Revisit Your Kits
Our laboratory uses many “plop plop fizz fizz” tests for qualitative screening, like most labs. These quick and easy tests have been in labs as long as I can remember with a few enhancements over the years that have made them even easier e.g. internal controls. Some of them, such as our influenza test kit, haven’t changed years.
When should we revisit our kits?
It’s interesting to consider why laboratories choose to change. Much of the time, change is done to us (regulations, administrative policy, budget cuts, etc.), but choosing to change a test menu item is done to ourselves. The physicians won’t notice on a report if a result is still positive or negative. It’s one of those cases in today’s medicine when change can be constructive. It’s also a chance to involve everyone in the decision.
Reasons to change kits include:
- Group Purchasing Organization (GPO) compliance. Your hospital may belong to a GPO such as Premiere or Healthtrust that contracts with vendors for discounted pricing and rebates. Your laboratory may have to order a certain percentage of supplies (varies according to the GPO) to comply. Generally a GPO is a good thing, since price contracts are often aggressive compared to what a company will offer, especially for lower volume testing.
- Cost. Sometimes -- well, always -- it’s about cost. The cost per test is calculated by the total cost of supplies, controls, repeats, confirmations, and other variable expenses divided by the number of billable tests. This can vary quite a bit from what the vendor claims.
- Better sensitivity and/or specificity. Technology improves incrementally, so it’s always a good idea to check literature and vendor references. New kits can offer better sensitivity or specificity or a different technology e.g. an optical reader that can make a test more reliable.
Labor and comfort level are important intangibles. If techs hate a kit because there are too many steps, the timing is too fussy, or the end point is too equivocal, the time and repeat testing can be expensive. That’s when revisiting can help a team the most.
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