David,
My first assignment on this job was to "consolidate" various subspecialty areas of a full service hospital lab into a Core Lab. Although this was done in the US, I think you may be interested in my experience.
The main reasons the hospital wanted a Core lab: Personnel savings due to cross coverage, scheduling flexibility, and better utilization of existing space. I can say with confidence that all three of these goals have been met.
Here is a brief description of our way of doing it. We first evaluated what tests should be performed in the core lab, and what needed to be in a specialty area. The large volume, automated tests were the obvious candidates for the core lab. We added to these some other tests that could be transferred from a specialized analyzer to a large volume instrument. Small volume tests were evaluated if they needed to be performed in house for TAT or other patient care issues, or if they could be sent to a reference lab. After all the tests were accounted for, we decided on the number of "benches", or workstations. Each workstation is covered by one tech during peak times, but more than one bench could be consolidated into a workstation during night and weekends. Some benches contain one instrument, such as the automated chemistry or the hematology bench, while others may contain several instruments, such as the blood gas + coag bench. Instruments that were assigned to one workstation were moved close to each other within the existing lab space, and we added computer (network) outlets for the interfaces and terminals. Specialized tests, such as nucleic acid tests or forensic toxicology tests remained in their own separate areas. Once the number of benches per shift were known, we looked at staffing. We counted the necessary number of techs per shifts, and the necessary skill mix. We started an in-house training program to cross-train technologists who didn't have the necessary skills to cover sufficient number of benches. We only cross trained enough techs to be able to cover all benches all the time, but didn't train everybody on everything. Training on too many benches would've been counterproductive, because we couldn't keep the techs proficient on the long run. Specimen processing personnel were scheduled by sliding shifts to accommodate the actual number of samples that would arrive in an hour.
Supervisory duties were also adjusted for the core lab concept. Administrative duties (scheduling, ordering, etc.) were equally divided between the supervisors with certain administrative functions being rotated between them. Technical duties were kept with the specialized supervisor, i.e., the hematology supervisor may be responsible for the scheduling of all core lab personnel this month, but she is only responsible for hematology and coag instrument maintenance, instrument purchase, and similar things. This would ensure that we can maintain appropriate technical expertise.
Once all the design and training were completed, we set a date to switch over to the core lab. That was over five years ago, and we've never regretted it. The core lab concept has worked very well for us.
I hope you will find this informative. Don't hesitate to email me if you have further questions.
Geza
Geza S. Bodor, MD
Denver Health Medical Center
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> -----Original Message-----
> From: Lloyd David [mailto:[log in to unmask]]
> Sent: Thursday, May 29, 2003 5:08 AM
> To: [log in to unmask]
> Subject: Combined Biochemistry/Haematology labs
>
>
> Dear Colleagues
>
> I would appreciate members views as to the benefits (and pitfalls) of
> combined Biochemistry/Haematology laboratories, particularly
> the effect upon
> staff utilization.
>
> Many thanks
>
> David
>
> Dr David Lloyd
> Consultant Clinical Biochemist
> Royal Albert Infirmary
> Wigan
> Tel:01942 822129
> Fax: 01942 822134
> email: [log in to unmask]
>
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