Article 3

Managing cost, quality and profitability in a clinical laboratory - Diagnostics - Expres...
Page 1 of 3
Issue dtd. 1st to 15th August 2005
- Home > Diagnostics > Story Print this Page| Email this page
INSIDE
COVER STORY
Managing cost, quality and profitability in a clinical
INTERVIEW
laboratory
NEWS
Sambhu Chakraborty
HOSPINEWS
DIAGNOSTICS
Accreditation of clinical laboratory has always been regarded as an expensive
HEALTH INSURANCE affair but effective implementation of accreditation system ensures quality,
saves cost and increases profitability. In most of the cases, laboratories
SUPPLEMENTS
consider accreditation as a piece of paper, which may be utilised only as a
CRITICARE marketing tool. But sadly, due to lack of interest from top management, lack of
LABWATCH knowledge about the requirement of accreditation and its implementation, it is
left unimplemented in most of the cases.
HOSPIUPDATE
ARCHIVES Equipment history is one of the prime areas where cost can be managed and
SUBSCRIBE profitability can be increased. Equipment breakdown may affect laboratory
CUSTOMER SERVICE
sample testing turnover severely and lead to clinician and patient
CONTACT US
ADVERTISE dissatisfaction.
ABOUT US
Present clinical laboratory standard ISO 15189 is well defined. Continual
improvement (clause no 4.12) will help the accredited laboratory to find out the
Network Sites
Express Computer
scope of profitability and other facets like cost saving etc and can be
IT People
implemented in the following way:
Network Magazine
Business Traveller  Required to maintain the breakdown history data.
Exp. Hotelier & Caterer  Find out the down time of the machine.
Exp. Travel & Tourism  Find out the reason of breakdown.
Exp. Pharma Pulse
 Prepare statistical chart.
Express Textile
Group Sites
 Draw fish bone diagram to find out the root cause.
ExpressIndia  Prepare an improvement plan to reduce the breakdown of the machines.
Indian Express  Monitor the action.
Financial Express  Prepare a statistical data on down time.
 Find out the profitability.
Indian Express
A) Technical Awareness of phlebotomists/ nursing staff and medical
Business officers: Test results often misguide the clinician when nursing staff lack
Publications Division training in sample collection, patient preparation, storage and transportation of
sample.
They should be thoroughly trained in (i) drawing blood from indwelling (arterial,
central venous) or umbilical lines. While drawing blood form indwelling lines or
catheters errors due to dilution and or contamination from flushing solution
should be avoided.
ii) When an intravenous solution is being administered in a patient’s arm, blood

should be drawn from the opposite arm. If an intravenous infusion is running in
both arms, samples may be drawn after the intravenous infusion is turned off
for at least two minutes before venipuncture and applying the tourniquet below
the intravenous infusion site. These causes repeat sample test and ultimately
one has to bear the cost of re-testing of sample. The condition of the sample
deteriorates due to lack of knowledge in sample handling. Laboratory can collect
the data in the case of number of repeat test and accordingly prepare a plan to
reduce it, which can be considered as continual improvement.
B) Technical awareness of clinician: A laboratory can increase the relevant

knowledge among clinicians by organising a formal workshop/seminar. In many
cases, results are misrepresented due to insufficient information about the
patient or history.
file://F:\phd\journals\PUBLISHED ARTICLE\Article-3.htm 03/10/2015

Managing cost, quality and profitability in a clinical laboratory - Diagnostics - Expres... Page 2 of 3
For the tests of monitoring anticoagulant therapy, the request forms must have
a column for the physician ordering the test to indicate the purpose of the test e
g monitoring heparin/ low molecular weight heparin and/or oral anticoagulant
therapy as applicable.
Laboratory should bring awareness among clinicians about the necessity of

clinical history as required for various cases especially in histopathology and
cytopathology test area. All this will help laboratory to reduce repeat tests,
reduce correlation tests and save time of consultant and technician.
C) Control of non-conformance: This is another area, which is almost

