Quality Policy

QUALITY POLICY

Nothing comes before quality. We are acutely aware that our patients and physicians are depending upon us to produce accurate, complete and timely laboratory results. We meet this need because we never forget that each specimen represents a person awaiting a laboratory report that they can trust to help in making important healthcare decisions. Proficiency testing, quality control, document control and quality assurance exercised at the pre-analytical, analytical and post-analytical stages ensure that each specimen receives the best quality testing that laboratory medicine offers.

Our commitment to quality is genuine and strong. Similarly, our commitment to compliance is based upon our belief that each person in our company will do the right thing every time, without compromise. We are pledged to this philosophy of ethical behavior and know that while this encompasses adherence to all applicable regulations and standards, it goes beyond what the law requires. Our commitment to our patients requires no less.

EQAS PROGRAMS

Clinical Biochemistry:
Biochemistry EQAS-CMC Vellore
Clinical Pathology:
NABL-Sysmex
AIIMS, New Delhi

GENERAL INFORMATION
1]Request Forms: The forms should have the following entries – Name, Age & Sex, Unit & Ward, IP/OP Number, Income – Non Paying / Paying Case, Convict/MLC/Non MLC, NGGO/ESI with Numbers, Clinical History, Provisional Diagnosis, Previous Test Results, Signature & Name of Unit Assistant Professor
2] Rights:Lab tests are based on Mechanical & Subjective Observations. All constituent divisions of the CDL have independent Internal and External QC mechanisms. Feed back is welcome for better service. If results do not correlate with the clinical parameters of the patient, call the concerned lab and inform the issue and ask for a repeat test if required.
3]Collections: EDTA Bottles [Red Necked] for CP/Hematology Blood Samples and Yellow Necked Bottles / Plain Bottles for Biochemistry Blood Samples are available at request.
4] Working: The CDL works for 24hours on all days. OPD : On all days 7.30am to 12.30pm. Routine Indoor: All Days7.30am to 5.00pm. Emergency undertaken all 24hours. Samples and Requests to be marked ‘URGENT’
5] Enquiries shall be made to the respective divisional Medical Officers and Technical Supervisors.

Statistics


Year200420052006200720082009201020092010
Basic Biochemistry145181213908263386292644513233561198613321592216773109
Endocrinology4314134034295511323152717311935
Clinical Pathology259948237744261366405533505533547930607287720504984945
Cytopathology218433924269384138413082332838623789
Hematology21993186365243694369479560351307620924
Histopathology381740914142412541254390551057866018
Bacteriology816861557314180894413049639499244955264761
Mycology103110142293204288292402520
Virology / Serology121541541517113123341843218849172861885824846
Parasitology9413018157120172132185124

Pathology

ANATOMIC & SURGICAL PATHOLOGY:
The Department of Pathology has a dedicated histopathology lab service for all material received from the theatres and wards of TVMCH and other affiliate hospitals. The laboratory has automated processing systems and undergoes quality assurance reviews between the pathologists. This unit of our department is the standalone supplier of rare specimens of tissue material for pathology museums in government run medical schools in the southern region of State of Tamilnadu.

CLINICAL PATHOLOGY:
The Department has a fully deployed Clinical Pathology unit in the TVMCH for patients being seen at the affiliate hospitals. All areas of Clinical study including the study blood, urine and body fluids are available. The lab routinely undergoes quality assurance reviews between the pathologists and with EQAS programs. The laboratory has automated Cell Counters, Automated Urine Analysis System and ESR analyser. This lab works 24×7 with a team of dedicated technicians.

LABORATORY HEMATOLOGY:
The Department of Pathology has a dedicated Hematopathology service easily accessible for patients being seen at the TVMCH and other affiliate hospitals. All areas of Hematopathology are available for consultation including: study of peripheral blood, bone marrow, lymph nodes, or extra-nodal tissues. The lab routinely undergoes quality assurance reviews between the pathologists and with EQAS programs. The laboratory has automated Cell Counters, ESR analyzers and Coagulation Systems.

CYTOPATHOLOGY:
The Department has a dedicated cytopathology service including a PAP smear program for the Obstetrics & Gynaecology OPD and Wards, FNAC OP & Fluid Cytology services for patients being seen at the TVMCH and other affiliate hospitals. All areas of cytopathology are available for consultation including: study of surface nodules, CT Scan and Ultrasonogram Guided studies. The lab routinely undergoes quality assurance reviews between the pathologists.

IMMUNOPATHOLOGY:
The Department runs immunopathology service that includes a wide panel of immunocytochemical and immunohistochemical stains. The lab routinely undergoes quality assurance reviews between the pathologists.

