Laboratory medicine Laboratory medicine disciplinary branch of medicine providing the healt em with laboratory results....(R.Dybkaer) al laboratory 5189, 3.8: atory for the biological, microbiological, immunolo cal, immunohaematological, biophysical, cytological logical, or other examination of materials derived uman body....
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Laboratory medicineLaboratory medicine
Multidisciplinary branch of medicine providing the health care system with laboratory results....(R.Dybkaer)
Medical laboratoryISO 15189, 3.8:laboratory for the biological, microbiological, immunological,chemical, immunohaematological, biophysical, cytological, pathological, or other examination of materials derived from the human body....
Future trends and challengesFuture trends and challenges
1. Financial limitations forces concentration of resources2. Overlapping techniques also require laboratories
"without walls"3. Genomics, transcriptomics, proteonomics, metabolomics4. Professional expertise5. Improvement of quality of service and of consultation
in the sense of TDM6. POCT engagement of central laboratories7. Justification of laboratory medicine as a discipline
Competence centre for LMCompetence centre for LM
1.Step: integration of clinical microbiology in the centrallaboratory = Institute for Laboratory Medicine
Future trends and challengesFuture trends and challenges
1. Financial limitations forces concentration of resources2. Overlapping techniques also require laboratories
"without walls"3. Genomics, transcriptomics, proteonomics, metabolomics4. Professional expertise5. Improvement of quality of service and of consultation
in the sense of TDM
6. POCT engagement of central laboratories7. Justification of laboratory medicine as a discipline
Strategies of central laboratories for engagement in POCTStrategies of central laboratories for engagement in POCT
1. The top management should decide on the responsibilities
2. Installation of a POCT commission chaired by the laboratory director(selection and justification of POCTinstruments, quality assurance program,comparability of results with laboratory results)
3. Nomination of a POCT coordinator
4. On-line network between laboratory and POCT stations
Indications for POCT glucoseIndications for POCT glucose
1. at least 5 tests per week
2. insulin therapy
3. suspicion for hypoglycemia
4. training of patients
not for diagnosing type 2 DM or glucose intolerance
Future trends and challengesFuture trends and challenges
1. Financial limitations forces concentration of resources2. Overlapping techniques also require laboratories
"without walls"3. Genomics, transcriptomics, proteonomics, metabolomics4. Professional expertise5. Improvement of quality of service and of consultation
in the sense of TDM6. POCT engagement of central laboratories
7. Justification of laboratory medicine as a discipline
Evaluation of method comparisonsEvaluation of method comparisons
1.Step1.Step
definition of the analytical comparability definition of the analytical comparability
(conventual concept)(conventual concept)
2.Step2.Stepdetermination of the diagnostic relevance determination of the diagnostic relevance (future concept)(future concept)
SummarySummary1. Vision: same quality and comparable results in Europe by
means of harmonisation of methods, of reference intervals,development of decision limits and the sameaccreditation system. ELM tries to support these goals.
2. all disciplines must come under one roof or on one platform in so-called competence centres which should be organized on a regional basis servicing a population of 0.5 to 1.0 million people. If the region is spread, especially in rural areas, satellite laboratories may be required. Several competence centres can co-operate for special expertise.