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Objectives: To implement an electronic laboratory utilization management system (laboratory expert system [LES]) to provide safe and effective reductions in unnecessary clinical laboratory testing. Methods: The LES is a set of frequency filter subroutines within the Veterans Affairs hospital and laboratory information system that was formulated by an interdisciplinary medical team.Results: Since implementing the LES, total test volume has decreased by a mean of 11.18% per year compared with our pre-LES test volume. This change was not attributable to fluctuations in outpatient visits or inpatient days of care. Laboratory cost savings were estimated at $151,184 and $163,751 for 2012 and 2013, respectively. A significant portion of these cost savings was attributable to reductions in high-volume, large panel testing. No adverse effects on patient care were reported, and mean length of stay for patients remained unchanged. Conclusions: Electronic laboratory utilization systems can effectively reduce unnecessary laboratory testing without compromising patient care.

Lost, delayed or incorrect laboratory results are associated with delays in initiating treatment. Delays in treatment for Multi-Drug Resistant Tuberculosis (MDR-TB) can worsen patient outcomes and increase transmission. The objective of this study was to evaluate the impact of a laboratory information system in reducing delays and the time for MDR-TB patients to culture convert (stop transmitting). 78 primary Health Centers (HCs) in Lima, Peru. Participants lived within the catchment area of participating HCs and had at least one MDR-TB risk factor. The study design was a cluster randomized controlled trial with baseline data. The intervention was the e-Chasqui web-based laboratory information system. Main outcome measures were: times to communicate a result; to start or change a patient's treatment; and for that patient to culture convert. 1671 patients were enrolled. Intervention HCs took significantly less time to receive drug susceptibility test (DST) (median 11 vs. 17 days, Hazard Ratio 0.67 [0.62-0.72]) and culture (5 vs. 8 days, 0.68 [0.65-0.72]) results. The time to treatment was not significantly different, but patients in intervention HCs took 16 days (20%) less time to culture convert (p = 0.047). The eChasqui system reduced the time to communicate results between laboratories and HCs and time to culture conversion. It is now used in over 259 HCs covering 4.1 million people. This is the first randomized controlled trial of a laboratory information system in a developing country for any disease and the only study worldwide to show clinical impact of such a system. ClinicalTrials.gov NCT01201941.

Background Before public health emergencies became a major challenge worldwide, the scope of laboratory management was only related to developing, maintaining, improving, and sustaining the quality of accurate laboratory results for improved clinical outcomes. Indeed, quality management is an especially important aspect and has achieved great milestones during the development of clinical laboratories. Current status However, since the coronavirus disease 2019 (COVID‐19) pandemic continues to be a threat worldwide, previous management mode inside the separate laboratory could not cater to the demand of the COVID‐19 public health emergency. Among emerging new issues, the prominent challenges during the period of COVID‐19 pandemic are rapid‐launched laboratory‐developed tests (LDTs) for urgent clinical application, rapid expansion of testing capabilities, laboratory medicine resources, and personnel shortages. These related issues are now impacting on clinical laboratory and need to be effectively addressed. Conclusion Different from traditional views of laboratory medicine management that focus on separate laboratories, present clinical laboratory management must be multidimensional mode which should consider consolidation of the efficient network of regional clinical laboratories and reasonable planning of laboratories resources from the view of overall strategy. Based on relevant research and our experience, in this review, we retrospect the history trajectory of laboratory medicine management, and also, we provide existing and other feasible recommended management strategies for laboratory medicine in future. Influential events during the history impacted laboratory management activities (left). After COVID‐19 outbreak, the scope of management outside the laboratory has extended exponentially the scope (right).

Abstract Objectives In a clinical laboratory, the design of the workspace directs the workflow and significantly affects the productivity of clinical laboratory scientists (CLS). With the chronic shortage of CLS, a well-designed workspace is essential to take full advantage of available staff, especially in high-volume laboratories. Methods Through the use of quality improvement tools, a manual body fluid testing workspace was redesigned to address weaknesses in the layout that led to excessive physical steps taken by staff. Results System engineering tools such as a fishbone diagram, spaghetti diagrams, Plan-Do-Study-Act cycles, and a counterbalance measure were all used in a CLS-led quality improvement initiative to redesign a workspace in the manual body fluid processing area of a clinical laboratory at Mayo Clinic. Conclusions After the redesign, physical steps taken and time to process body fluids were reduced by an average of 40% and 32%, respectively, demonstrating the utility of quality improvement tools in clinical laboratory settings.

Demographics of the science, technology, engineering, and mathematics (STEM) workforce and student body in the US and Europe continue to show severe underrepresentation of Black, Indigenous, and people of color (BIPOC). Among the documented causes of the persistent lack of diversity in STEM are bias, discrimination, and harassment of members of underrepresented minority groups (URMs). These issues persist due to continued marginalization, power imbalances, and lack of adequate policies against misconduct in academic and other scientific institutions. All scientists can play important roles in reversing this trend by shifting the culture of academic workplaces to intentionally implement equitable and inclusive policies, set norms for acceptable workplace conduct, and provide opportunities for mentorship and networking. As scientists are increasingly acknowledging the lack of racial and ethnic diversity in science, there is a need for clear direction on how to take antiracist action. Here we present 10 rules to help labs develop antiracists policies and action in an effort to promote racial and ethnic diversity, equity, and inclusion in science.

How virtual classrooms and dire finances could alter academia: part 1 in a series on science after the pandemic. How virtual classrooms and dire finances could alter academia: part 1 in a series on science after the pandemic.

The 2015 Institue of Medicine report Improving Diagnosis in Health Care highlighted that diagnostic errors cause patient harm and that improvement in the diagnostic process requires better collaboration among physicians and laboratory professionals. The purpose of this study is to understand why physicians do not contact laboratory professionals when facing diagnostic challenges and identify opportunities for laboratory professionals to become more recognized members of the clinical care team. A random sample of 31,689 physicians from the American Medical Association Masterfile were surveyed about diagnostic challenges in laboratory test ordering and results interpretation, solutions to these challenges, and interactions with laboratory professionals. We received responses from 1768 physicians (5.6%). When faced with diagnostic challenges, they reported using electronic resources because they find it difficult and time-consuming to contact the laboratory. Only 20% had an effective way to access laboratory professionals, mostly seeking help for logistical but less for clinical issues. Continuing medical education, professional articles, and updates from the laboratory were helpful. Laboratory professionals have an opportunity to play a greater role in the diagnostic process by becoming active members of the clinical care team, beyond providing results. This study provides strategies to increase laboratory professionals' role in the diagnostic process.

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) created an exceptional situation in which numerous laboratories in Europe simultaneously implemented SARS-CoV-2 diagnostics. These laboratories reported in February 2020 that commercial primer and probe batches for SARS-CoV-2 detection were contaminated with synthetic control material, causing delays of regional testing roll-out in various countries.