MEDT 08 :

Module 1:
Laboratory
Introduction to Laboratory Management
Management

MODULE 01
INTRODUCTION TO LABORATORY MANAGEMENT

At the end of this module, you are expected to:

1. Explain what is laboratory management and its importance to medical technology

2. Explain the types of laboratory errors
3. Types of laboratory services and different types of laboratory

LABORATORY MANAGEMENT

What is Laboratory Management?

 The effective utilization of men and the efficient utilization of resources for the
attainment of a pre-determined objective.
 Has been called the art of getting things done through people.
 Activities are completed and accomplished efficiently and effectively with and through
people.

Importance of Laboratory Management to Medical Technology

o Revolutionary advances in health care system include discovery of various
and complex diagnostic procedures, usage of automation for the conduct of
laboratory procedures, the onset of novel diseases and other factors greatly
affect the field of laboratory in delivery of its services. These developments
require that medical and paramedical personnel continue to update their
knowledge, skills, attitude to competently and adequately meet those
changing needs, produce quality test results that the national and international
community will trust in cases of national and international emergency.
o Laboratory management course will be of help in many aspects of laboratory
related functions and systems in the delivery of quality health services to the
people and examines the various factors that impact the system.
o Health laboratories – is a term that is meant to be inclusive of:
1. Clinical laboratories
2. Diagnostic laboratories
3. Medical laboratories
4. Public health laboratories
5. Animal and environmental health laboratories

The Phases of management process are:

1. Planning
2. Organizing
3. Directing
4. Staffing
5. Controlling

Course Module
 MEDT 08 :
Module 1:
Laboratory
Introduction to Laboratory Management
Management

•Defining goals
Planning •Establishing strategy and schedule

•Assigning task, people and arranging resources to accomplish work.

•Establishing working relationship
Organizing •Determining what needs to be done, how it will be done and who will do it.

•Leading and motivating people.

Directing •Influencing people to work hard and achieve the organizational goals.

•The process of determining personnel and job needs, recruiting qualified

staff, matching them with the appropriate job and training them to perform
Staffing the work assigned.

•Monitoring activities
•Changing plans for new development.
Controlling •Resolving conflicts

Negative Consequences of Laboratory Errors

 Laboratories produce test results that are widely used in clinical and public health
settings, and health outcomes depend on the accuracy of the testing and reporting. If
inaccurate results are provided, the consequences can be very significant, including:
o Unnecessary treatment
o Treatment complications
o Failure to provide the proper treatment
o Delay in correct diagnosis
o Additional and unnecessary diagnostic testing

LABORATORY ERRORS

VARIATIONS
Are errors encountered in the collection, preparation and measurement of samples,
including transcription and releasing of laboratory results.
Types of Errors
1. Random Error
 Is present in all measurements;
 It is a type of error which varies from sample to sample. without any real pattern
 Is the basis for varying differences between repeated measurements – variations
in technique.
 It is due to human error/operator (technical error) and environmental conditions
(variations in techniques) such as wrong patient identification, pipetting error,
mislabeling of samples, temperature fluctuation, and improper mixing/dilution of
sample and reagent, specimen mix-up, incorrect computer print-out)

Course Module
 MEDT 08 :
Module 1:
Laboratory
Introduction to Laboratory Management
Management

2. Systematic Error
 It is an error that influences observations consistently in one direction (constant
difference-constant error).machine or instrument error
 It is detected as either positive or negative bias – often related to calibration
problems, deterioration of reagents and control materials, improperly made
standard solutions, contaminated solutions, unstable and inadequate reagent
blanks, leaky ion selective electrode (ISE), malfunctioning of machine and poorly
written procedures.
 It is a measure of the agreement between the measured quantity and the true
value.
a. Constant Error (either up and down)
- it refers to a difference between the target value and the assayed
value.
- it is independent of sample concentration.
- it exists when there is a continual difference between the comparative
method and the test method regardless of the concentration and
affects all results equally.
b. Proportional/Slope/Percent Error
- it results in greater deviation from the target value due to higher sample
concentration.
- it exists when the difference between the test method and the
comparative method values is proportional to the analyzed
concentration
3. Clerical Error
 The highest frequency of clerical errors occurs with the use of handwritten labels
and request forms.

