PURPOSE – The purpose of this paper is to show how over the last 18 months Bolton Hospitals NHS Trust have been exploring whether or not lean methodologies, often known as the Toyota Production System, can indeed be applied to healthcare. DESIGN/METHODOLOGY/APPROACH – This paper is a viewpoint. FINDINGS – One’s...

Tight glycemic control (TGC) in the intensive care unit is essential to comprehensive clinical management.  However, TGC that is too aggressive in the wrong patient populations (particularly non-diabetics) can result in hypoglycemia, which brings with it a set of sequelae that can increase morbidity and mortality....

When a new D-dimer method is to be implemented either as a substitute for a currently used D-dimer assay or as a supplement, maybe as a point-of-care assay, it is necessary to do a clinical comparison of the "old" assay versus the "new" assay. The major pitfalls in D-dimer comparisons are addressed in this paper.   ...

Clinical laboratory test results are a very important parameter in diagnosis, monitoring and screening. 70-80 % of decisions in diagnosis are based on laboratory results and more and more laboratory analyses are requested. Thus a lot of data are provided and it is therefore imperative for patient care (and safety)...

Analytical methods are often developed at one site and transferred to other sites for routine use. Increasingly, the method development is made by manufacturers of instruments and reagents. Regulatory agencies have ruled that the responsibility for the performance of IVDs in the laboratories mainly should lie with...

Recent studies of D-dimer as a “rule-out” test for deep venous thrombosis (DVT) frequently have used duplex ultrasound rather than venography as the gold standard. Because duplex ultrasound has limited ability to image the calf veins, there is potential for ultrasound studies to classify patients with calf DVT as...

In an exclusive acutecaretesting.org interview, Dr Mario Plebani, Head of the Department of Laboratory Medicine at the University Hospital of Padova, Italy and international patient safety advocate, talks about how laboratory, clinicians and manufacturers can work together to reduce errors in testing and diagnosing...

Definite diagnosis of infection requires microbiological documentation; however, the identification of a specific etiology is frequently missing. In addition, bacterial cultures require at least 24-48 hours for a final result, which is too long for a decision to start antibiotics. Currently, the evaluation of the...

With the use of a new Data Management System (DMS) software program [1], the majority of Point Of Care Testing (POCT) equipment throughout the Waikato District Health Board region has been connected to the Laboratory Information System (LIS) and the Hospital Information System (HIS). Prior to the new DMS, viewing...

Introduction of point–of-care testing (POCT) in hospitals requires the use of principles of change management. Manufacturers can support this process. E-learning programs adapted to the local situation with regular updates, a centralized accreditation and user-registration system and service level agreements are...