neglected, laboratory should maintain the non conformance records, non
conformance and its root cause records can indicate the area where preventive
action plan is required that will cover cost and profitability as follows:
Non conformance data will indicate the volume of reagent/consumables, man-

hours involved which can be converted into loss and by managing it can be
profitable for the laboratory.
It may prevent occurrence of any potential non-conformance may identify the

technician’s competency requirement nd equipment performance which can help
to improve the testing turnover by effective utilisation of resources
D) Inventory control: Most of the laboratory does not calculate reorder level.
Sometimes testing cannot be done due to non-availability or shortage of
kit/reagent and all this area can be considered and willprofitable.
E) Storage: Storage of kit reagent, consumables and sample is another area.

Condition can be deteriorated in both the cases if kit is not performing correctly
or if the sample condition is deteriorated, repeat test or correlation test is done,
or re-sampling is done. All this repetition of work involves man-hours, reagent,
machine operation and use of other lab equipment. This can also be converted
into rupees and saving of that will be a profit for the laboratory.
F) Handling of equipment: Equipment is defined in ISO 15189 that covers all

equipment, reagent, consumables, reference etc. A simple method study tool of
Industrial Engineering application can indicate the amount of wastage thereby
help saving the resources.
G) Turnaround time or reduction of reporting time cycle: In this stage

also, duplication of work is involved. In some cases, resources are not
competent and not utilised effectively, target on reduction of reporting time also
involve co-ordination of all laboratory activities and this will automatically
improve the productivity means testing turnover.
H) Feedback and complaint: This is another area of laboratory identifying the

problem and to determine the scope of improvement. Analysis of complaint and
feedback statistically will provide the necessary data on the area of
improvement. Data collection will cover the number of complaint in a period,
repetition of complaint even after taking corrective action, classification with
nature of complaint and its numbers. Using Fish bone diagram can solve critical
complaint and bottleneck areas. Presentation of data can indicate all those
areas needed to improve.
Laboratories can make or prepare a target plan on each area, which should be
followed by an action plan, implementation monitoring, record keeping and
finding the profitability. Implementation of ISO 15189 standard and NABL 112
document will also help the laboratory on managing quality and profit both. For
a big laboratory, Six Sigma can be applied for better management of cost
savings.
The author is a laboratory accreditation consultant in Kolkata.
Email:mailto:%[email protected] or [email protected]
Back to Top

Managing cost, quality and profitability in a clinical laboratory - Diagnostics - Expres... Page 3 of 3
© Copyright 2001: Indian Express Newspapers (Mumbai) Limited (Mumbai, India). All rights reserved throughout
the world. This entire site is compiled in Mumbai by the Business Publications Division (BPD) of the Indian Express
Newspapers (Mumbai) Limited. Site managed by BPD.

Article 3

Uploaded by

Copyright:

Available Formats

Article 3

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Article 3

Uploaded by

Copyright:

Available Formats

Managing cost, quality and profitability in a clinical laboratory - Diagnostics - Expres...

Issue dtd. 1st to 15th August 2005

ii) When an intravenous solution is being administered in a patient’s arm, blood

B) Technical awareness of clinician: A laboratory can increase the relevant

file://F:\phd\journals\PUBLISHED ARTICLE\Article-3.htm 03/10/2015

Laboratory should bring awareness among clinicians about the necessity of

C) Control of non-conformance: This is another area, which is almost

Non conformance data will indicate the volume of reagent/consumables, man-

It may prevent occurrence of any potential non-conformance may identify the

E) Storage: Storage of kit reagent, consumables and sample is another area.

F) Handling of equipment: Equipment is defined in ISO 15189 that covers all

G) Turnaround time or reduction of reporting time cycle: In this stage

H) Feedback and complaint: This is another area of laboratory identifying the

The author is a laboratory accreditation consultant in Kolkata.

file://F:\phd\journals\PUBLISHED ARTICLE\Article-3.htm 03/10/2015

file://F:\phd\journals\PUBLISHED ARTICLE\Article-3.htm 03/10/2015

You might also like