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Planning for the future: The Department of Defense Laboratory Joint Working Group and Global Laboratory Information Transfer

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MILITARY MEDICINE 2000年第7期165卷 46-47页

作者： Huff, WB USAF Inst Environm Safety & Occupat Hlth Risk Anal Epidemiol Surveillance Div Brooks AFB TX 78235 USA

The Department of Defense (DoD) Laboratory Joint Working Group plans unified laboratory strategy under the auspices of the Armed Forces Institute of Pathology Board of Governors. One goal of the Laboratory Joint Working Group is to advocate clinical integration through automation of data transfer between medical treatment facilities using the DoD standard platform, Composite Health Care System (CHCS). A working group project team is implementing global laboratory information transfer, which enables CHCS-to-CHCS communication throughout the DoD, A prerequisite to global laboratory information transfer is the standardization of laboratory test nomenclature across all CHCS systems using LOINC (Logical Observation Identifiers, Names and Codes). This makes possible easier access to information among caregivers and therapeutic and public health disease managers and enhances global surveillance of disease outbreaks and continuity of care. The end result is the first-ever electronic transfer of laboratory results between all DoD facilities.

关键词：预测信息管理实验室/组织和管理军事医学/组织和管理人群监测人类

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The role of total laboratory automation in a consolidated laboratory network

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CLINICAL CHEMISTRY 2000年第5期46卷 751-756页

作者： Seaberg, RS Stallone, RO Statland, BE N Shore Long Isl Jewish Hlth Syst New Hyde Park NY 11042 USA Univ Minnesota Sch Law Minneapolis MN 55414 USA

Background: In an effort to reduce overall laboratory costs and improve overall laboratory efficiencies at all of its network hospitals, the North Shore-Long Island Health System recently established a Consolidated Laboratory Network with a Core Laboratory at its center. Methods: We established and implemented a centralized Core Laboratory designed around the Roche/Hitachi CLAS Total Laboratory Automation system to perform the general and esoteric laboratory testing throughout the system in a timely and cost-effective fashion. All remaining STAT testing will be performed within the Rapid Response Laboratories (RRLs) at each of the system's hospitals. Results: Results for this laboratory consolidation and implementation effort demonstrated a decrease in labor costs and improved turnaround time (TAT) at the core laboratory. Anticipated system savings are similar to$2.7 million. TATs averaged 1.3 h within the Core Laboratory and less than 30 min in the RRLs. Conclusions: When properly implemented, automation systems can reduce overall laboratory expenses, enhance patient services, and address the overall concerns facing the laboratory today: job satisfaction, decreased length of stay, and safety. The financial savings realized are primarily a result of labor reductions. (C) 2000 American Association for Clinical Chemistry.

关键词：自动化/经济学自动化/仪器和设备临床化学试验/经济学临床化学试验/仪器和设备社区网络医院实验室/经济学实验室/组织和管理人类

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The need for a military public health laboratory symposium

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MILITARY MEDICINE 2000年第7期165卷 5-7页

作者： Gaydos, JC US Dept Def Global Emerging Infect Surveilllance & Response S Div Prevent Med Walter Reed Army Inst Res Silver Spring MD 20910 USA

The Department of Defense Global Emerging Infections Surveillance and Response System has a mission to identify vulnerabilities in the military health system related to the occurrence of emerging infectious diseases, Public health laboratory (PHL) functions are critical to the detection and control of emerging infectious diseases and were assessed. Four important services were evaluated: (1) surveillance for antibiotic resistance, (2) laboratory-based infectious disease surveillance, (3) provision of diagnostic services for uncommon infections, and (4) specimen referral and information transfer within a defined PHL infrastructure. Initial assessments identified several shortcomings and a lack of information about PHL functions. Therefore, a PI-II, symposium was held in September 1999 to define the state of civilian and military PHL functions, identify problems and interventions, and encourage civilian-military networking. After the symposium, selected attendees met in two workshop groups. One addressed the first two functions;the other addressed the last two.

关键词：传染病控制传染病/诊断传染病/流行病学抗药性微生物实验室/组织和管理实验室技术和方法军事医学/组织和管理组织目标人群监测公共卫生美国人类

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The state of Public Health Laboratories

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MILITARY MEDICINE 2000年第7期165卷 8-11页

作者： Wilcke, BW Vermont Dept Hlth Div Hlth Surveillance Burlington VT 05402 USA

Public health laboratories in the United States exist at the federal, state, and local level. The earliest laboratories were created in the late 1800s in the wake of the work of Robert Koch and Louis Pasteur. Currently, these laboratories make up a loosely formed network. The combined state portion of this network employs more than 6,000 staff members, tests more than 20 million specimens each year, and has a combined annual budget of more than $300 million. Public health laboratories are found in a variety of organizational settings. Several efforts have been made to define the roles of public health laboratories. Recently, the Association of Public Health Laboratories adopted a consensus position that has formally set forth the core functions, which include activities such as environmental testing, emergency response, surveillance, and reference services. Public health laboratories are being challenged with funding, new technology, and current issues such as bioterrorism, food safety, and antimicrobial resistance.

