Communication- Process PDF

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Communication- Process...

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COMMUNICATION PROCESS  

Is the exchange of information between at least two persons The act or process of receiving and transmitting messages

Elements of Communication  Sender: person wishing to transmit a message  Message: the actual format of the communication effort.  Mode of Transmission: the vehicle by which a message is sent.  Receiver: the target of the message; either an individual or group.  Decoding: how a receiver translates the message

5. Presence of mutuality – eye contact, sound of voice and body language. 6. Composure – ability to compose oneself

Communication and Data processing Communications  Major component of all medical care Essence of Lab Med  The acquisition of data,  The validity of data  To assist the physician in diagnosis, therapeutic and prognostic decision. Types of Laboratory Communications A. Intralaboratory Communications B. Extralaboratory Communications

Types of Communication A. Intralaboratory Communications 1. Verbal – refers to spoken words. 2. Non-verbal – refers to written, laboratory result. Barriers to Communication 1. Structural – distance, spatial constraints Action: remove or find alternative routes 2. Semantics – words and messages, symbolism, figures, penmanship Action: Pay attention to both content and context of message 3. Technical – noise, distracting activity, lost message, information overload. Action: Find alternatives routes or times. 4. People – moods, emotions, feeling, halo effect, perception problems, interpersonal factors (social and personal differences) Action: provide training, groundwork, feedback, explanations, reassurance, trust and credibility. 5. Outcome – failure or low acceptance of the message Action: ensure that the outcome is within the ability of the receiver to perform Improving the Communication Process 1. Good Listening – asking questions, seeking feedback 2. Empathy – with concern and interest. 3. Repetition – sending message through several different routes 4. Presence of understanding – elements of communication

1. Policy Manuals  Dress codes  Food and smoking rules  Telephone use  Laboratory organizations and reporting relationship  Writing, review and authorization of procedures  Vacation and holiday request  Supply requisition  Absences and late arrival notification  Reporting and releasing of test results  Specific statements about enforcement of safety rules. 2. Procedure Manual  Often referred as “SOP”, standard operating  Quality Control Systems for laboratories should be designed to assure the medical reliability of the laboratory data. 3. Other Internal Manuals  Administrative Manual  Safety Manual  Quality Management Manual  4. Continuing In-Service Education - Regular continuing education sessions for laboratory staff 5. Intralaboratory Staff Meetings

B. Extralaboratory Communications 1. Manual of Procedure and Collection Instruction - A complete detailed book of instructions covering the ordering of tests, - Precautions for special procedures, - The proper method for preservation of specimens and pertinent standard procedures of the laboratory. Example: Specimen Collection Manual – a manual or section of the laboratory service manual that contain detailed instructions for patients and health care providers. 2. Laboratory User’s Manual - Useful in teaching institutions  Physicians,  House officers  Students – who need ready access to information about laboratory service. a. The first section – a directory of the laboratory sessions (hematology, chemistry) with listing of the key staff, the laboratory section, telephone numbers, operating hours and special instructions b. The second half – an alphabetical computer listing of the laboratory measurements and examinations Ex. Laboratory Service Manual – manual designed for users of the lab, covers policies and procedures concerning operational factors. 3. Laboratory Bulletins - Periodic laboratory bulletins, newsletter or measurements of the month, circulated to the medical staff, are useful means of communicating information about new laboratory services or policies. - Generally most effective when a standard format has been devised and when they are issued on a regular basis. 4. Other Extra Laboratory Communications - Laboratory Directors should be available and responsive to written or verbal communication from the Clinician users of the laboratory. - Laboratory staff becomes aware of its failure or success in meeting the needs of users.

REQUISITION AND REPORTING Requisition  Assures adequate identification of the patient and specimen - indicate the measurements for examinations desired.  An additional important function is the provision of administrative and billing data.  Laboratory tests must be made in writing  These request and reports shall identify the patient with certainly.  Minimum identification data shall include at least the following:  Full name of patient  Hospital number (name of ward)  Room number, bed number  Age  Sex  Attending physician  Clearly specify the tests to be performed and the kind of service required.  Time of collection should also indicated.  Record book should be maintained for the daily accession of specimens, each of which should be numbered or otherwise appropriately identified.  This record should contain at least the following information:  Laboratory procedure  Identification of the patient  Name of the physician  Date and time the specimen was collected  Date and time and by whim the specimen was received  Date, time and by whom the specimen was examined  Condition of any unsatisfactory specimen  Type of test or procedure performed  Results and date of reporting Reports Written Reports - Laboratory head is responsible for all laboratory reports and that authenticated and dated reports of clinical pathology tests should be filed promptly with the patient’s record and duplicated copies kept in the laboratory - Reports should be time stamped to record the date and hour the procedure was completed.

