This document discusses courier services for transporting laboratory specimens. It covers the options of using internal couriers employed by the facility or external couriers contracted from an outside vendor. It also discusses using a mixture of both. Key considerations for courier services include costs, regulations, and ensuring specimen integrity during transportation. Proper packaging and labeling of specimens is important for compliance with shipping regulations. Technology and integrated software systems can help optimize dispatch, routing, and tracking of specimens.
Study of outbound logistics in Singapore shipping industrySoham Pablo
A study of the processes followed in a typical outbound process in the shipping industry, with the emphasis being on Singapore. ERP implementation opportunity.
Vehicle routing and scheduling Models:
Travelling salesman problem
vehicle routing problem with time window
Pick up and delivery problem with time window
Study of outbound logistics in Singapore shipping industrySoham Pablo
A study of the processes followed in a typical outbound process in the shipping industry, with the emphasis being on Singapore. ERP implementation opportunity.
Vehicle routing and scheduling Models:
Travelling salesman problem
vehicle routing problem with time window
Pick up and delivery problem with time window
Focused differentiation strategy - strategic management - Manu Melwin Joymanumelwin
A focused differentiation strategy requires offering unique features that fulfill the demands of a narrow market.
Some firms using a focused differentiation strategy concentrate their efforts on a particular sales channel, such as selling over the Internet only.
Third party logistics providers typically specialize in integrated operation, warehousing and transportation services
&
Fourth party logistics (4 PL) companies serve as consultants who manage the relationship between the principal company and one or more 3PLs to make sure all operations are running smoothly.
A small project report to study logistics and supply chain in detailsKumail Raza Muni
This project report is basically to understand various phases of logistics and supply chain with reference to DHL Company.
It can be referred by the one working on a project pertaining to logistics and supply chain subject.
Hi Friends
This is supa bouy
I am a mentor, Friend for all Management Aspirants, Any query related to anything in Management, Do write me @ supabuoy@gmail.com.
I will try to assist the best way I can.
Cheers to lyf…!!!
Supa Bouy
Focused differentiation strategy - strategic management - Manu Melwin Joymanumelwin
A focused differentiation strategy requires offering unique features that fulfill the demands of a narrow market.
Some firms using a focused differentiation strategy concentrate their efforts on a particular sales channel, such as selling over the Internet only.
Third party logistics providers typically specialize in integrated operation, warehousing and transportation services
&
Fourth party logistics (4 PL) companies serve as consultants who manage the relationship between the principal company and one or more 3PLs to make sure all operations are running smoothly.
A small project report to study logistics and supply chain in detailsKumail Raza Muni
This project report is basically to understand various phases of logistics and supply chain with reference to DHL Company.
It can be referred by the one working on a project pertaining to logistics and supply chain subject.
Hi Friends
This is supa bouy
I am a mentor, Friend for all Management Aspirants, Any query related to anything in Management, Do write me @ supabuoy@gmail.com.
I will try to assist the best way I can.
Cheers to lyf…!!!
Supa Bouy
‘Document Delivery Reimagined: Law Firm Librarians Lead the Way’ is a Reprints Desk e-book that details the market insights behind the 2014 service re-launch, after acquiring California-based 4 Research Solutions, Inc. in late 2012.
4C Associates has the insight, technology and experience to drive rapid profit improvement.
We offer specialist consulting, technology and managed services to transform your costs. We apply industry and functional expertise to deliver exceptional benefits.
I prepared this presentation for the end of semester. You can use it as you find it helpful.
Currently I am creating ElifNotes ( https://elifnotes.com ) for students looking help in English Literature studies.
http://www.twitter.com/cockermouse
Product Management And Service Delivery Process - FlackVentures ExampleKate Pynn
A lifecycle methodology enforces some very important processes that deliver critical value to Service Delivery. Some key contributions are:
Business driven goals (e.g. profit, performance, credible schedules, resource effectiveness….)
Roles and responsibility clarification (e.g. delegation, decision making, optimization….)
Organizational effectiveness (e.g. resource structure for task, enable cross functional efforts….)
Planning enforcement at the beginning before major resources committed
Continuous learning enabled that builds core competency in credible delivery plans.
Laboratory is a place that is equipped with different instruments, equipments and chemicals (reagents) etc., for performing experimental works, research activities and investigative procedures.
