By Kenneth D. McClatchey DDS MD
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Additional resources for Clinical laboratory medicine : clinical application of laboratory data
Test Appropriateness Education In 1990, the JCAHO encouraged test appropriateness education when it published a standard that provided laboratory physicians with a strong policy to support education of clinical physicians in test appropriateness (40). ‖ Furthermore, this standard (now part of a matrix of factors) is a key factor in the decision-making process for accreditation. The standard allows the laboratory director and managers to set up education guidelines, working in conjunction with clinical physicians and other providers for test appropriateness training.
14. 16 indirect costs using formulas and examples can be found in Cost Accounting in the Clinical Laboratory, published by the National Committee for Clinical Laboratory Standards (32), and textbooks by Travers (27,31). 14. Analysis of total operating cost. (Adapted from Matz A, Usry MF. Cost accounting: planning and control, 7th ed. ) Indirect costs are assigned to total cost based on a multitude of factors that are part of hospital or corporate operations. They are added to the cost of tests as a percentage rather than as actual amounts for each item.
The problems with operating too much automated equipment are (a) it generates too many labor costs, (b) optimum discounts are not always available unless test volume per instrument is very large, (c) it causes a requirement for additional quality control, standards and maintenance, and (d) it is usually not used to full capacity in noncommercial settings (39). Furthermore, if excessive or additional equipment is operated when staffing is less than optimal, the staff will be overstressed, will exceed its point of maximum efficiency, may produce errors, and will increase expenditures by using more reagents and supplies to keep up with the unchecked demand (Fig.