Biochemistry


I. CLINICAL BIOCHEMISTRY [7.00AM-7.00PM]
Blood GlucoseBlood Glucose : Fasting Samples to be taken at 7.00am after over night fast. PP Samples to be taken 1 ½ hrs/2hrs after break fast.
RandomSr Lipid Profile : Fasting Samples to be taken at 7.00am after over night fast.
FastingMinimum Volume 2ml Specify time of sampling. Samples should reach lab within 15mts. Turn around time 3hours
Post Prandial
Blood Urea /BUN
Serum Creatinine
Serum Lipid Profile
Cholesterol
Triglycerides
LDL
HDL
VLDL
Cholesterol /HDL ratio
LDL/HDL ratio
Serum ElectrolytesDo no squeeze arm for sampling. Specify time of sampling. Minimum Volume 2ml Samples should reach lab within 30mts. Turn around time 3hours.
Na,    K
Cl,     HCO3
Serum Proteins
Total
Albumen
Globulin
Plasma CPK[MB]
Serum Uric Acid
Serum Calcium
Serum Cholinesterase
Liver Function Test
SGOT
SGPT
ALP
LDH
Sr Bilirubin Total
Sr Bilirubin Direct
Sr Bilirubin Indirect
Glucose Tolerance TestTUESDAYS ONLY : Patient has to be directly referred to the CDL. Turn around time 5hours
Body Fluid AnalysisSpecify time of sampling. Minimum Volume 2ml Samples should reach lab within 30mts. Turn around time 3hours
Stone AnalysisTurn around time 7days
Urinary 24hour ProteinTurn around time 6 Hours
Urinary CreatinineTurn around time 6 Hours
Urinary Screening for In Born Errors of MetabolismTurn around time 6 Hours
Thyroid Profile TestFRIDAYS ONLY : Fasting Samples to be taken at 7.00am after over night fast. Case selection for tests only after discussion with Medical Officer i/c Biochemistry.
T3
T4
TSH
OTHERS
EMERGENCY BIOCHEMISTRY [24X7]
Blood GlucoseMinimum Volume 5ml Specify time of sampling. Samples should reach lab within 15mts. Turn around time 1hour
Blood Urea /BUN
Serum Creatinine
Ser Electrolytes
Na, K, Cl, HCO3
Ser Cholinesterase
Sr Bilirubin Total
Sr Bilirubin Direct
Sr Bilirubin Indirect
Body FluidAnalysis
Plasma CPK[MB]
EMERGENCY CLINICAL PATHOLOGY LABORATORY[24X7]
Blood HemoglobinTurn Around time 1hour
Urine AcetoneTurn around time 15mts
Fluid Cell CountInform the lab prior to taking sample. And should reach the lab within 10 mts Turn around time 1hour
Occult BloodTurn around time 1hour. Inform the lab prior to taking sample
CLINICAL PATHOLOGY  LABORATORY[7.00AM-7.00PM]
1] BLOODSend Samples in EDTA Bottle [Red Neck]
TC,Send Samples in EDTA Bottle [Red Neck]. Shake the bottle before sending sample to lab [to reach lab within 1 hour]. Turn around time 4hours. Minimum volume 2ml
DC,
Hemoglobin
ESR
Platelet CountDo not squeeze the limb to take blood. Send Samples in EDTA Bottle [Red Neck]. Shake the bottle before sending sample to lab [to reach lab within 1 hour]. Turn around time 4hours. Minimum volume 1ml
Smear forMP/MF
Retic Count
2] URINESend in plain labelled capped bottle. No additives. Minimum volume 3ml
Albumen
Sugar
Deposits
Blood
Acetone
Bile Salts
B Pigments
3] BODY FLUIDS Cell CountSend in plain labelled capped bottle. 1 drop of Formalin / 10cc. Turn around time 4hours. Inform the lab prior Sample should reach lab in 10 mts. Minimum volume 1ml
4] MOTIONSend in plain labelled capped bottle. Turn around time 4hours. Inform the lab prior to sending sample. Should reach the lab in 30mts.
Ova
Cyst
Blood
Red Sugar
5] SEMEN ANALYSISSend in plain labelled capped wide mouth bottle. Turn around time 6hours. Inform the lab prior to sending sample. And should reach the lab within 5mts. Minimum volume 2ml
HEMATOLOGY[7.00AM-1.00PM]
HemogramTake Blood in EDTA Bottle [Red Neck]. Shake the bottle before sending sample to lab [to reach lab within 1 hour]. Turn around time 4hours. Minimum volume 3ml. Do not squeeze the limb to take blood. The requisition should have clinical history & lab test results.
Peripheral Smear StudyTake Blood in EDTA Bottle [Red Neck]. Shake the bottle before sending sample to lab [to reach lab within 1 hour]. Turn around time 4hours. Minimum volume 1ml. Do not squeeze the limb to take blood. The requisition should have clinical history & lab test results.
Bone Marrow StudyThe Medical Officer i/c of CP/Hematology should be informed prior to taking sample. Requisition should have clinical history, Peripheral Smear study & Hemogram results. Sample to lab to reach lab within 1 hour. Turn around time 24hours. Minimum 6 slides. Peripheral Smear to accompany BMA slides.
Hemolysis ProfileThe Medical Officer i/c of CP/Hematology should be informed prior to taking sample. Requisition should have clinical history, Peripheral Smear study & Hemogram results. Sample to lab to reach lab within 1 hour. Turn around time 24hours. Minimum volume 3ml. Peripheral Smear to accompany sample.
1] Coombs Test
2] Os Fragility T
3] Sickle Test
4] Heinz Body T
5] AutoHemolysis
6] NESTROFT
7] Incubated OFT
Hemostasis TestThe Medical Officer i/c of CP/Hematology should be informed prior to taking sample. Requisition should have clinical history, Peripheral Smear study & Hemogram results. Sample to be taken in tube issued in lab by technician. Sample to reach lab within 10mts. Turn around time 4hours. Minimum volume 3ml. Peripheral Smear to accompany sample.
1] Bleeding Time
2] Clotting Time
3] PT – INR
4] APTT
5] Fibrinogen
6] Clot Lysis Time
7] Platelet Count
CYTOPATHOLOGY[8.00AM-1.00PM]
FNACRequisition should have clinical history, Lab results. Turn around time 24hours.
[Fine Needle Aspiration Cytology]
Guided FNACMedical Officer i/c Cytology to be requested. Requisition should have clinical history, Lab results. Turn around time 24hours.
CERVICAL/VAGINAL SMEAR STUDYRequisition should have clinical history, Lab results. Turn around time 24hours.
BUCCAL SMEAR STUDYRequisition should have clinical history, Lab results. Turn around time 24hours.
HISTOPATHOLOGY[10.00AM-4.00PM] [COLLEGE]
Requisition should have DETAILED clinical  history & ALL relevant Lab results. The Samples should be sent in 10% Formalin – filled to 10 times the volume of the biopsy. Turn around time 5days.

