Adding value to laboratory medicine: a professional responsibility

Abstract

Laboratory medicine is a medical specialty at the centre of healthcare. When used optimally laboratory medicine generates knowledge that can facilitate patient safety, improve patient outcomes, shorten patient journeys and lead to more cost-effective healthcare. Optimal use of laboratory medicine relies on dynamic and authoritative leadership outside as well as inside the laboratory. The first responsibility of the head of a clinical laboratory is to ensure the provision of a high quality service across a wide range of parameters culminating in laboratory accreditation against an international standard, such as ISO 15189. From that essential baseline the leadership of laboratory medicine at local, national and international level needs to ' add value ' to ensure the optimal delivery, use, development and evaluation of the services provided for individuals and for groups of patients. A convenient tool to illustrate added value is use of the mnemonic ' SCIENCE ' . This tool allows added value to be considered in seven domains: standar disation and harmonisation; clinical effectiveness; innovation; evidence-based practice; novel applications; cost-effectiveness; and education of others. The assessment of added value in laboratory medicine may be considered against a framework that comprises three dimensions: operational efficiency; patient management; and patient behaviours. The profession and the patient will benefit from sharing examples of adding value to laboratory medicine.

Elements of Effective Practice in Patient-Centred Laboratory Medicine

“…This R&D is independent of the testing department aims at designing and developing research studies for clinical application tests for new innovative biotechnology, assisting in technical transfer in clinical biochemistry, conducting certification and auditing for new clinical technologies [7,13], improvement of current clinical laboratory examinations and assistance with internal auditor for quality management. It could be seen that the majority of devices and testing kits from clinical biotechnology companies have passed the quality control analysis while re-examination in the actual clinical laboratory is critical because of the environmental variations [14,15].…”

Current Evidence and Future Perspectives on the Effective Practice of Patient-Centered Laboratory Medicine

“…They cannot, however, deliver what is required without leadership from and partnership with the laboratory medicine community. The time is now right for laboratory medicine specialists in all countries to take up the challenge to look outside the laboratory and forge effective links with multidisciplinary teams that seek to optimize clinical outcomes and patient experiences in an efficient and costeffective way (76 ).…”

Harmonisation of specialist training and continuing professional development in laboratory medicine: a long but necessary journey

“…There have even been special issues of journals dedicated to harmonisation in laboratory medicine [10,11]. Thus, there is growing acceptance of the proposal that harmonisation is part of the added value of laboratory medicine and that it is a professional responsibility [12].…”

“…There is an issue about our identity with peers, users of the service, patients and the public. A high percentage of clinical decisions are influenced by the results that we produce [12] but our failure to present ourselves as a readily identifiable specialty within medicine means that our impact is poorly appreciated. The recent decision of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) to adopt the term 'specialist in laboratory medicine' is a welcome move to make the profession more recognisable [15].…”