guideline on standardisation of workload data collection
TRANSCRIPT
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HAEMATOLOGY
Dr Siti Zaharah Idris
Jawatankuasa Khas Beban Kerja Patologi
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1. Total no of specimens
2. Total no of tests
3.Test grouping (no of specimens & tests for individual group)
◦ A. General Haematology
◦ B. Basic Hemostasis and Thrombosis
◦ C. Specialised Hemostasis and Thrombosis
◦ D. Red Cell Disorders
◦ E. Haemoglobin Disorders
◦ F. Immunophenotyping
◦ G. Molecular Diagnosis For Non Malignant Haematology
◦ H. Molecular Diagnosis For Malignant Haematology
◦ I. Genetics for Haematological disorders
◦ J. Stem Cell Transplantation
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Total number of specimen = total number of specimens received and used for testing
When > 1 specimen received for one test, the number of specimen to be captured in workload will depend on test performed on these specimens
E.g. PB & BMA samples are received in 2 separate EDTA tubes from one patient for leukemia/lymphoma IPT, the screening and confirmatory tests are performed on BMA only, so number of specimen=1
PB specimen that is not used for testing is not counted
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Each profile test in general haematology & basic hemostasis
and thrombosis is counted as a single test
However, the tests in profile are individually counted within
designated group.
E.g. blood counts in profile (in FBP, DIVC screening, Hb
Analysis and acute leukemia screening by IPT) are counted
under FBC in general haematology
E.g. Reticulocyte count in profile ( in FBP, Hb analysis) is
counted under reticulocyte count in general haematology
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PT and APTT in profile (e.g DIVC screening, Factor assay) are counted under PT and APTT in basic hemostasis & thrombosis
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Profile tests in specialised hematology is counted based on the individual tests in each profile
Any additional test is individually counted as one test in the profile
e.g. Hb Analysis: ◦ gel electrophoresis in alkaline phase = 1 test and
◦ Gel electrophoresis in acid phase = 1 test
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e.g. IPT :every monoclonal antibody used is counted as 1 test
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For BMA, other than routine stains (MGG and Perl stain) each additional cytochemical stain performed is individually counted as 1 test
Control slides are not counted to ensure accurate data collection
MPO stain performed in leukemia/lymphoma IPT is counted as 1 test
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Workload calculation for ABO and Rhesus blood grouping (immunohaematology) is captured for primary healthcare services (Klinik Kesihatan) only
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Workload for CSF cytology testing is capture depending on local practices and the specialist reporting the test
In many lab, CSF cytospin for blasts is offered, performed and reported by hematopathologist
CSF cytology other than for blasts is under cytology services
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For quantitative molecular testing, duplication of tests is mandatory for every primer
Each primer used is counted as 1 test, regardless of the number of repeats
Molecular tests, including molecular genetics is counted based on every molecular defect or gene tested.
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The workload for urine biochemistry and urine cast & crystals is to be reported under Chemical Pathology, regardless of where the test are performed
This principle also applies for urine for eosinophils and urine for dysmorphic RBCs
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Non-test technical activities such as media preparation for transport and cell culture for cytogenetic test is captured mainly for purpose of manpower requirement
It is not counted in the total number of tests performed
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Genetic testing for congenital anomaly and cancers are done in either stand-alone molecular genetic laboratories or as part of pathology disciplines such as anatomic pathology
Therefore, workload is captured depending on where the tests are being performed
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