Clinical laboratory management review : official publication of the Clinical Laboratory Management Association / CLMA
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Clin Lab Manage Rev · Jan 1999
Hospital-physician relationships in the integrated delivery system: an ethical analysis.
The need to compete for managed care contracts is causing hospitals and physicians to dramatically change how they do business with each other. Most significant is the formation of integrated delivery health-care systems. The emergence of these systems creates an enhanced need for physicians and administrators to better understand what the other actually does. This article examines the new health-care marketplace from both perspectives and how integrated delivery systems affect individual and community patient care, and it offers guidelines for effective hospital-physician relationships within integrated delivery systems.
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Clin Lab Manage Rev · Nov 1998
How to develop an effective decentralized laboratory testing program.
In this article, we offer practical guidelines for developing an effective decentralized laboratory testing (DLT) program. Based on more than 10 years of experience with a DLT program for bedside blood glucose monitoring, we have identified eight essential steps in this process, including: developing an effective multidisciplinary DLT committee that oversees the various DLT programs; performing a needs analysis and a cost analysis as part of the application for approval of a program from the DLT committee; instrument selection and method evaluation; and, finally, implementing a DLT program including initiating a quality assurance program. A collaborative effort by everyone from the beginning is an important key to success.
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Clin Lab Manage Rev · Nov 1998
Managing Me Incorporated: how to survive and thrive in the 21st century.
No matter what your job position or title, YOU are President and Chief Executive Officer of "Me Incorporated", the single most exciting company in the world. We are in the midst of a great revolution, summarized in the "Delta Table of Revolutions". Part one of this table looks at macro trends--trends affecting our economy and society. ⋯ The key to success for Me Inc. is to close the skills gap. This must be undertaken in a carefully planned way. You must form a clear, concise, and, above all, written plan with specific, realistic, and measurable goals.
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Powerful forces are changing the provision of health care. Management is transitioning into new responsibility for a leaner, more flexible, customer-focused operation to support the goals of integrated systems of the 21st century--to minimize disease and to promote health. In response to this evolution, the clinical systems management concept describes multidimensional competencies, which are transportable throughout the continuum of care (1). These new knowledge competencies and core competencies applied in a different context are characterized in this paper.
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Clin Lab Manage Rev · Mar 1998
Cost-effectiveness of cardiac troponin I in a systematic chest pain evaluation protocol: use of cardiac troponin I lowers length of stay for low-risk cardiac patients.
We evaluated several measures of clinical and fiscal interest to assess the effect of adding an automated cardiac troponin I (c-TnI) assay to our current cardiac panel, which consists of creatine kinase MB (CK-MB), myoglobin, total CK activity, and a calculated CK-MB relative index. Samples were collected on admission and at 3, 6, and 8 hours after admission as part of our diagnostic protocol. ⋯ We found that adding c-TnI to our testing regimen decreased LOS for the large test population. Within this large test population, patients classified as low risk for acute myocardial infarction experienced statistically and clinically significant shorter LOS and lower total and variable hospital costs; for patients with unstable angina, there was an increase (though not statistically significant) in laboratory costs.