6.introduction To Laboratory Services-Student's

Introduction to Laboratory Services
Milwida Josefa B. Villanueva, RMT, MSMT©

Faculty, Department of Medical Technology
No part of this material may be distributed and reproduced. The file is for your own use only.
Clinical Laboratory Personnel
No part of this material may be distributed and reproduced. The file is for your own use only. MJV
1. Laboratory Director (Pathologist)
-A pathologist is a specialist in the study of disease and works in both clinical
pathology and anatomical pathology.
-Acts as a consultant to physicians
-Has direct responsibility all areas of the laboratory
- Responsibilities include working with the laboratory administrator to establish
laboratory policies, interpret test results, perform bone marrow biopsies and
autopsies, and diagnose disease from tissue specimens or cell preparations.
2. Laboratory Manager (Administrator) or Chief-Medical
Technologist
- Responsible for overall technical and administrative management of the
laboratory
- Usually a medical laboratory scientist(MLS) with a master’s degree and 5 or
more years of laboratory experience.
3. Technical Supervisor or Section Head
- MLS with experience and expertise related to the particular laboratory section
or sections; often have specialty certifications on each section.
- Responsibilities of the technical supervisor include reviewing all laboratory test
results; consulting with the pathologist on abnormal test results; scheduling
personnel; maintaining automated instruments by implementing preventive
maintenance procedures and quality control measures; preparing budgets;
maintaining reagents and supplies; orienting, evaluating, and teaching
personnel; and providing research and development protocols for new test
procedures.
4. Medical Laboratory Scientist
- Has a bachelor’s degree in medical technology and 1 year of training in an
accredited medical technology / clinical laboratory science program.
- Performs laboratory procedures that require independent judgment and
responsibility with minimal technical supervision
- Maintains equipment and records; performs quality assurance and preventive
maintenance activities related to test performance setting.
5. Medical Laboratory Technician
- Performs routine laboratory procedures according to established protocol
under the supervision of a technologist, supervisor, or laboratory director.
• Collecting and processing biological samples
• Performing routine analytic tests
• Recognizing factors that affect test results
• Recognizing and reporting abnormal results
• Recognizing and reporting equipment malfunctions
• Demonstrating skills to new employees and students
6. Phlebotomist
- Collects blood from patients for laboratory analysis.
- Usually has completed a structured phlebotomy training program.
- Trained to identify the patient properly, obtain the correct amount of blood by
venipuncture or microtechnique, properly label and transport samples to the
laboratory, prepare samples to be delivered to the laboratory sections, and
observe all safety and quality control policies.
Hospital Organization
- Phlebotomists may be scheduled to work at one of these areas or
patients from these areas may be referred to the laboratory for
sample collection.
- May range in size (in terms of bed capacity) from 50 to more than
300 beds.
- May vary in extent of services provided
Classification of Hospitals (DOH)
- According to Scope of Services
- According to Functional Capacity
- According to Ownership
According to Scope of Services
A. General
- a hospital that provides services for all kinds of illnesses,
diseases, injuries or deformities. A general hospital shall provide
medical and surgical care to the sick and injured, as well as
maternity, newborn and child care. It shall be equipped with the
service capabilities needed to support board certified/eligible
medical specialists and other licensed physicians rendering services
in, but not limited to, the following:
A. General
• Clinical Services – Family Medicine, Pediatrics, Internal Medicine, Surgery,
Obstetrics and Gynecology
• Emergency Services
• Outpatient Services
• Ancillary and Support Services – clinical laboratory, imaging facility and
pharmacy.
B. Specialty
- May be devoted to the treatment of the following:
1. A particular type of illness or for a particular condition requiring a
range of treatment.
2. Patients suffering from a particular diseases of a particular organ
or group of organs. (e.g. Lung Center of the Philippines, Philippine
Heart Center, National Kidney and Transplant Institute)
3. Treatment of patients belonging to a group such as children,
women, elderly or others (e.g. Philippine Children’s Medical Center)
Classification of Hospitals
According to Functional Capacity
Level 1 – 25 to 75 beds
Classification of Hospitals
According to Ownership
I. Government
- Created by law
- May be under: National Government, LGU, DOH, State Universities and Colleges
II. Private
- Owned, established, and operated with funds from donation, principal, investment, or
other means by any individual, corporation, association, or organization
Hospital Organization
Traditional hospitals contain many different patient areas and departments to which the
phlebotomist must travel to collect samples.
Hospital Services:
1. Nursing Services
- Deals directly with patient care
2. Support Services
- Ex: communications systems, food, housekeeping
3. Fiscal Services
- Business Aspect (Accounting, Admitting, Data Collection and Health Information Management)
4. Professional Services
- Assist the physician in the diagnosis and treatment of disease.
Reference Laboratories
• Large, independent reference laboratories contract with health-care providers
and institutions to perform both routine and highly specialized tests.
• Phlebotomists are hired to collect samples from patients referred to the
reference laboratory. National Reference Laboratories (NRL) in the Philippines:
National Kidney Transplant Institute