DIFFERENT TYPES OF LABORATORY

What is a Clinical Laboratory?

Clinical laboratory is a facility where tests are done on clinical specimens (materials
derived from the human body) in order to get information about the health of a patient for
the purpose of diagnosis, treatment, and prevention of disease by physicians, dentists,
and other persons authorized by license to diagnose and treat humans with diseases.
Classification of Clinical Laboratories
A. Based on Ownership
1. Government-owned Clinical Laboratory
- Operated and maintained partially or wholly by the national government, a
local government unit (provincial, city, or municipal) or other political unit or
department
2. Privately-owned Clinical Laboratory
- Owned, established, and operated by any private individual, corporation,
association, or organization

Course Module
 MEDT 08 :
Module 1:
Laboratory
Introduction to Laboratory Management
Management

B. Based on Functions
1. Clinical Pathology
- includes clinical chemistry, hematology, immunohematology, microbiology,
immunology, clinical microscopy, endocrinology, molecular biology,
cytogenetics, toxicology, therapeutic drug monitoring, and other similar
discipline.

The Clinical area is the division that processes the test requests more familiar to
the general public; such as blood cell counts, coagulation studies, urinalysis, blood
glucose level determinations and throat cultures. Clinical area is further divided
into several major sections including:

A. Chemistry
- It is the section of clinical laboratory that is generally concerned with
analysis of body fluids
- It involves the use of chemical test to analyze various components of
blood and urine.
- This large array of tests can be further sub-categorized into sub-
specialties of:

a. General or routine chemistry – commonly ordered blood

chemistries (e.g., liver and kidney function tests).
b. Special chemistry – elaborate techniques such as electrophoresis,
and manual testing methods.
c. Clinical endocrinology – involves testing of hormones, and
diagnosis of endocrine disorders.
d. Toxicology – involves testing of drugs of abuse and other
chemicals.
e. Therapeutic Drug Monitoring – measurement of therapeutic
medication levels to optimize dosage.
B. Hematology
- The section in the laboratory that goes into the study of blood.
- By examining the cells in a blood specimen, the technologist can detect
disorders such as leukemia, anemia, other blood diseases, infection
and monitoring their treatment.
C. Coagulation
- Requires citrated blood samples to analyze blood clotting times and
coagulation factors.
D. Urinalysis Section / Clinical Microscopy Section
- Routine screening procedure to detect disorders and infections of the
kidney and to detect metabolic disorders such as diabetes mellitus and
liver disease.
E. Microbiology
- Where the identification and susceptibility testing of pathogenic
microorganisms are performed. Tests like 10% KOH for fungi and India
Ink are also being done in this section. The tests available in the

Course Module
 MEDT 08 :
Module 1:
Laboratory
Introduction to Laboratory Management
Management

microbiology laboratory may employ the use of conventional and

automated systems.
F. Blood Bank
- The section of the laboratory where blood may be collected, stored and
prepared for transfusion.
- Also called immunohematology section because the testing
procedures involve antigens and antibodies.
G. Serology (Immunology)
- Performs tests to evaluate the body’s immune response; that is, the
production of antibodies (immunoglobulins) and cellular activation.
H. Informatics
- The section in control of the Laboratory Information System (LIS)
- Where the results are being validated before being released/ uploaded
to the system.