Medical laboratory is one part of the laboratory that is equipped with various biomedical instruments, equipments, materials and reagents (chemicals) for performing different laboratory investigative activities by using biological specimens (whole blood, serum, plasma, urine, stool, etc).
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
2. Ideas
o Employees
o Costs
o Training
o Transportation
o Dispatch Systems
o Specimen Handling
o Obamacare
o Partnerships
3. Internal Couriers
Facility hires and trains
Part of the healthcare team
Dedicated to pick ups including
mail, x-rays, medical records,
hospitals, clinics, physician offices
and other departments
Facility pays for company cars,
salary and employee benefits
4. External Couriers
Contracted with an outside source
Logistics is managed by an
independent vendor
Employees hired and trained by the
vendor
Performance of courier outside of
hiring hospital’s control
5. A Mixture of the Two Systems
Internal couriers may be used for
established physician routes
External couriers may be used for routine
routes between hospital sites
External courier services may be used for
vacation, sick time, new routes, new
areas
STAT’s
Internal couriers are supplemented using
outside sources for a variety of functions
6. Courier Employee Positives
Good for standard route pickups
Work long hours
Work hard
Very courteous
Good employees, semi-retired
Good driving record
Valid driver's license
Good work ethic
Required to transport heavy packages
Working knowledge of municipal streets, state
highway systems, maps, GPS, etc.
7. External Courier Negatives
Not showing up for vacation
coverage
Not dressing professionally
Falter at handling MD offices not
knowing where to go to get
lockboxes
Calling off that day, not replacing
and not notifying customer
8. Costs
o Car maintenance
o Training
o Vehicles ($20K)
o Insurance ($150/mo)
o Gas credit card for
drivers ($3.33-3.85/gal)
o Driver’s education
o Body work for fender
benders ($819)
o Salary and benefits
($28K)
9. Regulations
1. Occupational Safety and
Health Administration (OSHA)
2. Centers for Disease Control
(CDC) Bloodborne
pathogens
3. Department of
Transportation (DOT)
4. International Air
Transportation Association
(IATA)
5. International Civil Aviation
Organization (ICAO)
6. World Health Organization
(WHO)
7. Clinical Laboratory
Improvement Amendments
(CLIA)
10. And More Regulations
College of American Pathologists (CAP)
The Joint Commission (TJC)
Food and Drug Administration (FDA)
State such as Ohio Department of Health
(ODH)
Health Insurance Portability and
Accountability Act (HIPAA)
Business Associate Agreements (BAA)
11. Hazmat Employer
Does hospital send out staff need training if there is a courier packing the
box?
If the staff is classifying/packaging specimens for transportation. The
hospital, clinic and doctor's office are considered the shipper of the
package.
Does the person placing specimens into a box for shipment need to be
trained and certified?
Any persons handling specimens for transport must be trained and
certified to handle medical specimens.
What Category of specimens require Dangerous Goods Training?
Staff must be trained if providing specimens (dangerous goods) for
transportation.
Where can lab staff/couriers receive training for Dangerous Goods
Handling?
Employers must provide training for their employees.
IATA regulations require recurrent training every 2 years, unless there are regulation
changes prior to that time. DOT regulations require all training records be held as long as
the employee is retained and for 90 days thereafter.
12. Classification of Specimens
1. Exempt Human Specimens
Patient specimens where there is a minimal likelihood
that pathogens are present are not subject to these
regulations if the specimen is packed in a package
which will prevent any leakage and is marked with
the words “Exempt Human Specimen”.
2. Category B, Biological Substances (650)
UN3373; An infectious substance which does not
meet the criteria for inclusion in Category A.
3. Category A, Infectious Substances (620)
UN2814; An infectious substance which is transported
in a form that, when exposure to it occurs, is capable
of causing permanent disability, life threatening or
fatal disease in otherwise healthy humans.
13. Shipping
Packing methods and shipping guidelines are important in assuring quality
patient care and maintaining specimen integrity .
For the safety of others, specimens need to be classified into respective
shipping groups.
Standardized methods and procedures so that all specimens are
packaged and transported correctly.
The temperature at which specimens are held and or transported is a
critical component and different packaging will be needed for frozen,
refrigerated and ambient temperatures to achieve optimal
environmental control during transit.
Additional steps may need to be taken in seasons/locations where
extremes of heat or cold could affect specimen integrity.
Basic infection control procedures must also be followed, including
adherence to universal precautions protocols.
