Healthcare Structure Flashcards
Hospital branches
Fiscal and information services, support services, nursing services, and professional services
Fiscal and information services
Responsible for admissions and medical records, as well as for billing, accounting, and other financial aspects of the hospital. Human resources may also be part of this.
Support services
Includes all aspects of the physical plant of the hospital, such as cleaning, maintenance, and security, as well as food service and purchasing
Nursing services
Provide direct care to patients. Phlebotomist have a great deal of direct contact with this branch.
Professional services
Provide services at the request of licensed practitioners, including physicians and nurse practitioners who aid in the diagnosis and treatment of patience. Each department provides specialized services. Includes cardiac catheterization, clinical laboratory, nuclear medicine (uses radio isotopes to perform tests and treat diseases), occupational therapy, pharmacy, physical therapy, radiation, therapy, radiology, or medical imaging, and respiratory therapy (perform arterial blood gases)
Clinical laboratory
Also called a medical laboratory; divided into two main areas: the anatomic and surgical pathology area, which analyzes the characteristics of cells and tissues, and the clinical pathology area, which analyzes blood and other body fluids. The phlebotomist works in the clinical pathology area of the clinical laboratory.
The clinical laboratory is usually under the supervision of a pathologist.
Anatomic and surgical pathology area
This area is usually divided into three sections, or departments, including cytogenics, cytopathology, and histology.
Anatomic and surgical pathology area
This area is usually divided into three sections, or departments, including cytogenics, cytopathology, and histology
Cytogenetics
Examines chromosomes for evidence of genetic disease, such as Down syndrome
Cytopathology (cytology)
Processes and stains the cells that are shed into body fluids, or removed from tissue with a needle (aspiration) and examines them for the presence of cancer or other diseases. The cytotechnologist assists in this work. One of the most common tests performed in psychology is the Pap smear.
Histology
Prepares tissues from autopsy, surgery, or biopsy for microscopic examination by a pathologist. Special stains are used to highlight particular cell morphology. The histotechnologist helps prepare samples for the pathologist to examine.
Clinical pathology area
Blood and other body fluids can be analyzed in a number of ways, and the divisions within the clinical pathology area reflect these differences. The number of sections in this area depends on the size of the hospital. In some laboratories, some functions may be combined. The clinical departments in a typical laboratory are as follows:
- Blood banking or immunohematology
- chemistry
- Specimen processing
- Coagulation and hemostasis
- hematology
- Flow cytometry
- microbiology
- Molecular diagnostics
- serology or immunology
- Urinalysis and clinical microscopy
- phlebotomy
- Referrals
Blood bank or immunohematology
Deals with blood used for transfusions. Blood is tested there to identify the blood type of both patient and donor blood to determine their compatibility. Compatibility testing is performed to ensure that the patient’s immune system does not reject the donor blood. Specimens for this department are drawn in a plain red-top tube or a special pink-top tube containing a chemical called ethylenediaminetetraacetic acid (EDTA). The strictest attention must be paid to patient identification and sample labeling. A fatal transfusion reaction may occur if either patient identification or labeling are incorrect. In compatibility testing, patient serum is mixed with donor RBCs to look for clumping of cells, caused by a reaction between the patients antibodies and the antigens on the donor cells. If clumping is seen, the donor blood cannot be used. Patients can also donate their own blood for later, called autologous donation.
With the use of a centrifuge, blood can be separated in several ways to obtain the following components: packed cells, fresh, frozen plasma, platelets, cryoprecipitate (clotting)
Chemistry
Performs a range of tests on the chemical components of blood. Chemistry tests may be performed as either single tests or as groups called chemistry panels. The most common tests and panels include basic metabolic panel (BMP), coronary risk or lipid panel, electrolytes, general health or comprehensive metabolic panel (CMP), glucose (GTT), liver function panel, myocardial infarction, renal disease, pancreas, drug tests.
These panels or tests are used to screen for a variety of diseases or assess the general wellness in patients. General types of tests performed include toxicology, immuno, chemistry, and electrophoresis. Immunochemistry tests use antibodies to detect a range of substances in the blood.
Specimen processing
Chemistry tests are performed on on either serum or plasma. Serum is collected in a tube without anticoagulants (red top tube) or in a serum separator tube (SST). Plain red top tubes need 45 to 60 minutes for full claw activation, and an SST needs a minimum of 30 minutes. When results are needed quickly or stat, blood can be collected in a tube with clot activators. After clotting, serum is separated out by centrifugation. A centrifuge spins the sample at high speed to separate components based on density. Serum is normally a clear, pale yellow fluid. The color and appearance of the serum sample can be altered by both of the patients condition and the collection technique. Liver disease can increase the amount of of bilirubin in the serum, making it appear a darker yellow (called icteric serum). Recent ingestion of fats or other lipids can make the sample cloudy (lipemic serum). Hemolysis, breakage of RBCs, can give the serum a pink tinge (hemolyzed serum). Hemolysis may occur as a result of a poorly performed draw.
