| The advent of simplified laboratory tests designed for the physician's office has expanded the world of diagnostic testing beyond the traditional environment of the clinical laboratory and the highly skilled technologist. The volume of laboratory testing in the physician's office continues to increase due to two factors: (1) laboratory tests generate income for the physicians and (2) health care reimbursements are declining.; The nationwide prospective payment system which has been instituted in most hospitals has forced major cutbacks in hospital expenditures. In attempts to defray these costs, many laboratory tests are performed in the physician's office before patients are admitted to the hospital. Unfortunately, most physicians' offices are unprepared to meet this challenge. Many of the test results generated from office laboratories are meaningless due to untrained personnel, lack of consistent procedures, and absence of controls to verify the validity of test results.; The purpose of this dissertation is to educate physicians' office personnel in the establishment of a quality control program. The first half of the manual discusses federal and state regulatory requirements, laboratory safety, procedure manuals, specimen collection and handling, equipment maintenance, quality control records, and reporting of results. Sequential chapters discuss the four major categories of laboratory medicine (urinalysis, microbiology, hematology, and chemistry) with repsect to the choice of an appropriate screening test to meet the needs of a particular laboratory. The primary evaluation criteria discussed are technical aspects (how well the test performs), functional aspects (what is required to perform the test), and costs (both direct and indirect). Quality control procedures for each type of test are recommended.; Adoption of the principles of this manual will increase the quality of health care throughout the nation, not only by assuring valid laboratory results in the physician's office, but by eventual cost reduction in total health care. |
