PRINCIPLES OF

MEDICAL TECHNOLOGY
PRACTICE 1
 UNIT 2
CLINICAL LABORATORY
 OUTLINE
• General overview
• Classification of medical laboratories
• Laboratory Sections
• Information flow in the clinical laboratory
• Three phases of laboratory testing
• Laboratory policies
 STUDENT OUTCOMES

At the completion of this unit, the students should be able to:

• Identify and differentiate the classification of clinical Laboratory
settings
• Explain the roles, functions, and services offered by the different
sections of the laboratories.
• Justify and explain various information on a laboratory requisition.
• Identify the different phases of laboratory testing.
 CLINICAL LABORATORY

• Facility
• Specimens (whole blood, serum, plasma, urine,
stool, etc) from the human body
• Collected, processed, examined or analyzed
• Prevention, diagnosis & treatment
CLINIC AL LABORATORY
 CLASSIFICATION OF CLINICAL
LABORATORY
DEPARTMENT OF HEALTH
Administrative Order no. 2021-0037

A. Based on Ownership
1. Government
2. Private
B. Based on Function
1. Clinical Pathology
2. Anatomical Pathology
 CLASSIFICATION OF CLINICAL LABORATORY
(BASED ON FUNCTION)
Clinical Pathology:

1. Clinical Chemistry 7. Immunohematology

2. Hematology 8. Cytogenetics
3. Microbiology 9. Endocrinology
4. Clinical Microscopy 10. Toxicology
5. Immunology 11. Therapeutic drug
6. Molecular Biology monitoring
CLASSIFICATION OF CLINICAL LABORATORY
(Based on Function)
Anatomical Pathology :
1. Surgical Pathology
2. Immunohistopathology
3. Cytology
4. Autopsy
5. Forensic Pathology
6. Molecular Pathology
CLASSIFICATION OF CLINICAL LABORATORY
(Based on Function)
Molecular Pathology :

Deal with analysis of genes, proteins and other molecules in

samples of organs, tissues or bodily fluids
 CLASSIFICATION OF CLINICAL LABORATORY

C. Based on Institutional Character:

1. Institution-based
2. Freestanding
D. Based on Service capability
1. General Clinical and Anatomic Pathology
2. Clinical Laboratory for Anatomic Pathology only
3. Clinical Laboratory for Molecular Pathology only
CLASSIFICATION OF CLINICAL LABORATORY
(BASED ON SERVICE CAPABILITY)

1. General Clinical Laboratory

a. Primary Category
b. Secondary Category
c. Tertiary Category
d. Limited Service capability
CLASSIFICATION OF CLINICAL LABORATORY
(BASED ON SERVICE CAPABILITY)

1. General Clinical Laboratory

a. Primary Category
1. Routine hematology (CBC)
2. Qualitative platelet determination
3. Routine urinalysis and fecalysis
4. Blood typing – for hospital based

* minimum of 10 square meters in floor area

CLASSIFICATION OF CLINICAL LABORATORY
(BASED ON SERVICE CAPABILITY)

1. General Clinical Laboratory

b. Secondary Category
1. Routine Clinical Chemistry
2. Quantitative platelet determination
3. Cross matching
4. Gram staining
5. KOH staining for fungal disease

*minimum of 20 square meters in floor area

 CLASSIFICATION OF CLINICAL
LABORATORY (BASED ON SERVICE
CAPABILITY)

1. General Clinical Laboratory

c. Tertiary Category
1. All secondary lab services
2. Special chemistry (Cardiac markers)
3. Special Hematology (coagulation tests)
4. Immunology/Serology (HIV, hepa profile, tumor markers)
5. Microbiology – culture and sensitivity

* Minimum of 60 square meters in floor area

CLASSIFICATION OF CLINICAL
LABORATORY (BASED ON SERVICE
CAPABILITY)

1. General Clinical Laboratory

d. Limited Service capability
a. Dialysis centers
b. Social hygiene clinics
CLASSIFICATION OF CLINICAL
LABORATORY (BASED ON SERVICE
CAPABILITY)
2. Special Clinical Laboratory
a. Assisted reproduction technology laboratory
b. Molecular and cellular technology
c. Molecular pathology, Forensic pathology and Anatomic
laboratory
CLASSIFICATION OF CLINICAL LABORATORY
E. National Reference Laboratory
1. Confirmatory testing
2. Surveillance
3. Resolution of conflicting results
4. Training and research
5. Evaluation of diagnostic kits and reagents
 NATIONAL REFEREN CE
LABORATORY

1. RESEARCH INSTITUTE FOR TROPICAL MEDICINE

 NATIONAL REFERENCE
LABORATORY

2. San Lazaro Hospital STD-AIDS Cooperative Center

Laboratory (SACCL)
 NATIONAL REFERENCE
LABORATORY

3. EAST AVENUE MEDICAL CENTER

 NATIONAL REFERENCE
LABORATORY

4. NATIONAL KIDNEY AND TRANSPLANT INSTITUTE

 NATIONAL REFERENCE
LABORATORY

5. LUNG CENTER OF THE PHILIPPINES

 CLASSIFICATION OF
CLINICAL
LABORATORY

F. Satellite Testing Sites

The testing site is owned
by a licensed laboratory
but situated some distance
from the main laboratory.
CLASSIFICATION OF CLINICAL
LABORATORY
G. Mobile Clinical Laboratories
• laboratory testing unit
• moves from one testing site to
another testing site
• has a temporary testing location
• shall have a base laboratory
• permitted to collect specimens only
• operate within a 100-km radius
from its main lab
LABORATORY SECTIONS

