title: Strategic considerations in clinical laboratory management: a laboratory leadership role in clinical pathways. Establishing the laboratory's direct contribution to the institution's performance.
abstract: This clinical laboratory serves a unique, though incompletely recognized, function in medical care as the source, moderator, and conduit of vital information supporting the detection, confirmation, and monitoring of disease states. To carry out that function effectively, the laboratory must actively participate in developing clinical pathways based on medical programs. Clinical pathways define the operational and quality requirements for the services involved in meeting the medical program objectives. Because of the laboratory's unique position in the acquisition and flow of information, its contribution must continue as a planned process--based on accurate assessment of value, cost, and resource inputs--rather than in a discrete, event-driven manner. Two examples of clinical pathway development, partly given by the laboratory, illustrate its application in nutritional screening and monitoring for metabolic support and in emergency department admitting decisions on myocardial damage at Bridgeport Hospital (Bridgeport, CT). The paper suggest two activities, point-of-care testing and screening for fetal lung development, that could benefit considerably from clinical pathway information shared across the experiences of several institutions.
authors.affiliation: Bridgeport Hospital, CT, USA.
authors.forename: L H
authors.initials: LH
authors.lastname: Bernstein
authors.forename: F I
authors.initials: FI
authors.lastname: Scott
mesh_terms: D002637:Chest Pain / Q000628:therapy; D019091:Critical Pathways; D006801:Humans; D007755:Laboratories, Hospital / Q000592:standards*; D007857:Leadership; D009751:Nutritional Requirements; D009937:Organizational Objectives; D019095:Point-of-Care Systems; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D017749:Total Quality Management; D014481:United States