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Laboratory management and workload recording
66
THE ROYAL COLLEGE OF PATHOLOGISTS OF AUSTRALIA
2. For confirming the thyroid status of thyrotoxic patients previously treated with radioactive iodine (I3lI). Only 64.3””of euthyroid treated thyrotoxicosis patients had total T, in the reference range, whereas the total T, concentration was always in the reference range. 3. In thyrotrophin releasing hormone (RH) ’I stimulation studies. Normally serum T S H responses to T R H suffice but in patients with borderline clinical primary hypothyroidism, studies of serum T, responses were also very useful. In patients with 1311-treated thyrotoxicosis, it was shown that measurement of T:,responses to T R H is as essential as the response in TSH.
LABORATORY MANAGEMENT AND WORKLOAD RECORDING
WILLIAMS,MARJORIE J.
Veterans Adminisrration, Washinston, D.C.
Presented on behalf of rhe College of American Pathologists The College of American Pathologists is concentrating considerable effort in developing methods for measurement of the various components in laboratory management. Among its accomplishments is the development in conjunction with the Canadian Association of Pathologists of a Workload Recording Method for Clinical Laboratories, which is rapidly becoming a standard in North America. The precision of its nomenclature and definitions permit valid measurement while the unit values (weighting factors) add discrimination. Valuable information is accumulating on ranges of productivity for technical-clerical staff in hospitals and independent laboratories. Productivity is generally similar in all hospitals with more than 50 beds and the median approximates 45 unit values/paid man-hour in general hospitals. Productivity tends to be somewhat higher in independent laboratories with their more circumscribed operations. The continuing value of the Workload Recording Method is now assured with the establishment of procedures for self-renewal. A ‘universal’ protocol is availabk for collection of data for timing studies with centralized computer analysis support. New timing studies are accepted only after joint agreement on their validity. The Workload Recording Method through measurement of productivity can identify staffing requirements and, since salaries are major laboratory costs, the unit values become important in cost-finding procedures. Standard cost-finding techniques using the Workload Recording Method are now in preparation by the College and will be followed by the development of charts of accounts and publication of a manual.
SEQUENTIAL PATHOLOGICAL CHANGES SEEN I N CONTROLLED TRAUMA TO THE SPINAL CORD OF THE SHEEP
YEO,J. D. and PAYNE,W. H. Spinal Znjurizs Unit and Department of Clinical Pathology, The Royal North Shore Hospital of Sydney
Many patients with spinal cord damage suffer permanent paralysis and loss of sensation although the cord was severely bruised rather than lacerated by the displacement of the vertebral column. Experimental work has suggested that this apparently irreversible injury may be caused by ischaemia and could be at least partly reversed by the early introduction of physical or chemical treatment. In our experiment a controlled contusion injury is inflicted on the spinal cord of sheep. This shows swelling of the cord caused by congestion, haemorrhage and swollen axons and myelin sheaths. Between 2 and 4 h after the injury, breakdown and coalescence of myelin sheaths is the earliest structural evidence of permanent damage to the cord. When isotope rather than contrast myelography is used there is usually only partial obstruction to the flow of CSF so that the cord swelling alone is probably not responsible for the ischaemia. A local noradrenalin effect was suspected and a catecholamine antagonist injected within 1 h of the injury some reduction of the functional deficit and the size of the central cystic lesion in the cord was achieved. Further experiments are planned to measure the effect of alpha-methyl paratyrosine (a catecholamine antagonist) on the levels of noradrenalin in the blood and spinal cord.
THE ROYAL COLLEGE OF PATHOLOGISTS OF AUSTRALIA
2. For confirming the thyroid status of thyrotoxic patients previously treated with radioactive iodine (I3lI). Only 64.3””of euthyroid treated thyrotoxicosis patients had total T, in the reference range, whereas the total T, concentration was always in the reference range. 3. In thyrotrophin releasing hormone (RH) ’I stimulation studies. Normally serum T S H responses to T R H suffice but in patients with borderline clinical primary hypothyroidism, studies of serum T, responses were also very useful. In patients with 1311-treated thyrotoxicosis, it was shown that measurement of T:,responses to T R H is as essential as the response in TSH.
LABORATORY MANAGEMENT AND WORKLOAD RECORDING
WILLIAMS,MARJORIE J.
Veterans Adminisrration, Washinston, D.C.
Presented on behalf of rhe College of American Pathologists The College of American Pathologists is concentrating considerable effort in developing methods for measurement of the various components in laboratory management. Among its accomplishments is the development in conjunction with the Canadian Association of Pathologists of a Workload Recording Method for Clinical Laboratories, which is rapidly becoming a standard in North America. The precision of its nomenclature and definitions permit valid measurement while the unit values (weighting factors) add discrimination. Valuable information is accumulating on ranges of productivity for technical-clerical staff in hospitals and independent laboratories. Productivity is generally similar in all hospitals with more than 50 beds and the median approximates 45 unit values/paid man-hour in general hospitals. Productivity tends to be somewhat higher in independent laboratories with their more circumscribed operations. The continuing value of the Workload Recording Method is now assured with the establishment of procedures for self-renewal. A ‘universal’ protocol is availabk for collection of data for timing studies with centralized computer analysis support. New timing studies are accepted only after joint agreement on their validity. The Workload Recording Method through measurement of productivity can identify staffing requirements and, since salaries are major laboratory costs, the unit values become important in cost-finding procedures. Standard cost-finding techniques using the Workload Recording Method are now in preparation by the College and will be followed by the development of charts of accounts and publication of a manual.
SEQUENTIAL PATHOLOGICAL CHANGES SEEN I N CONTROLLED TRAUMA TO THE SPINAL CORD OF THE SHEEP
YEO,J. D. and PAYNE,W. H. Spinal Znjurizs Unit and Department of Clinical Pathology, The Royal North Shore Hospital of Sydney
Many patients with spinal cord damage suffer permanent paralysis and loss of sensation although the cord was severely bruised rather than lacerated by the displacement of the vertebral column. Experimental work has suggested that this apparently irreversible injury may be caused by ischaemia and could be at least partly reversed by the early introduction of physical or chemical treatment. In our experiment a controlled contusion injury is inflicted on the spinal cord of sheep. This shows swelling of the cord caused by congestion, haemorrhage and swollen axons and myelin sheaths. Between 2 and 4 h after the injury, breakdown and coalescence of myelin sheaths is the earliest structural evidence of permanent damage to the cord. When isotope rather than contrast myelography is used there is usually only partial obstruction to the flow of CSF so that the cord swelling alone is probably not responsible for the ischaemia. A local noradrenalin effect was suspected and a catecholamine antagonist injected within 1 h of the injury some reduction of the functional deficit and the size of the central cystic lesion in the cord was achieved. Further experiments are planned to measure the effect of alpha-methyl paratyrosine (a catecholamine antagonist) on the levels of noradrenalin in the blood and spinal cord.