Laboratory Integration and Consolidation in a Regional Health System

Cook, Jim

doi:10.1093/labmed/lmw069

Cited by 5 publications

(3 citation statements)

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“…The investment in a laboratory that can perform high-complexity testing and rapidly increase capacity in response to demand not only serves the main academic medical center, but also supports the regional health system and public health of the region at large. 6 The well-established goals to provide high-quality, efficient care with TATs that can maximally support clinical operations 20 are demonstrated here. This would not have been possible if our institution had not invested in its laboratory.…”

Section: Discussionmentioning

confidence: 93%

Mounting a Regional Response to the COVID-19 Pandemic: Another Reason to “Keep” Your Lab

Paczos

2020

Archives of Pathology &Amp; Laboratory Medicine

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Context: Declining reimbursement shifts hospital laboratories from system assets to cost centers. This has resulted in increased outsourcing of laboratory services which can jeopardize a hospital systems ability to respond to a health care crisis. Objectives: To demonstrate investment in a core laboratory serving an academic medical center equipped a regional health system to respond to the pandemic. Design: COVID-19 diagnostic testing data was analyzed. Volumes were evaluated by result date (3/16/2020 – 5/6/2020) and the average of received to verified turn-around-time (TAT) was calculated and compared for in-house and send-out testing, and different in-house testing methodologies. Results: Daily viral diagnostic testing capacity increased by greater than 3000 % (from 21 tests per day to 658 tests per day). Total viral diagnostic testing resulted by the core lab increased by 128 times over 22 days of test method validation and 826 times over the analysis period while average turn-around-time per day for send-out testing increased from 3.7 days to 21 days. Decreased overall average TAT was observed at the core laboratory (0.45 days) verses send-out testing (7.63 days) ( P < .001). Conclusions: Investment in a core laboratory provided the health system with the necessary expertise and resources to mount a robust response to the pandemic. Local access to testing allowed rapid triage of patients and conservation of scarce personal protective equipment. In addition, the core laboratory was able to support regional health departments and several hospitals outside of the system.

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Section: Discussionmentioning

confidence: 93%

Mounting a Regional Response to the COVID-19 Pandemic: Another Reason to “Keep” Your Lab

Paczos

2020

Archives of Pathology &Amp; Laboratory Medicine

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“…Given the nature of the problem, the degree of duplication is unknown. Future efforts to integrate laboratory result systems could alleviate resource overutilisation 34…”

Section: Discussionmentioning

confidence: 99%

Improving annual albuminuria testing for individuals with diabetes

et al. 2022

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BackgroundAnnual albuminuria screening detects the early stages of nephropathy in individuals with diabetes. Because early detection of albuminuria allows for interventions that lower the risk of developing chronic kidney disease, guidelines recommend annual testing for all individuals with type 2 diabetes mellitus and for those with type 1 diabetes for at least 5 years. However, at the Eskind Diabetes Clinic at the Vanderbilt University Medical Center, testing occurred less frequently than desired.MethodsA quality improvement team first analysed the clinic’s processes, identifying the lack of a systematic approach to testing as the likely cause for the low rate. The team then implemented two successive interventions in a pilot of patients seen by nurse practitioners in the clinic. In the first intervention, staff used a dashboard within the electronic health record while triaging each patient, pending an albuminuria order if testing had not been done within the past year. In the second intervention, clinic leadership sent daily reminders to the triage staff. A statistical process control chart tracked monthly testing rates.ResultsAfter 6 months, annual albuminuria testing increased from a baseline of 69% to 82%, with multiple special-cause signals in the control chart.ConclusionsThis project demonstrates that a series of simple interventions can significantly impact annual albuminuria testing. This project’s success likely hinged on using an existing workflow to systematically determine if a patient was due for testing and prompting the provider to sign a pended order for an albuminuria test. Other diabetes/endocrinology and primary care clinics can likely implement a similar process and so improve testing rates in other settings. When coupled with appropriate interventions to reduce the development of chronic kidney disease, such interventions would improve patient outcomes, in addition to better adhering to an established quality metric.

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“…), as well as in the healthcare human resources [36], for the purpose of continuous development, has been highlighted by the latest global health policy initiatives, characterized by concurrent propositions regarding the different areas of sustainable development. These approaches clearly emphasize the drive for consolidation of the healthcare sector [37][38][39][40].…”

Section: Discussionmentioning

confidence: 99%

Effects of Hospital Decentralization Processes on Patients’ Satisfaction: Evidence from Two Public Romanian Hospitals across Two Decades

et al. 2022

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Patient satisfaction represents an essential indicator in assessing healthcare quality, as it is an extensive source of information regarding the healthcare provider’s ability to meet patients’ expectations and is a key predictor of patients’ behavioral approaches. The purpose of this study is to evaluate the degree of satisfaction of patients who have been admitted for inpatient hospitalization in two public hospitals located in the North-West of Romania, during two different periods of administration/management of healthcare services, in the context of an ongoing decentralization process of public healthcare services (initiated in 2010). An exploratory study was conducted in the period of April–December 2021, based on a patient satisfaction survey, through which the quality of in-hospital services was evaluated at present and up until 2010, by the hospitalized patients in both periods. In total, 208 survey responses were validated and analyzed. The chi-square test and t-test were used for statistical processing. The results of the survey revealed that the percentage of patients that evaluated the inpatient experience as excellent was significantly higher during the period when hospitals were administered by local authorities than during the period of centralized administration (68.27% vs. 28.37%; p < 0.001), both in medical care as well as in hospital hotel services (71.63 vs. 29.81%), respectively (56.25 vs. 27.40; p < 0.001). The results obtained from this survey indicate that the decentralization of hospital units has had a positive effect on the quality of inpatient medical services and highlight the need for formulating and finalizing a policy aimed at developing and enhancing medical services.

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Laboratory Integration and Consolidation in a Regional Health System

Cited by 5 publications

References 0 publications

Mounting a Regional Response to the COVID-19 Pandemic: Another Reason to “Keep” Your Lab

Mounting a Regional Response to the COVID-19 Pandemic: Another Reason to “Keep” Your Lab

Improving annual albuminuria testing for individuals with diabetes

Effects of Hospital Decentralization Processes on Patients’ Satisfaction: Evidence from Two Public Romanian Hospitals across Two Decades

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