Laboratory Services
The Phelps Clinical Laboratory
Have you ever wondered what happens to those little vials of blood your doctor has you give for tests? The following is provided to give you an idea of what goes on behind the laboratory doors.
What is tested in the laboratory? In a hospital lab, we do testing on clinical specimens. Some of the tests done in a clinical lab might have similarities to tests done in other types of labs, but clinical labs do not test water samples or other materials.
What is a clinical specimen? A clinical specimen is anything from a patient. Common specimens to test are blood and tissue, but the specimen can be anything. For example, some tests are done on sweat. There are tests that some clinical labs might do on hair or fingernails. In our lab, the majority of tests are done on blood, urine, cerebral spinal fluid, or other bodily fluids, or on tissue, that is, some solid piece of some part of the body.
What comprises the laboratory department? The Laboratory at Phelps and in most hospitals is divided into separate sections, depending on the technology being used or the specific type of testing being done. Clinical Chemistry concentrates on tests done on the fluid portion of blood, as well as some other bodily fluids. Hematology looks at the cellular components of blood and coagulation involved in clotting. Microbiology deals with infectious diseases, which can include diseases caused by bacteria, viruses, fungi, parasites, or tuberculosis. The Blood Bank deals with transfusions and Donor Services supplies blood for the Blood Bank. Phlebotomy collects blood specimens for testing. Histology and Cytology deal with anatomic pathology.
What is the difference between lab technicians and lab technologists? Lab technologists earn a BS degree, which involves three or four years at an accredited college or university, followed by one year in a Clinical Laboratory rotating through the different lab sections. Some technologists go on to specialize in one area, while others continue to work in multiple areas of the lab.
Lab technicians have less training than lab technologists, but with experience, they may function almost at the level of a technologist. Since New York State Department of Health guidelines require that certain tasks must be performed by a technologist or higher, Phelps predominantly employs technologists.
What is a pathologist? A pathologist is a physician specialist who has a medical degree prior to specializing in pathology.
How many people are on the Phelps Laboratory staff? In addition to three pathologists, Phelps' Lab has 40 - 45 full-time employees, and an additional 20 - 25 part-timers.
When is the lab in operation? The lab is in operation 7 days a week, 24 hours a day. There is always a qualified tech in the lab whose job it is to run stat specimens, to man the Blood Bank, or to deal with whatever support the lab needs to provide to the other hospital services. Not all tests are available 24/7, but many are. Aside from being able to cross match units of blood and arrange for blood transfusions, the lab is always ready to accept specimens for culture, cardiac enzymes, drug monitoring, and basic testing such as coagulation testing, complete blood count (CBC), electrolytes, and chemistry assays.
What is the difference between a hospital lab and an independent lab? The two types of labs have a lot of similarities. Both have the same types of equipment and divisions, technologists, and technicians, but the character and culture of the two are different. A hospital laboratory is an integral part of the hospital. It is a "service center," which consults with patients' physicians. Independent labs, also called commercial labs, are separate from the hospital and are “profit centers.” Both types of labs are regulated by the Department of Health.
How do I know if lab results will be accurate? All labs — hospital and independent — spend extraordinary amounts of time, effort, and money to assure that results are accurate. In a typical lab, as many as 25% of samples are over and above patient specimens and are used to calibrate and control testing. This is a huge commitment to quality. Still, no lab is perfect, and a certain degree of scrutiny is always required. The best way to do that is to take advantage of all of the opportunities to put laboratory results in some sort of reasonable context. History and good communication between the lab and the ordering physician is important. In this regard, hospital labs offer an advantage.
What are some of the other advantages of using the hospital lab? The ability to correlate with previous results or with physician clinical information adds a layer of scrutiny beyond all the internal efforts made toward accuracy. Ultimately, you count on the quality of the lab, the relationship of the physician with the lab, and the correlation between results and clinical information, as well as looking at results over time. In the hospital lab, if there is any question, problem with the nature of a specimen, or any technical, storage, or transportation problems, you can count on there being rapid communication, and any suspect result will be re-checked.
Why am I told to fast before a lab test? Most tests can be run on a specimen regardless of whether the patient has been fasting. Certain tests are very sensitive to changes that occur after a meal and can only be interpreted by comparing results in a fasting state. The duration of fasting is dependent on the type of test. For example, blood sugar can be done after a 6-hour fast, but for triglycerides or a lipid profile, a full 12-hour fast is required.
What should a patient do with a lab result? It is a good idea to keep a record of your lab results for future reference and comparison. If a lab result is normal, filing a copy is sufficient. If a lab result is abnormal, it should be discussed with your physician who might recommend repeating the test or running some additional testing to determine the cause of the abnormality.
Who certifies laboratories? The Phelps Laboratory is inspected by New York State Department of Health, the Joint Commission for the Accreditation of Healthcare Organizations (the lab is surveyed along with the rest of the hospital), the College of American Pathologists, AABB (American Association of Blood Banks), and the FDA. Each agency has a separate focus when it inspects the lab or a portion of it. All of these inspections are performed with an eye toward assuring that laboratories offer the highest possible quality of patient testing.
To contact the Laboratory at Phelps, call (914) 366-3900.