guideline on standardisation of workload data collection

HAEMATOLOGY

Dr Siti Zaharah Idris

Jawatankuasa Khas Beban Kerja Patologi

1. Total no of specimens

2. Total no of tests

3.Test grouping (no of specimens & tests for individual group)

◦ A. General Haematology

◦ B. Basic Hemostasis and Thrombosis

◦ C. Specialised Hemostasis and Thrombosis

◦ D. Red Cell Disorders

◦ E. Haemoglobin Disorders

◦ F. Immunophenotyping

◦ G. Molecular Diagnosis For Non Malignant Haematology

◦ H. Molecular Diagnosis For Malignant Haematology

◦ I. Genetics for Haematological disorders

◦ J. Stem Cell Transplantation

Total number of specimen = total number of specimens received and used for testing

When > 1 specimen received for one test, the number of specimen to be captured in workload will depend on test performed on these specimens

E.g. PB & BMA samples are received in 2 separate EDTA tubes from one patient for leukemia/lymphoma IPT, the screening and confirmatory tests are performed on BMA only, so number of specimen=1

PB specimen that is not used for testing is not counted

Each profile test in general haematology & basic hemostasis

and thrombosis is counted as a single test

However, the tests in profile are individually counted within

designated group.

E.g. blood counts in profile (in FBP, DIVC screening, Hb

Analysis and acute leukemia screening by IPT) are counted

under FBC in general haematology

E.g. Reticulocyte count in profile ( in FBP, Hb analysis) is

counted under reticulocyte count in general haematology

PT and APTT in profile (e.g DIVC screening, Factor assay) are counted under PT and APTT in basic hemostasis & thrombosis

Profile tests in specialised hematology is counted based on the individual tests in each profile

Any additional test is individually counted as one test in the profile

e.g. Hb Analysis: ◦ gel electrophoresis in alkaline phase = 1 test and

◦ Gel electrophoresis in acid phase = 1 test

e.g. IPT :every monoclonal antibody used is counted as 1 test

For BMA, other than routine stains (MGG and Perl stain) each additional cytochemical stain performed is individually counted as 1 test

Control slides are not counted to ensure accurate data collection

MPO stain performed in leukemia/lymphoma IPT is counted as 1 test

Workload calculation for ABO and Rhesus blood grouping (immunohaematology) is captured for primary healthcare services (Klinik Kesihatan) only

Workload for CSF cytology testing is capture depending on local practices and the specialist reporting the test

In many lab, CSF cytospin for blasts is offered, performed and reported by hematopathologist

CSF cytology other than for blasts is under cytology services

For quantitative molecular testing, duplication of tests is mandatory for every primer

Each primer used is counted as 1 test, regardless of the number of repeats

Molecular tests, including molecular genetics is counted based on every molecular defect or gene tested.

The workload for urine biochemistry and urine cast & crystals is to be reported under Chemical Pathology, regardless of where the test are performed

This principle also applies for urine for eosinophils and urine for dysmorphic RBCs

Non-test technical activities such as media preparation for transport and cell culture for cytogenetic test is captured mainly for purpose of manpower requirement

It is not counted in the total number of tests performed

Genetic testing for congenital anomaly and cancers are done in either stand-alone molecular genetic laboratories or as part of pathology disciplines such as anatomic pathology

Therefore, workload is captured depending on where the tests are being performed