Laboratry organisation Flashcards
Diagnosis, monitoring, screening and prevention from conception to post mortem
Pathology statistics
- billion tests performed annually
- 50% of biochemistry tests are related to the management of chronic disease
- 300,000 tests performed daily
- Workforce of 27,000
- Pathology responsible for 70% of all diagnoses
What are the 5 original disciples of pathology?
- Haematology
- Microbiology & virology
- Clinical chemistry
- Histopathology and cytology
- Immunology
What are the blood sciences?
- Haematology
- Biochemistry
- Transfusion
- Immunology
What are the infectious sciences?
- Bacteriology
- Virology
- Mycology
- Parasitology
What are the cell sciences?
- Histology
- Cytology
Genetics and molecular sciences
- Genetics
- Molecular
Development of Tests and Techniques
- Manual
- Semi-automated
- Total automation
- Advanced techniques
- New analytes/more tests • Shorter TAT
- Increasing population
- Aging population
What is the role of an MLA?
Often way in to gain experience and secure a Trainee BMS post
- Sample Reception Pre-analytical processing
What is the role of an associate practitioner (AP)?
In-between MLA and BMS Develop skills and gain experience
- Analyser maintenance and troubleshooting
- Quality control procedures
- Processing samples
- Storage and retrieval
What is the role of Band 5 Biomedical Scientist (BMS)?
24/7 service CPD
- Analysis and reporting
- Quality Assurance
What is the role of Band 6 Biomedical Scientist (BMS)?
Specialised portfolio
- Senior Biomedical Scientist
What is the role of Band 7 Biomedical Scientist (BMS)?
Specialist Portfolio and MSc
- Head of Section
What is the role of a Clinical Scientist (BMS)?
STP, Often specialist
- Complex tests
- develop services
- quality, clinical role,
- R&D management and equipment procurement
- Validation
Organisational positions in pathology
Shotgun and selective approach
Sample reception
• ~7,000 samples daily o Inpatient
o Outpatient
o Other hospitals in the Trust
o GP
o “Send aways”
- Electronic ordering
- Manual bookings
- Barcode labelling
- Separating
- Sorting
- Sample rejection
- Missing specimens?
Most routine diagnostic testing
- Urea and electrolytes
- Liver function
- Tumour markers
- Serology
Manual steps replaced with robots :
- Assays
- Sample loading
- Reflex testing
- Repeats
- Sample storage
Staff
- Daily/weekly/monthly maintenance
- QC and Calibration
- Result interpretation and reporting
- Add-ons
- Pending lists
- Problematic samples
Total automation- Abbott
Specialist training
- Smaller number of tests
- Referral labs
- High complexity - Mass Spectrometry/HPLC
o Vitamin D
o Drugs
o Trace metals
o Toxicology
Laboratory accreditation
UKAS
• Accreditation of diagnostic laboratories
o ISO/IEC 15189 : 2003 Medical Laboratories – Particular Requirements For Quality And Competence
o ISO 22870:2006 Point-of-care testing (POCT) Requirements for quality and competence - intended to be used in conjunction with ISO 15189
- Regular inspections – compliance with standards
- Provides meaningful feedback
- Powers to withdraw accreditation
Quality management system
“Provides the integration and organisational structure of processes, procedures and resources needed to fulfil a quality policy and thus meet the needs and requirements of the users.” – ISO 9001:2015
• All hospital laboratories have a QMS and a Quality Manager
Policy – A statement of intent
Plans And Objectives – A means of putting the intent into practice Processes – What happens in practice Procedures – Provide the information in order to conduct the processes
Records – Evidence that the procedures are carried out
Quality team
UKNEQAS
- IQC performance
- Documentation
- Training logs
- Horizontal and Vertical Audits
Carter Report
- Review of NHS Pathology Services
- Pathology budget £ 2.5 billion per year – less than 3 % of total NHS budget
- Improvements to the accreditation process • Lack of control over specimen transport
- Poor IT connectivity
- Improve service user understanding of the tests
- 25-30% unnecessary test requests
- Consolidation of Pathology services - merger
