CLINICAL LAB SCIENEC

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ESSENTIALS OF CLINICAL LABORATORY SCIENCE
frequently possible as a cost-effective way of gaining access to technology without
large capital outlays required to purchase the instruments.
A manufacturer’s profits are not usually based on the price of a piece of
equipment, and to the extent that they are, the research necessary for designing
and producing the machine would require a substantial price tag if the equipment
were bought. Competing pieces of equipment also make it a practical practice for
manufacturers to provide the equipment in return for an assured level of use of
reagents and consumable materials, such as specimen containers. In this type of
arrangement, new versions of testing equipment may be procured easily as they
arrive on the market, and the lease-purchase contract may be for only 2 years, or
may be for longer periods if desired. This makes for excellent business practice for
the medical laboratories and entire health systems.
Repeat Testing
It is in the best interest of the laboratory to minimize repeat testing to the fullest
extent possible. The need to repeat a test or tests may occur for a variety of reasons.
System errors may yield an occasional value that is completely unacceptable,
perhaps indicating a level that would not be conducive to the survival of the
patient, while the other tests for that patient are normal. Often, results must be
evaluated by comparing them with other tests that correlate with the results of a
given test. The statistical term “delta checks” is described in Chapter 10, Quality
Assurance. This check helps to eliminate errors on patients who have had a certain
test done for perhaps several days in a row, and there is no clinical reason in some
instances for a change in test values to have occurred. When a mistake is made
that may require repeating an entire “run” (or batch of tests), a great deal of time,
reagents, and consumables have been wasted, adding to operational costs. Many
instruments “flag” results that may be out of the ordinary, which would prompt
the technician or technologist to repeat the questionable test. Random errors,
or occasional errors that occur even under the best of circumstances, and when
instruments seem to be operating perfectly, do occur. This occasional erroneous
result will not greatly affect the costs of operation, but it does require that the
laboratory worker have the knowledge to perform troubleshooting procedures.
Performing preventive maintenance as outlined by the manufacturer on a regular
basis will do a great deal to avoid time-consuming repairs causing disruption of
services. Recurring problems of a similar nature for a piece of equipment may
signal that a breakdown is imminent and may require a service call.
Costs Incurred When Equipment Is “Down”
In all laboratories, the bane of the existence of managers and technical workers
is the malfunction of equipment. The large and extremely sophisticated equipment
that handles high volumes of procedures each day may unexpectedly cease
functioning. In this case, it is helpful when a technologist on site is able to troubleshoot
and remedy the problem. Some manufacturers are able to troubleshoot
equipment over a telecommunications line. Quite frequently, laboratories will
retain old equipment that can duplicate the work of the newer version. It is possible
to bring older replacement equipment online quickly to avoid disruptions
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