Laboratories • Classification of Ownership – Government – Private • Classification of Function – Clinical Pathology – Anatomic Pathology • Classification by Institution Character – Institution-based – Freestanding • Classification by Service Capability – General Clinical Laboratory • Primary Category • Secondary Category • Tertiary Category • Limited Service Capability – Special Clinical Laboratory Laboratory Service Model Examples • Primary Laboratory • Secondary Laboratory • Tertiary Laboratory • National Reference Laboratory • Stat Laboratory • Point-of-Care Human Resource • Every clinical laboratory shall be headed and managed by a pathologist, certified either as a Clinical Pathologist, an Anatomic Pathologist, or both by the Philippine Board of Pathology • There shall be an adequate number of medical technologists and other health professionals with documented training and experience to conduct the laboratory procedures
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