A. SPECIMEN PROCESSING
LABORATORY SECTIONS

B. HEMATOLOGY SECTION
HEMATOLOGY SECTION
 LABORATORY SECTIONS

C. COAGULATION SECTION
 LABORATORY SECTIONS

D. CLINICAL MICROSCOPY
 LABORATORY SECTIONS

D. CLINICAL MICROSCOPY
 LABORATORY SECTIONS
E. PARASITOLOGY
LABORATORY SECTIONS

F. CLINICAL CHEMISTRY
LABORATORY SECTIONS

G. CLINICAL MICROBIOLOGY
LABORATORY SECTIONS
H. IMMUNOLOGY/SEROLOGY
SECTION
 LABORATORY SECTIONS

SEROLOGY TESTS
▪ Pregnancy tests – detects B-HCG
▪ Dengue Test
▪ HbsAg – for hepatitis
▪ Bacterial Agglutination test
a. Widal test - Typhoid fever
b. Weil-Felix – non specific test for
typhus fever
LABORATORY SECTIONS
I. IMMUNOHEMATOLOGY/BLOOD BANK
LABORATORY SECTIONS

J. HISTOPATHOLOGY/CYTOPATHOLOGY
 INFORMATION FLOW IN THE
CLINICAL LABORATORY
❖Laboratory requisition
⮚A form used by physician to document the tests that are to be
performed on patients.
⮚Contains the following:
✔Patient’s demographic data: name, data, address, birth date
✔Patient Gender
✔Date & time of collection
✔Room number ( in-patient or out-patient)
✔ Test slection
 INFORMATION FLOW IN THE
CLINICAL LABORATORY
❖Laboratory requisition
⮚Contains the following:
✔ Date and time of collection
✔Identification of the person who performed the collection,
✔ name and signature of ordering physician
✔Source of specimen
✔Physician’s clinical Diagnosis
✔Additional comments
LABORATORY REQUEST FORM
 INFORMATION FLOW IN THE
CLINICAL LABORATORY

❖Laboratory Directory
• Internal test number
• Acronyms or abbreviations of the test
• Type of specimen required
• Specimen volume and the minimum acceptable
volume
 INFORMATION FLOW IN THE
CLINICAL LABORATORY
❖Laboratory Directory
• Collection notes
• Storage instruction of specimen
• Stability of the specimen
• Reference Ranges
• Clinical Significance
• Test schedule or testing interval/frequency
• Method
 LABORATORY REPORTS

• to transmit test results

• Reference ranges
• Date and time of the specimen collection
• Name, address of the laboratory
• Name and identification number of patient
• Source of specimen
• Date & time the report was generated
LABORATORY REPORTS
THREE PHASES OF LABORATORY TESTING
A. PREANALYTICAL PHASE
▪ occurs first in the laboratory process
• Patient preparation
• Paper work and data entry
• Specimen collection, processing, storage and
transportation.

• Responsible Personnel
***Phlebotomist, laboratory technician
THREE PHASES OF LABORATORY
TESTING
B. ANALYTIC PHASE
▪ Considered the “actual” laboratory testing
or the diagnostic procedures, processes and products
• Proper instrument maintenance
• Reagent supplies
• Quality control
• Responsible Personnel
• ***Medical Technologist or Medical Lab Scientist
 QUALITY CONTROL
❖Ensure Accuracy, precision, and reliability of the
test procedure.
❖Validates the following:
• Test reagents/ kits
• Testing process
• Training of the lab personnel performing the
test
THREE PHASES OF
LABORATORY TESTING
C. POST- ANALYTIC PHASE
❖Includes the following:
• Review and analysis of results
• Recording and reporting of test results
• Storage and disposal of specimen
• Releasing of results

• Responsible personnel
***Medical Technologist, Section Supervisor, Chief Med.
Tech., office clerk or staff
 LABORATORY POLICIES
A. Laboratory hour and emergency
work
▪ definite working hours
▪ outside regular working hours, organize
a system for testing urgent specimens.
 LABORATORY POLICIES

B. Range of tests to be performed and those to be

referred to higher level
1. the number of staff available
2. the availability of material resources
3. the types of health institutions (hospital or health
center)
 LABORATORY POLICIES

C. Referral of specimens (when necessary)

Example specimens for HIV detection and water

samples for bacteriological analysis
 LABORATORY POLICIES

D. Collection of laboratory specimen

URINE SAMPLE TRAY

CLEARLY LABELED SPECIMEN
 LABORATORY POLICIES
E. Workload capacity of a laboratory
- should matched to the number of staff
- their level of training
- size of the laboratory
- the availability of laboratory facilities
 REFERENCES

1. Department of Health , Administrative Order No. 2007 – 0027

2. Seyoum, Berhau (2006). Introduction to Medical Laboratory
Technology. Ethiopia Public Health Training Initiative, The Carter
Center, the Ethiopia Ministry of Health, and the Ethiopia Ministry of
Education.
3. Lieseke, C. and Zeibig, E. (2012). Essentials of Medical
Laboratory Practice. F.A Davis Company. Philadelphia, USA.
INTERNET:
REFERENCES
• https://www.encyclopedia.com/medicine/encyclopedias-almanacs-
transcripts-and-maps/medical-laboratories-0
Encyclopedia.com, Medical Laboratories

• https://www.limswiki.org/index.php/Reference_laboratory
Reference laboratory-LIMSWiki

• https://study.com/articles/Lab_Manager_Job_Description_Duties_and_Req
uirements.html
Lab Manager job description, duties and requirements. Study.com
INTERNET:
REFERENCES
http://lcp.gov.ph/images/NEQAS_CC/1_Announcement.pdf
National Reference Laboratory for Clinical Chemistry

Department Order No. 393-E series 2000, Designation of National Reference Laboratories and transfer of
corresponding Equipment, Instruments Supplies, Specimens, Records Form the Bureau of Research and
Laboratories To the designated Reference laboratories