Research Institute for Tropical Medicine
Lung Center of the Philippines
East Avenue Medical Center
STD-AIDS Cooperative Central Laboratory (SACCL)
Blood Donor Centers
- Phlebotomists collect, label and prepare blood, plasma and other
components for transfusions.
- Consistently interact with the public, conducting interviews and

testing samples to screen potential donors.
Quality Assurance in Healthcare
- All management systems are now focused on getting the job done.
- All promise more efficient and effective management
- Some have been effective in making larger profits while others
have been effective in providing a better service to the client
Quality Assurance
Total Quality Management (TQM)
- is a management plan that ensures that the quality expected
can be met. This establishes the assurance of adequate supplies
and personnel, up-to-date procedures, and acceptable patient
outcomes.
Quality Assurance
Continuous Quality Improvement (CQI)
- aims at more than just meeting the minimum standards.
- there must be constant efforts to improve what is being done.
Quality Assurance in
Phlebotomy
- The result of the test that is sent to
the physician depends on the
quality of the sample that the
phlebotomist obtains
- Most of the preanalytical process is
the responsibility of the
phlebotomist.
Quality Assurance in Phlebotomy
- All the procedures should be based on specific guidelines
- Established policies and procedures fall under an overall
process called Quality Assurance
Quality Assurance
QA is defined as a program that guarantees quality
patient care by tracking outcomes through scheduled
reviews.
Guidelines are developed for all the processes and
when formally adopted becomes the QA program.
Quality Assurance Indicators
- Indicators can measure quality, adequacy, accuracy,
timeliness, effectiveness, customer satisfaction etc.
Thresholds and Data

- Threshold values must be established for all clinical
indicators
- Monitor and evaluate continuously to ensure quality
improvement.
Process and Outcomes
- To ensure that the same process is always followed,
there must be controls and checks along the way.
- The use of controls in a process is known as Quality
Control
Quality Control
- Component of a QA program
- QC process in phlebotomy involves checking all the
operational procedures to make certain they are performed
correctly
Areas of Phlebotomy subject to QC
- Patient preparation procedures
- Specimen collection procedures
- Identification
- Equipment ( puncture devices, evacuated tubes)
- Labeling
- Technique
- Collection priorities
- Delta checks
Documentation
- Major component of QA program
- QA documents have been developed to: standardize
procedure, inform nursing personnel on importance of patient
preparation and record problems
- Can be used for legal purposes as well
- Can provide information for QA purposes
- Patient medical records
User Manual
- Chart or Type form
- Example of QA documentation
- Contains information on minimum amount of
specimen required, special handling desired, reference
values, TAT.
Procedure Manual
- Written in a special format (NCCLS)
- States laboratory policy and procedures that apply to
each test in the lab
- Standardization process
Information Found in a Procedure Manual
- Purpose of the procedure
- Specimen type and collection method
- Equipment and supplies required
- Detailed step by step procedure
- Limitations and variables of the method
- Corrective actions
- Method validation
- Normal values and references
QA Forms
- QA Forms include equipment check forms and
incident or occurrence report forms
Equipment check Forms
- Special forms for recording checks on tube additives,
vaccum strengths and expiration dates – verification of new
lot numbers
- Refrigeration temperatures – recorded daily
- Control checks on centrifuge – tachometer readings
and maintenance performed
Equipment check Forms
Incident Reports
- Must be filled out when a problem occurs
- Identifies the problem, state the consequence, and
describe the corrective action
- Should be used to ensure that the event does not
reoccur

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Introduction to Laboratory Services

Milwida Josefa B. Villanueva, RMT, MSMT©

National Kidney Transplant Institute

- Consistently interact with the public, conducting interviews and

Thresholds and Data

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