关键词：传染病/诊断传染病/流行病学疾病暴发流行实验室/组织和管理实验室/统计学和数值数据模型组织管理组织目标人群监测公共卫生公共卫生管理研究美国/流行病学人类

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Antibiotic resistance monitoring: A laboratory perspective

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MILITARY MEDICINE 2000年第7期165卷 40-42页

作者： Trevino, S Wilford Hall USAF Med Ctr Lackland AFB TX 78236 USA

Efficient monitoring of antimicrobial resistance (AR) can produce timely and important data and information that will benefit patients and could assist in the detection of a bioterrorist event. The microbiology laboratory staff of the largest U.S. Air Force medical facility attempted to improve AR monitoring at their hospital by reviewing their current capabilities and the capabilities of other available monitoring systems. The systems reviewed included the DataTrac System (Vitek bioMerieux, Hazelwood, Missouri) and the military Composite Health Care System, which were already in use, and the WHONET 5 (World Heath Organization, Geneva, Switzerland) and The Surveillance Network (MRL Pharmaceutical Services, Herndon, Virginia), The Surveillance Network was selected for incorporation into the hospital AR monitoring program with modifications to comply with military command requirements. Information gathered during the review and selection process are presented and may be helpful to others who are looking to improve their hospital AR monitoring programs.

关键词：生物战临床实验室信息系统抗药性微生物实验室/组织和管理微生物学/组织和管理军事医学人群监测/方法人类

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The influence of an expert system for test ordering and interpretation on laboratory investigations

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CLINICAL CHEMISTRY 1999年第8期45卷 1168-1175页

作者： Smith, BJ McNeely, MDD Acquired Intellegence Inc Victoria BC V8P 2L5 Canada MDS Metro Lab Serv Victoria BC V8Z 5K8 Canada

Background: The Laboratory Advisory System (LAS) is an expert system interface that works interactively with clinicians to assist them with test selection and result interpretation throughout the laboratory investigation of a patient. Methods: To study the influence of the LAS on laboratory investigations, a repeated-measures experiment using clinical vignettes was conducted. To collect baseline data on how laboratory investigations are currently conducted, clinicians investigated one-half of the vignettes using a conventional (noncomputer) approach. To determine the influence of the LAS on clinicians' behavior, the other half of the vignettes were investigated using the LAS. Results: Clinicians using the LAS (compared with conventional practice) ordered fewer laboratory tests during the diagnostic process (mean, 17.8 vs 32.7), completed the diagnostic workup with fewer sample collections (mean, 5.8 vs 7.5), generated lower laboratory costs (mean, $194 vs $232), shortened the time required to reach a diagnosis (mean, 1 day vs 3.2 days), showed closer adherence to established clinical practice guidelines, and exhibited a more uniform and diagnostically successful investigation. Conclusion: The LAS enhances the outcome of the investigation and improves laboratory utilization (C) 1999 American Association for Clinical Chemistry.

关键词：临床实验室信息系统临床实验室技术/经济学实验室/经济学实验室/组织和管理医师软件人类

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Alliance of US labs plans to build map of cell signalling pathways

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NATURE 1999年第6759期402卷 219-220页

作者： Abbott, A

Alfred Gilman, a prominent US cell biologist, is seeking funds for a multi-laboratory, multidisciplinary initiative called the Alliance for Cellular Signalling. It would map how molecules in a cell interact with each ... 详细信息

关键词： B淋巴细胞/代谢合作行为实验室/组织和管理心肌/代谢研究/组织和管理信号传导美国动物小鼠

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A survey of endocrine function testing by clinical biochemistry laboratories in the UK

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ANNALS OF CLINICAL BIOCHEMISTRY 1999年第1期36卷 112-112页

作者： Gunnenberg, A Astley, P Goldie, DJ Morriston Hosp Dept Chem Pathol Swansea SA6 6NL W Glam Wales Southmead Gen Hosp Dept Clin Chem Bristol BS10 5NB Avon England

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论高等院校基础医学教学实验室建设与管理改革

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基础医学教育 1998年第4期6卷 99-100页

作者：王火团广东广州第一军医大学基础部 510515

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实验室管理体制改革的探索

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基础医学教育 1996年第3期4卷 57-58页

作者：刘丽华大同医专037008

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