V.I. Starodubov¹, P.G. Malkov¹, M.A. Morozova⁴, G.A. Frank³ L.V. Moskvina^3
1Federal Research Institute for Health Organization and Informatics of Ministry of Health and Social Development of the Russian Federation, Moscow
²Moscow State Lomonosov University, Moscow
³Russian Medical Academy of Posgraduate Study, Moscow
⁴6th Moscow State Diagnostic Center.

Summary. We present the technology of production processes’ reorganization based on process approach, which allows forming a logically built, documented, transparent system for managing pathologic department. It is shown that a complex technological system should provide a stream organizing principle of the process and robotization main process stages in pathologic laboratory. A model of the process pathologic laboratory is formed using the principles of graphical modeling IDEF 0. The model is a preparatory (pre-analytical), research (analytical) and final (post-analytical) stages. The effectiveness of integrated approach demonstrated by the comparative technical and economic evaluation of manual and hardware methods in histological processing of tissue from the standpoint of cost effectiveness, improving the organization and informatization process. We have shown the possibility of significantly reducing overhead costs and economic losses by eliminating wasteful spending work-time used for manual execution of individual process steps. Thus the employment ready-to-use paraffin reduce cost up to 85.5%, ready-to-use solutions Mayer hematoxylin – up to 8.4%, using disposable microtome blades – up to 98.5%. Modeling and subsequent transformation process improved the quality of care and efficiency of laboratory capabilities to create conditions for increasing the volume of studies performed, to introduce a single standard of the laboratory, to shorten deadlines studies. These submissions may be useful for professionals in making decisions regarding the logistics of morphological laboratories.

Keywords. Pathologic anatomy, histology laboratory equipment, standardization of histological methods of investigation, informatization of laboratories.

References

1. GOST Ð ISO 9000-2001 Sistemy menedzhmenta kachestva. Osnovnyye polozheniya i slovar [GOST Ð ÈÑÎ 9000-2001 Quality management systems. Basic regulations and dictionary] Moscow: Gosstandart; 2001. 26 p.
2. GOST Ð ISO 10017-2005 Sistemy menedzhmenta kachestva. Statisticheskiye metody. Rukovodstvo po primeneniyu v sootvetstvii s GOST Ð ISO 9001 [GOST Ð ÈÑÎ 10017-2005 Quality management systems. Statistical methods. Guidelines for application according to GOST Ð ÈÑÎ 9001] Moscow: Gosstandart; 2005. 20 p.
3. GOST Ð ISO 9001-2001 Sistemy menedzhmenta kachestva. Trebovaniya. [GOST Ð ÈÑÎ 9000-2001 Quality management systems. Requirements]. Moscow: Gosstandart; 2001. 21 p.
4. GOST Ð ISO 9004-2001 Sistemy menedzhmenta kachestva. Rekomendatsii po uluchsheniyu [GOST Ð ÈÑÎ 9004-2001 Quality management systems. Recommendations for modernization ]. Moscow: Gosstandart. 2001. 47 p.
5. PD IDEF 0-2000. Metodologiya funktsionalnogo modelirovaniya IDEF 0. [ÐÄ IDEF 0–2000. Methodology of functional modeling IDEF 0]. Moscow: Gosstandart; 2000. 75 p.
6. Prikaz Minzdravsotsrazvitiya RF ot 03.12.2009 ¹944n. "Ob utverzhdenii poryadka okazaniya meditsinskoy pomoshchi onkologicheskim bolnym [Internet] [The regulation of MoH&SD of the RF of 2009, December 03 ¹944í “On approving the order of delivering medical care to oncological patients]. 2009 [cited 2011 May 21]. Available from: http://minzdrav-kbr.ru/index.php?option=com_content&view=article&id=179%3A----03122009-944&catid=44%3A2009-08-21-11-17-34&Itemid=60&lang=
7. A Guide to the Project Management Body of Knowledge (PMBOK Guide). USA Project Management Institute. 2000. 216 p.
8. Bossuyt X., Verweire K., Blanckaert N. Laboratory medicine: challenges and opportunities. Clin. Chem. 2007;53(10):1730-1733.
9. Buesa R.J. Adapting lean to histology laboratories. Ann. Diagn. Pathol. 2009;13(5):322-333.
10. Eccles M., Mason J. How to develop cost-conscious guidelines. Health Technol Assess 2001;5(16):1-69.
11. Finkelstein S.N. An approach to studying the cost behavior of changing utilization of a hospital laboratory. Hum. Pathol. 1980;11(5):435-439.
12. Frith C.H., Highman B. Konvicka A.J. Advances in automation for experimental Pathology. Lab. Anim. Sci. 1976;26(2):171-185.
13. Hughes B. The comparative effectiveness challenge. Nat. Rev. Drug Discov. 2009;8(4):261-263.
14. John T.A. Facilities available for biomedical science research in the public universities in Lagos. Nigeria. Niger Postgrad. Med. J. 2010;17(1):6-14.
15. Mathai A.M., Naik R., Pai M.R., Baliga P. Microwave histoprocessing versus conventional histoprocessing. Indian J. Pathol. Microbiol. 2008;51(1):12-16.
16. Mayer M. Laboratory cost control and financial management software. Clin. Chim. Acta 1998; 270(1):55-64.
17. Mina A., Favaloro E.J., Koutts J. A practical approach to instruments selection, evaluation, basic financial management and implementation in pathology and research. Clin. Chem. Lab. Med. 2008;46(9):1223-1229.
18. Muirhead D., Aoun P., Powell M., Juncker F., Mollerup J. Pathology economic model tool: a novel approach to workflow and budget cost analysis in an anatomic pathology laboratory. Arch. Pathol. Lab. Med. 2010;134(8):1164-1169.
19. Travers E.M. Economic tools for the pathologist. Clin. Lab. Med. 1995;15(1):179-201.
20. Zarbo R.J. Quality assessment in anatomic pathology in the cost-conscious era. Am J Clin Pathol. 1996;106(4). Suppl 1:3-10.

Write Comment

Please keep the topic of messages relevant to the subject of the article. Personal verbal attacks will be deleted. Please don't use comments to plug your web site. Such material will be removed. Just ensure to *Refresh* your browser for a new security code to be displayed prior to clicking on the 'Send' button. Keep in mind that the above process only applies if you simply entered the wrong security code.
Name:
E-mail
Comment:
Code:*