Microbiology


II. CLINICAL MICROBIOLOGY [8.00AM-4.00PM]
DivisionsInvestigations
BactriologyDirect Microscopy
Gram Stain
Acid fast stain
Fluorecent sstains
Culture and Sensitivity
Clinical SerologyWidal Test
Card Tests
Rheumatoid Factor
Aso Test
RPR Test
Clinical VirologyCard Tests
HBSAG
Dengue – IgM, IgG
CHIK
LEPTOCHEK
ELISA
DENGUE – IgM
CHIK
JAP Encephalitis
HIV
MycologyKOH MOUNT
Lactophenol Cotton Blue Mount
Fungal Culture
ParasitologyStool Examination
Wet Saline & Iodine Mount
Modified Acid fast Stain
Blood Smear Examination for MP/MF
Theatre SterilisationAerobic Culture
Anaerobic Culture for Tetanus
SpecimenInstructions
URINESend in sterile screw cap container to the lab within 2 hours or refrigerated at 4°C and delivered within 24 hours.
Mid stream urineDO NOT collect urine from bedpans, urinals, or catheter bags
Indwelling
catheter urine
SPUTUM If TB is suspected, use precautions to prevent spreading of infection.
Induced sputumDeep cough from the chest should be collected.
Suction tipCollect sputum in a dry  wide mouthed sterile container
BronchoalveolarTransport to the laboratory as soon as possible
lavageRefrigerate at 4°C if there is delay in delivery.
Bronchial washSend three consecutive samples
PUS  Aspirated pus is ideal. swabs – only an alternative
SuperficialSend it in a dry sterile container within 2 hours.
WoundsAvoid contamination with surrounding normal flora on skin etc.
Abscess
Pustule
Ulcer
Deep wound
SWABSSend in a dry sterile container  at the earliest
Throat, Urethra
Vaginal, Aural
Nasal swab
CONJUCTIVAL SWAB Use swab premoistened with sterile saline and send at the earliest
CORNEAL SCRAPINGS Collect and Bedside inoculation of material in to Blood agar, Chocolate agar, SDA, Thioglycollate broth. Send immediately.
BODY FLUIDS Collect in a dry sterile container and send to the lab without delay.
pleural fluid
pericardial fluid
peritoneal fluid
synovial fluid
amniotic fluid
vitreous fluid
CSFCollect in a dry sterile container and send to the lab without delay. CSF is never to be refrigerated
STOOLSend it in a clean leak proof container with  Cary-Blair/VRM.
Transport to lab as soon as possible
Send stool rather than rectal swabs
 BLOOD Wash the area with soap &water and then with 70%alcohol
Do not palpate again
Wear gloves while collecting - Drawn blood and immediately place in blood culture bottles and send within 24 hours.
Incubate at 37c
DONT REFRIGERATE
TISSUE BIOPSIESCollect in a dry sterile container and send to the lab without delay
It is not necessary to add sterile water to biopsies unless they are very small and in danger of drying out.
Microbiology specimens should never be put in formalin.
SKIN SCRAPINGS & Scrape the skin  from active  edge of lesion in a dry sterile petri dish/black paper
SLIT SKIN SMEAR
NAIL SCRAPINGSSend clipings of affected area
Hair ClipingsPluck hairs with intact shaft
Cut hairs are not satisfactory