Management, research, professional skills etc Flashcards
types of funding in a lab
bulk funded contracts (eg newborn screening, forensics, routine hospital tests)
schedule tests (for private labs) - reimbursed by MOH
fee for service (eg clinical trials, GPs)
What legislation governs safety in workplace?
Health and Safety in Employment (HSE) Act 1992 (amended 2002):
outlines employers and employees responsibilities
Hazardous Substances and New Organisms (HSNO)Act 1996
ISO 15190: Medical Laboratories - Requirements for Safety
components of risk management (4)
- Hazard identification
- Risk assessment
- Control of hazard (“Hierarchy of Control”)
- Monitor, review & evaluate
options to resolve specimen mix-up/contamination
clinical and lab correlation (incl dx, no of pieces etc)
routine morphology (if different organ, no need to go further!)
IHC
DNA fingerprinting
what do you do when a (diagnostic) error is detected?
correct report – do not alter original report; add an addendum
notify clinician
review circumstances and procedures leading to the error
how did the error occur and can the system be improved
examples of pre-pathology errors
identification error
missing or incorrect clinical history
transport (method or time)
examples of post-pathology errors
clerical errors
not sent/available to clinician
misunderstanding by clinician
clinician not informed of addenda
research process (7)
think of idea
literature search
develop protocol
obtain approvals
collect data
analysis and interpretation
dissemination/write-up
when is ethical review required in research?
Interventional studies
Studies that involve
departure from normal care
Use, collection or storage of
human tissue without consent
Use of Guthrie cards
Use of identifiable health
information without consent
Study involves vulnerable participants
who approves ethics in research
Health and Disability Ethics Committee (HDEC)
sensitivity vs specificity
sensitivity = “true positive rate” (the proportion of positives that are correctly identified as such) TP/(TP+FN)
specificity = “true negative rate” (the proportion of negatives that are correctly identified as such) TN/(TN+FP)
types of research (3)
audit (not really ‘research’): improves delivery of a health service, measures against standards with existing data
observational research: new knowledge about a health issue, includes case-controlled/cohort/case series
interventional research: new knowledge about an intervention, includes RCTs
critical appraisal of a paper
PECOT:
participants
exposure/comparison
outcomes
time
components of research
research question
research design
research analysis
components of research questions
idea first
then: feasibility, literature review, ethics, funding
generates: a research question
components of research design
hypothesis, methods, validation
results
components of research analysis
analysis
conclusion
future direction
communication of findings
what do you need to look at during critical appraisal? (3)
validity: randomisation, blinding, follow up
results: selection of outcomes, size of effect
applicability: differences in patient group and environment
examples of notifiable diseases in nz
giardia
yersiniosis
hydatids
leprosy
TB
listeriosis
resolving conflict
talk with the person
focus on events, not person
listen
identify points of agreement and disagreement
prioritise areas of conflict
develop plan and follow through on it
budgetary considerations in an existing lab
operating expenses (opex):
employees, reagents, disposables, depreciation, rent, utitilites, travel
capital expenses (capex)
fixed assests eg microscope, software
ADHB: minor capex totals approx 400k/year
major capex (>$100K) go through expenditure committee and ADHB Board
