Clinical laboratory services in Finland

Transkriptio

1 Clinical laboratory services in Finland Päivi Lakkisto Clinical instructor Helsinki University HUSLAB Modified from slides of Timo Kouri, Chief phycisian in Meilahti hospital laboratory, HUSLAB 1

2 21 Finnish hospital L districts 5 university hospital responsibility areas LP PP PP KAI KP V EP KS PS PK S P ES IS VS KH HUS PH EK KYM Kumppanuus kannattaa 2

3 Laboratory as a market 95% municipality-owned patient care 5% private services: a few laboratory centers providing comprehensive studies Clinical laboratories usually owned by regional municipal organisations (hospital districts) True costs charged internally from clinics and ambulatory units Kumppanuus kannattaa 3

4 Helsinki and Uudenmaa hospital district Länsi-Uudenmaan sairaanhoitoalue Lohjan sairaala Tammisaari Lohjan sairaanhoitoalue Pohja Sammatti Karjalohja Karjaa Nummi- Pusula Lohja Inkoo Hyvinkään sairaala Karkkila Siuntio Vihti Kellokosken sairaala Hyvinkää Mäntsälä Järvenpää Nurmijärvi Pornainen Tuusula Kerava Espoo Kirkkonummi Vantaa Kauniainen Hyvinkään sairaanhoitoalue Helsinki Sipoo Askola Peijaksen sairaala Porvoo Jorvin sairaala Hyksin sairaalat Helsingissä HYKSsairaanhoitoalue Liljendal Pernaja Lapinjärvi Loviisa Porvoon sairaala Porvoon sairaanhoitoalue Hanko Tammiharjun sairaala Länsi-Uudenmaan sairaala Kumppanuus kannattaa 4

5 Helsinki and Uudenmaa hospital district -laboratories Kumppanuus kannattaa 5

6 HUSLAB statistics Five laboratory disciplines (chemistry& haematology, microbiology, pathology, genetics, toxicology) 18 million tests + 2 million specimen collections annually 121 million euros 1600 employees Accredited services (SFS-EN ISO ja SFS-EN ISO 15189) Kumppanuus kannattaa 6

7 Laboratory process Pre-Analytical Test request (computer) Patient preparation Sample collection Analytical Post-Analytical Sample transport, preservation ANALYSIS ---- Reporting (data transmission) Quality control Interpretation Kumppanuus kannattaa 7

8 Kumppanuus kannattaa 8

9 Correct tube appropriate specimen

10 Meilahden sairaala-alue - Mejlans sjukhusområde - Meilahti Hospital Area Meilahden sairaala Mejlans sjukhus Meilahti Hospital 4 2. Syöpätautien klinikka Kliniken för cancersjukdomar Department of Oncology H2 7 H H P1 P2 Pysäköintilaitos Parkeringsanhälla Parking Tunnel H1 P1, P2 Hissit Hissarna H2 Lifts 3. Lastenklinikka Barnkliniken Children s Hospital 4. Lastenlinna Barnets borg Children s Castle 5. Hallintokeskus Förvaltningscentralen Administration Center 6. Ravioli Materiaalikeskus Materialcentralen Materials Manager Center 7. Palvelukeskus Servicecentralen Support Services Center 8. Kiinteistöhuolto Fastighetsunderhåll Real Estate Maintenance 10. Korva-, nenä- ja kurkkutautien klinikka Kliniken för öron-, näs- och halssjukdomar Department of Othorhinolaryngology 11. Silmätautien klinikka Kliniken för ögonsjukdomar Department of Ophtalmology 12. Opetusrakennus Undervisningsbyggnaden Lecture Halls 13. Turvakeskus Säkerhetscentralen Security Center Biomedicum Helsinki 16. Biomedicum Helsinki 17. Biomedicum Helsinki 18. Biomedicum Helsinki 19. Psykiatrian poliklinikka Psykiatriska polikliniken Psychiatric Outpatient Department 20. Voimakeskus Kraftstation Power Center 21. Iho- ja allergiasairaala Hud- och allergisjukhuset Skin and Allergy Hospital 22. Päiväranta 23. Ulfåsa 24. Haartman Instituutti Haartman Institute P1, P2 Pysäköintilaitos Parkeringsanläggning Parking Tunnel 9. Naistenklinikka Kvinnokliniken Dept. of Obst. and Gynec. 14. Terveystieteiden keskuskirjasto Centralbibl. för hälsovetenskap National Library of Health Sciences H Helikopterikenttä Landningsplats för helikopter Helicopter Landing Spot

11 Centralised analysis 60 % of all tests performed Highly automated production line

12 Meilahti Hospital Laboratory Ambulatory specimen collection, 3rd floor Emergency laboratory, 1st floor Automation laboratory, 1st floor Automation Haematology Coagulation Chemistry Immunochemistry Blood bank Specialised haematology Morphology Flow cytometry Special studies

13 Point-of-care tests Rapid diagnostics if clinically needed Non-laboratory workers and selfmonitoring tests (e.g. blood glucose) Assumed quality Lack of many needed tests Costs /analysis usually higher than in centralised laboratory tests 13

14 Challenges Cost efficiency rapid diagnostics Clinical need unavailable test Sufficient amount of personnel Interpretation of results Perceived and true quality 14

15 Take home message Most laboratories in Finland are municipality-owned and provide laboratory diagnostics for their hospital/ University hospital district patient-care units Analyses centralized and highly automated Point-of-Care tests are increasing, and already make up a substantial laboratory market 15