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Objectives: In the United States, minimum standards for quality control (QC) are specified in federal law under the Clinical Laboratory Improvement Amendment and its revisions. Beyond meeting this required standard, laboratories have flexibility to determine their overall QC program., Methods: We surveyed chemistry and immunochemistry QC procedures at 21 clinical laboratories within leading academic medical centers to assess if standardized QC practices exist for chemistry and immunochemistry testing., Results: We observed significant variation and unexpected similarities in practice across laboratories, including QC frequency, cutoffs, number of levels analyzed, and other features., Conclusions: This variation in practice indicates an opportunity exists to establish an evidence-based approach to QC that can be generalized across institutions.

The authors review the reasons behind the currently evolving restructuring within the healthcare industry and its implications for hospital laboratories. They predict a continuing decline in the volume of inpatient care with a similar effect on the volume of hospital laboratory testing. They also foresee a shift to independent laboratories in the volume of outpatient testing--currently a key revenue source for many hospital laboratories. For those hospitals that redefine their mission, inpatient testing for higher-acuity patients is one role, as is managing point-of-care testing in nontraditional settings.

Molecular testing is no longer exotic, distant, or complex. It's moving into your lab and revolutionizing the rapid diagnosis of pathogenic organisms as well as your role as a laboratorian.

Beware: Small savings in the lab may be expensive for the hospital. Examine the flow of laboratory operations in the context of the entire facility.

The selection of new instrumentation is a complex process. Each step must be carefully evaluated, since mistakes will remain in the laboratory for years to come. Infatuation with technology often leads to expensive mistakes.

The analytical and operational capabilities of clinical chemistry analyzers will continue to evolve as new technologies are developed. This will lead to increasingly greater automation and enhanced ease of use. However, it will be important for the laboratorian to understand these technologies in order to effectively integrate them and interact with them in the health care environment.

There are a wide variety of analyzers capable of performing STAT testing. Some are dedicated devices, while others are also used for routine work. The degree to which these instruments can meet the laboratory's requirements will depend on laboratory design, test menu, and volume. These factors should be considered when evaluating the appropriateness of a STAT facility and the selection of equipment.

This article discusses the ideal requirements of office laboratory instruments and analyzes the various operating modes and types of reagents. General and specific features of chemistry and hematology analyzers are presented. Lastly, the financial decision-making process is outlined.

Tumor cells of the congenital granular cell epulis (GCE), unlike those of the granular cell tumor (GCT), did not stain with antiserum to S-100 protein. Based on immunohistochemical findings it is concluded that the GCE and GCT differ in histogenesis; furthermore, ultrastructural studies of the authors are in agreement with others in supporting a mesenchymal origin of the GCE.

Analyses of technology and workflow can help a lab determine whether it needs a new instrument or other changes to improve operations.

A variety of chemistry analyzers exist for performing routine analysis, including sample-based and random access instruments with a wide range of throughput capabilities. Representative analyzers based on dry and liquid reagent technology are discussed.