OSHA mandates all body fluids be considered potentially infectious and
that appropriate engineering and work practice controls be
implemented while handling the specimen.
14. Shipping
Dangerous
Goods
o Shipper Marking: Indicating the
name and address of the
shipper
o Consignee Marking: Indicating
the name and the address of
the intended receiver of the
package
o Responsible Party Marking:
Indicating the name and phone
number of a person “responsible
for the shipment”
o Class 6 Infectious Substance
Label: Indicating shipment
contains Category A Infectious
Substance Affecting Humans
o UN Specific Label UN2814
15. Dry Ice Label
Class 9 Miscellaneous
Dangerous Label
o The quantity must be
included on this label as
(___kg). (no more than 2.2kg
of dry ice is allowed per
shipping container.)
o Double up arrows pointing
upwards must be on
opposing sides of the box.
o Place the pre-packed tape
strip across the box only in
one direction.
o Care should be taken to
allow enough space for
carbon dioxide gas to
escape as dry ice dissipates
16. Ground Transportation
Exempt Human Specimens are not regulated by
ground transportation.
Category A and B specimens are regulated by the
DOT.
Dedicated private or contracted carrier is defined
as a motor vehicle used exclusively to transport
biological substances or biological products.
While other medical or laboratory related
materials may also be transported in this
vehicle, its purpose is primarily to transport
specimens.
17. Air Transportation
o Charter, Commercial and Cargo Aircraft
are used for transportation of specimens
to reference laboratories .
o IATA regulations must be followed for all of
the listed air transport options.
o Regulations include procedures for Dry
Ice, Category A versus Category B
specimens, labeling of shipments, and
any documentation guidelines.
18. Factors Which Can Damage
a Specimen During Transportation
Not being able to:
Use a seat belt on cooler and place
cooler in back or place on floor so the
specimens are not jostled.
Keep tubes upright for proper position
during clotting and transportation.
Division of cooler for ice and room
temperature to maintain integrity.
19. Specimen
Transportation
Errors
Lost or Compromised
specimens major source of
physician and patient
dissatisfaction.
o Losing specimens
o Not picking up in a timely
fashion or forgetting pickups
o Not emptying coolers
o Not maintaining the
appropriate temperature for
stability resulting in poor
specimen integrity
21. Laboratory Tests Affected by Hemolysis
Concentration
Increased
potassium, phosph
orus, LDH, TP, AST, a
lbumin, acid
phosphatase, Mg,
Fe, Ca, ALT
Concentration
Decreased
RBC, Hgb, Hct
22. Decreased RBC’s
Red blood cells (RBC), perhaps, perform the
most important duty in the body when it
comes to blood. These cells carry oxygen
from the lungs and deliver it to the rest of the
body. Also, they bring carbon dioxide back to
the lungs so that it can be exhaled.
Not having enough red blood cells deprives
the body from getting the amount of oxygen
required for its functioning. This condition of
low red blood cell count is called
anemia, and it may indicate several factors.
23. Decreased RBC Diseases
Lupus
Colon Cancer
Vitamin B12 or Folate Deficiency
Chronic Bleeding
Bone Marrow Insufficiency
Sickle Cell
Rheumatoid Arthritis
Iron Deficiency Anemia
And More….
26. Increased Analytes
Aspartate aminotransferase (AST) in
liver, heart, and muscle
Alanine aminotransferase (ALT) found in
liver
Uric acid gout and poor diet
Total bilirubin in obstructive jaundice
Lactic acid dehydrogenase (LDH)
elevates in response to cell damage
28. Dispatch Systems
Need to know neighborhood and routes
Online system to order stats
Can check back on specimens
Maintain the routes as physicians are
added or lost
Rearrange routes to be productive
Know where the specimens are at all
times
Change specimen pick up times
29. Courier Software Solutions
Streamline the process
Ensure reliability and accountability
Easy to use
Manage delivery system
Integration with other components and
interconnection
The level of expertise and the
performance expectation bar just keeps
rising higher
30. Integration
o Order entry
o Dispatch
o Tracking
o Reporting
o Barcoding
o Scanning
o Geographical footprint
o Virtual nationwide network
o Allows for the laboratory to plan workload and staff
accordingly
o Able to re-route drivers due to weather, STATS, or other
environmental factors
32. Client Management
Allows for the customization of
billing, rates and services
Dispatches know exactly where the
drivers are, what specimens they have
Track orders on line
Delivery status, proof of delivery
Variety of management reports
Designed to fit specific customer needs
34. Obamacare
What does that mean?
