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Decision Making: In-House vs. Commercial Laboratory
Decision Making: In-House vs. Commercial Laboratory
Evaluation Factors: Practices must determine if in-house testing is practical and economical compared to using a commercial laboratory.
Evaluation Factors: Practices must determine if in-house testing is practical and economical compared to using a commercial laboratory.
Advantages of In-House Testing:
Advantages of In-House Testing:
◦ Provides essential diagnostic screening when commercial labs are unavailable, such as nights and holidays.
◦ Provides essential diagnostic screening when commercial labs are unavailable, such as nights and holidays.
Barriers to In-House Testing:
Barriers to In-House Testing:
◦ The significant time and care required for quality control may make it impractical for many practices.
◦ The significant time and care required for quality control may make it impractical for many practices.
II. Quality Control and Risk Management
II. Quality Control and Risk Management
Personnel Training: Staff performing tests often have minimal technical training, necessitating rigorous quality control procedures.
Personnel Training: Staff performing tests often have minimal technical training, necessitating rigorous quality control procedures.
Potential for Error: Errors are not limited to the testing phase; they can occur during:
Potential for Error: Errors are not limited to the testing phase; they can occur during:
◦ Sample collection.
◦ Sample collection.
◦ Sample handling.
◦ Sample handling.
◦ Recording of results.
◦ Recording of results.
Testing Methodologies
1) Manual Methods:
1) Manual Methods:
◦ Characterized as time-consuming.
◦ Characterized as time-consuming.
◦ Highly subject to human error.
◦ Highly subject to human error.
2)Automated and Semiautomated Systems:
2)Automated and Semiautomated Systems:
◦ Generally more expensive than manual methods.
◦ Generally more expensive than manual methods.
◦ Offer more streamlined processing but require specific logistical support.
◦ Offer more streamlined processing but require specific logistical support.
Instrumentation and Economic Considerations
Instrumentation and Economic Considerations
Total Cost of Ownership: Beyond the initial instrument price, practices must budget for:
Total Cost of Ownership: Beyond the initial instrument price, practices must budget for:
◦ Reagent costs.
◦ Reagent costs.
◦ Materials for calibration and quality control.
◦ Materials for calibration and quality control.
Support and Infrastructure:
Support and Infrastructure:
◦ Availability of personnel training.
◦ Availability of personnel training.
◦ Access to technical support.
◦ Access to technical support.
◦ Regular instrument maintenance and service.
◦ Regular instrument maintenance and service.
Service Contracts:
Service Contracts:
◦ Often cost-effective despite costing up to 10% of the instrument's purchase price.
◦ Often cost-effective despite costing up to 10% of the instrument's purchase price.
◦ Helps mitigate the high expense of individual instrument repairs.
◦ Helps mitigate the high expense of individual instrument repairs.
Analogy for Quality Control: Establishing an in-house laboratory without rigorous quality control is like sailing a ship with an untrained crew and no compass. While you might leave the dock faster than waiting for a professional ferry (a commercial lab), the risks of getting lost or making a technical error during the journey are significantly higher.
Analogy for Quality Control: Establishing an in-house laboratory without rigorous quality control is like sailing a ship with an untrained crew and no compass. While you might leave the dock faster than waiting for a professional ferry (a commercial lab), the risks of getting lost or making a technical error during the journey are significantly higher.
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