LABORATORY SERVICES
Clinical laboratories offer different laboratory services of both anatomical
pathology and clinical pathology services

Routine services include:

1. Routine Hematology
o CBC (complete blood count)
o Differential count
o Hematocrit/Hemoglobin
o Blood Indices
o Platelet count
2. Routine Chemistry
o RBS/FBS
o Kidney Function Tests
o Liver function Tests
o Lipid Profile
o Electrolytes
3. Routine Microbiology
o AFB
o Gram stain
o 10% KOH test
o India ink negative staining
o Culture and sensitivity
4. Routine Urinalysis and Fecalysis
5. Routine Coagulation
o Prothrombin Time
o APTT

Special Services:
1. Molecular Biology
 Polymerase Chain Reaction (PCR)

Course Module
 MEDT 08 :
Module 1:
Laboratory
Introduction to Laboratory Management
Management

2. Genetics – perform DNA analysis

 Cytogenetics
- using blood and other cells to get karyotype
- helpful in the pre-natal diagnosis of Down’s Syndrome as
well as in career (some cancers have abnormal
chromosomes)
3. Special Coagulation
- Mixing studies
4. Special Chemistry
 Electrophoresis
 Toxicology
 Immunochemistry
- EIA techniques to measure substances such as digoxin,
thyroid hormones, cortisol, vitamin B12, folate.

2. Anatomic Pathology
- includes surgical pathology, immunohistopathology, cytology, autopsy,
forensic pathology and molecular pathology
- Anatomical area is concerned with the diagnosis of disease based on the
macroscopic, microscopic, biochemical, immunologic and molecular
examination of organs and tissues.
Sections of the anatomical area include:
a. Cytology section
 In this section, the cytologist process and examine tissue and body
fluids for the presence of abnormal cells, such as cancer cells. Pap
smear is one of the most common tests performed in cytology.
b. Histology section
 In this section, the histology technician process and stain tissues
obtained from biopsies, surgery, autopsies, and frozen sections. A
pathologist examines the tissue.
c. Cytogenetics section
 It is the section in which chromosome studies are performed to
detect genetic disorders. Blood, amniotic fluid, tissue, and bone
marrow specimens are analyzed.

C. Based on Institutional Character

1. Institution-based
o Laboratories that operate within the premises of an institution such as
hospital, medical clinic, school, medical facility, for overseas workers
and seafarers, birthing homes, and psychiatry facility and drug
rehabilitation center.
2. Free-Standing
o A laboratory that does not form any part of any other institution

Course Module
 MEDT 08 :
Module 1:
Laboratory
Introduction to Laboratory Management
Management

D. Based on Service Capability

 General Clinical Laboratory

1. Primary Category
o Provides minimum service capabilities such as routine hematology,
qualitative platelet determination, routine urinalysis, and routine
fecalysis, and for hospital-based- blood typing.
2. Secondary Category
o Provides all tests conducted by primary category plus routine clinical
chemistry, quantitative platelet determination, for hospital- based-
cross matching and gram staining, KOH test.
3. Tertiary Category
o provides all tests conducted by secondary category laboratory plus
special chemistry, special hematology and coagulation tests,
immunology/serology, and microbiological tests including culture and
sensitivity
4. Limited Service Capability
o Applies to institution- based laboratories.
o Provides lab tests required for a particular service in institutions such
as but not limited to dialysis centers and hygiene clinics
E. Others

 Special Clinical Laboratory

o Laboratory that offers highly specialized services that are usually not
provided by a general clinical laboratory. Ex. Molecular biology,
assisted reproduction technology

 Alternate Sites of Testing

1. Point-of-care Testing laboratory (POCT)
o Laboratory testing near the site of the patient care rather than in the
clinical laboratory
o It includes testing at the bedside, outpatient sites, within or outside the
hospital or clinics, or at home.
o It permits testing near the patient’s location and is a supplement to, not
a replacement for central laboratory services.

References and Supplementary Materials

1. World Health Organization. (2011). Laboratory quality management system handbook.
USA: WHO
2. Venzon & Nagtalon. (2006). Nursing Management Towards Quality Care. 3rd ed.
Philippines: C & E Publishing, Inc.
3. Rodriguez, M. T. (2014). Clinical Chemistry Review Handbook for Medical Technologists.
Philippines: Cattleya Star Copy Center and Book Binding.
4. Suba & Florida. (2014). Introduction to Medical Technology with Science, Technology,
and Society. Philippines: Cengage Learning Asia Pte Ltd.

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