The official name for "ObamaCare" is the
Patient Protection and the Affordable Care
Act, a bill signed into law to reform the health
care industry.
ObamaCare requires that all insurance plans
cover preventive services and stops insurance
companies from dropping people when they
are sick, as well as offering a number of other
reforms and protections.
35. ObamaCare Medicare Advantage
The ObamaCare Medicare cuts will mainly affect
reimbursement rates for hospitals and private
health insurance companies.
ObamaCare also seeks to decrease the amount
paid to hospitals for Medicare.
Hospitals have already agreed to this practice
since everyone has insurance under the
Affordable Care Act.
Systems will see a large influx in the amount of
visitors to their hospitals, thus they should break
even or possibly profit, while saving the tax payers
money.
36. Medicare Value-Based
Purchasing Program
ObamaCare's new Medicare Value-Based Purchasing
Program means hospitals can lose or gain up to 1% of
Medicare funding depending on 20 factors that gauge
quality v. quantity care.
Hospitals are graded on a number of quality measures
related to the treatment of patients with heart attacks, heart
failures, pneumonia, certain surgical issues, re-admittance
rate, as well as patient satisfaction.
The ratings will be measured by the Hospital Consumer
Assessment of Healthcare Providers and Systems (HCAHPS).
Hospitals have substantial incentives to make sure
employees understand the legislation’s components, the 3rd
party HCAHPS process, and strategies to maximize efficiency
and customer service.
37. Value-based Payment Rewards
Hospitals for Providing Quality
Care
In other words if a hospital has a high re-admittance
rate or rated poorly for treatment they can lose a
percentage of funding or if they have a low re-
admittance rate or score well they can gain funding.
Some hospitals have already been hurt, while others
have gained significant funding. Although the
drawbacks are obvious in the short term it has created
an incentive to improve the quality of care in hospitals.
ObamaCare Medicare penalties / rewards will rise over
the next two years to a total of 2%.
http://obamacarefacts.com/obamacare-facts.php
38. Medicare Spending
26% of the U.S. federal Budget
Medicare providers will see $11 billion in
reimbursement cuts in 2013
Deficit reduction sequester was designed to
achieve savings of $1.2 trillion through 2021
Millions of dollars in Medicare reimbursement
are at stake for health care providers that
succeed or fail to navigate health care
legislations
39. Fun Facts
There are 9757 companies labeled as
couriers.
Approximately 5,815 Registered Hospitals
in the US.
5,010 Community Hospitals
213 Federal Government Hospitals
447 Non Federal Psychiatric Hospitals
129 Non Federal Long Term Care Hospitals
16 Hospitals of Institutions(Prison Hospitals,
College Infirmaries etc...). (Wiki Answers, 2013)
40. Think of All the Work!
According to a report by the US Census
Bureau there were over 661,400 doctors and
surgeons practicing medicine in 2008. In 2003
the US Department of Labor broke down the
categories to include 23,790
Anesthesiologists, 111,990 General
Practitioners, 50,140 Internists, 19,180
OB/GYNs, 26,910 Pediatricians, 19,530
Psychiatrists and 49,730 Surgeons. (U.S. Department of
Labor, Occupational Outlook Handbook, 2012-13 Edition, Physicians and Surgeons,
on the Internet at http://www.bls.gov/ooh/healthcare/physicians-and-surgeons.htm (visited
June 23, 2013).
42. Partnership
Willing to pay more for
better service
o Professionalism
o Simplify process
o Cost containment
o Quality patient
care
o Safety
o Reliability
43. Problems
Laboratory professionals work in one of the
most highly regulated environments in health
care
Small changes can be very difficult due to
time, budget and staffing constraints
Very difficult for laboratories to maintain a
high performing, cost effective courier service
Decreasing reimbursement environment and
tight budgetary constraints for capital
purchases
Competition between facilities
44. Laboratory Priorities
Phlebotomy
Quality Control
Patient Testing
Customer Service
Instrument Maintenance
Physicians, nurses, other ancillary
departments for care coordination
Reference Labs
Courier Services
45. Solutions
IT solutions
Tough performance standards need to be
met
Managerial expertise are needed to run
these programs
Look at ways to reduce costs and
maintain quality
Integration of services