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AmazStrategic Planning And Operations In The Health Care Systemon's Second Headquarters (Research Paper Sample)


There has been a recent reduction in budget allocation to the health care sector and hence the hospital as a result of the impact of low energy prices and the consequent reduction in the Government of Trinidad and Tobago revenues. Write a proposal to the Chief Financial Officer of the hospital and indicate the rationale for the retention of selected services (i.e. reagents for immunology testing such as ANA and dsDNA in the laboratory.They are essential in determining if a patient has an autoimmune disease among other tests. Also, reagent to do ELISA test determine if a person has HIV) at the hospital.


Strategic Planning
Institution Affiliation
Strategic Planning
The prevailing low energy prices that have affected revenue streams for the government of Trinidad and Tobago have significantly impacted budget allocation to our hospital. The hospital has resorted to eliminating some of the services offered to the patients. However, such a decision requires strategic planning to avoid crippling the government’s effort to provide comprehensive health coverage to its citizens. One of such important services is serology processes that require reagents for various tests. Consequently, the Chief Finance (CFO) has to make a strategic decision to ensure the retention of the service. A detailed justification for the retention of reagents for serology will be presented in this proposal based on strategic planning for hospital operations. In particular, the proposal will examine the importance of reagents for serology and the reason why the service should be retained.
Reagents play a crucial role in immunology and serology related tests. Immunology involves the study of the immune system, its functions, and possible disorders. On the other hand, serology involves the study of the blood serum. Both of these activities are undertaken in the laboratories and are closely related. In particular, they focus on identifying antibodies which are basically the protein developed from some types of white blood cells to counter the effects of foreign substances (or antigen) in the body (Angeletti et al., 2014). Serology and Immunology also involve investigating issues with the body's immune system such as cases of autoimmune diseases which involve body's immune system attacking its tissues, or cases of immunodeficiency disorders due to the underactive immune system. In a laboratory setting, immunoglobulins test to determine the amount of these proteins in the body due to their involvement in antibody activity. Excessive immunoglobulins may be due to a variety of conditions such as chronic diseases, cancers, infection, autoimmune disorders. On the other hand, lack of immunoglobulins may be due to conditions such as cancers, chronic diseases, and medicines. The rheumatoid factor tests also require reagents and are useful in the classification and diagnosis of rheumatoid arthritis. Similarly, human leukocyte antigens (HLA) tests use reagents to help in determining the compatibility in bone marrow, organs, and tissue. HLA is also instrumental in health care setting since it helps in determining paternity and also in the diagnosis of HLA-related disorders that include autoimmune conditions.
Complement fixation (CF) is an example of an immunological test that goes further to detect the presence of specific antigen or antibody (Kash et al., 2014). This process makes use of Guinea Pig Complement, Hemolysin, and Sheep Erythrocytes reagents. It is an important test that should be retained due to their efficiency in the diagnosis of conditions. Success test of the presence of various is usually manifested through agglutination. For example, the influenza virus agglutinates chicken red blood cells. Similarly, several viruses also have the capability to agglutinate red blood cells and has also been observed that the antibody may inhibit hemagglutination which leads to the development of hemagglutination inhibition assay. Notably, the sensitivity and specificity of the HA assay depend on the features of the HA antigen as well as its interaction with the antibody, which varies with the specific virus being tested.
Strategic decisions in health care should be informed by a number of factors including the retention of quality services, preserving organization's culture, and achieving goals and objectives of overall care (Boonham et al., 2014). To understand the importance of reagents and the reason why serology and immunology should be retained, it is necessary to examine the value of serologic tests among the patients at the hospital. From the discussion, it is evident that serologic tests can involve a wide range of laboratory techniques depending on the type of test or the disease to be diagnosed. However, the process for these tests is typically the same regardless of the condition tested or the technique used. As a result, they are economical to undertake depending on the nature of the condition to be tested. To understand why the hospital should retain serologic tests, it is important to understand how useful it is to the patients. Antigens provoke a response from the immunity. In an effort to preserve the quality of care, the hospital conducts several types of serologic tests such as agglutination assay, a precipitation test, and western blot test.