- Feasible reports should all be signed or initiated by the Medtech responsible for performing the procedure or by the Pathologist 

General Qualities of a Laboratory Report: 1. Compactness 2. Consistency of terminology, format ad usage of understandability 3. Clear and easy to understand 4. Logical and accessible location in medical chart 5. Statement of date and time of collection 6. Gross description and source of specimen when pertinent 7. Sharp differentiation of reference or normal and abnormal values 8. Sequential order of multiply results on single specimen 9. Identification of patient, patient location and physician 10. Assurance of accuracy of transcription of request

2. The date and time of specimen collection and identification of the person who collected the specimen. 3. The measurement or examination requested. When the same requisition is to be used for reporting, appropriate space for the results should be included. 4. Date and time of reporting and the initials of the Medtech performing the determination. 5. The identification of the laboratory. - The name of the head of the laboratory and/or associate Pathologist of the laboratory section in which the requisition is used. - If the procedure is performed by another laboratory, the laboratory’s name must also be shown on the reports. Patient and Specimen Identification 

Verbal Reports  Constitute a major problem for most laboratories  Major potential source of errors and medical liability  It is essential that verbal reports be given in order to facilitate medical care, particularly in an emergency situation.  The laboratory should require proper identification of the person receiving the report.  The person giving the report should repeat the patient’s name, identification number and location along with the results in order to confirm the identification.

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Alternative Methods to Verbal reports  Hand written results on either blank paper or pre-printed form  Facsimile transmission, on a process similar to photocopying a document, but done electronically to a remote output device.  A permanent report from the laboratory in the usual format would follow for medicolegal and medical record purposes. 1. Patient identification, usually in the upper right hand corner. Provision should be made for either handwritten or printed information.

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One of the problems in the clinical laboratories. Reliable patient and specimen identification is an essential feature of any accurate laboratory testing and reporting system. Identification system being used in the laboratory should be the same as that being used for admitting, nursing, pharmacy and other services to prevent confusion Laboratory professionals must make outmost care with the manual system of patient’s identification and specimen identification. Laboratory personnel should be instructed to seek positive identification by other persons who know the patient. Each specimen should be labeled immediately by the person collecting the specimen with the patient’s full name (correctly spelled), hospital wards and date. Improperly labeled or unlabeled specimens should not be accepted.

LABORATORY INFORMATION SYSTEM (LIS) 

A complete network of computer components designed - To incorporate all aspects of the informational needs of the laboratory and its customers from the intake of request for services and the processing of work flow to the deliver of results.

Terminology 

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Data: raw elements or single facts that by themselves have no meaning but when organized and evaluated together have the potential to reveal information. Information: data that have been processed, sorted and presented in such a manner that it increases the knowledge of the user Information system: a collection of interlinked and dependent parts that are organized to collect and input data, process the data into information, output the information to users and provide feedback to the system with the goal of meeting the complete informational needs of the organization.

Components 1. Hardware – the physical (plastic, wires) parts of the computer  Central Processing Unit: electronic portion of the computer; includes controlling unit and the quantitative analysis and data processing unit  Input devices: include keyboards, barcode readers, and computer links  Output devices: include printers and screens that allow the computer to disseminate information and communication with its users.  Computer memory and data storage: Read only Memory (ROM), random access memory (RAM), Main memory (CPU), database  Data storage devices: hard disk (stored in CPU), floppy disk, optical disk (CD, CDROM), disk drive – allows data to be extracted and entered in disks by the computer.

2. Software – the instruction (program) given to the computer to perform its tasks.  Application software: programs designed to meet specific needs of the users, such as word processing, pay roll, blood bank inventory management  System software: programs designed to control and run he operating systems of the computer including communications application software and database management Computer Networks 1. Local Area Network (LAN) – a computer network that connects computers and their equipment in confirmed area, usually a building or a place in which the users are in close geographic proximity to each other (i.e., a multifacility medical center complex) 2. Wide Area Network (WAN)  Hot based Lab. Information System: a local area network interfaced with a central controlling CPU whose program determines how data are received, processed and disseminated.  Client Server LIS: an open system that allows users to tap into the LIS with their independent computer systems, extract only the information they want and present it in the format they wish on their own computer screen or printer....