Furthermore, when making the decision to retain serology reagents, the strategic plan should be viewed from the perspective of shifting focus from the service to the client (Da Rin, Zoppelletto, & Lippi, 2015). Although reagents increase the quality and efficiency of the serology test, the experience of the client and benefits gotten cannot be ignored. Moore (2014) suggests that hospitals should not just focus on carrying out a process based on their abilities but also achieving satisfaction as well as obtaining the best results possible. In other words, a strategic decision should not only consider what but also how. The how a part can be found in the value of the reagents in the definitive diagnosis of HIV infection at any age. Serological testing of HIV using reagents identifies antigen and antibody generated in response to viral infection (Salter et al., 2014). The value of reagents and serology test can be found its ability to diagnose HIV, not only to children and adults but also to infants through a complex process that involves transferring maternal HIV antibody to the baby passively during pregnancy.
Additionally, the hospital should support the government's effort to promote quality assurance program for nation HIV/AIDS initiatives by investing in the laboratory with the capacity to perform diagnostic testing. Hence, the Chief Finance Officer should use existing resources provided by the government, the World Health Organization, and other sources to support quality diagnostic schemes (Da Rin, Zoppelletto, & Lippi, 2015). An examination of alternative methods reveals that the elimination of serology would adversely affect testing. many methods for alternative tests are available both commercially and non-commercially. Alternative methods for detection of nucleic acids tests (NAT) are also complex, inappropriate for non-specialist diagnostic laboratories, and also technically demanding. This usually the case for non-commercial assays that lack the stringent'' quality control measures and technical support from the suppliers (Hughes, 2017). Due to their inefficiency and quality, the non-commercial assay is not recommended for widespread diagnostics in the public health programs, except in cases where there are ongoing and functional laboratory quality assurance procedures in place.
Furthermore, the WHO Prequalification of Diagnostics Program has been evaluating the efficiency and performance of commercially available techniques for HIV testing such as CD4 enumeration and molecular technologies against serological assays with reagents. Recent prequalification results made available online reveal the sensitivity and specificity of serological assays reagents and recommends their use by countries as long as they are within the testing algorithm validated in-country by laboratory designated for that purpose. Reagents are also used in enzyme-linked immunosorbent assay (ELISA) besides the other tests to detect antibodies to HIV-1 and HIV-2. The commercially available reagents ELISAs have high specificity and sensitivity, hence they can detect all subtypes of HIV-1 and HIV-2.
With regard to costs, it is crucial to maintaining an open mind without being fixated solely on numbers. Consideration of the individual components and their combination to work together in a given test should be made since there are so many components in a typical diagnostic reagent. Although each element contributes to the total cost, the hospital can achieve significant cost savings by changing one element. For example, the detection buffer can be changed leading to a significant impact on the sensitivity of the test, hence reducing the volume of key reagents required and thereby reducing assay costs. Similarly, the end-user value of the test against the cost of the components must be taken into consideration too. For instance, a faster diagnostic test or one with highly improved performance may be costly to purchase, but will eventually save the end-user the valuable time and overall labor expenses.
The global trends in laboratory tests have worked in favor of reagents. In other words, trends reveal that reagents will continue to dominate laboratory tests in the future. However, with the continued growth of the reagents market predicted globally, research and development in the market will address new changes in technology as well as new test cases. It is crucial for the hospital to move with the trend since a lot of the products used in the laboratory come from diverse suppliers. One trend that can be observed in the reagents market is an evident steady shift away from the traditional dry-filled or the lyophilized reagent platform to entirely liquid-stable form. Besides the notable conveniences brought about by the liquid-stable form features, the new development in reagents offers inherent benefits in saving time and labor, by eliminating the routine reagent reconstitution processes, saving cost by removing any likely reconstruction errors, and enhanced test turnaround time as well as increased efficiencies as a result of improved instrument uptime. All these...

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