Clinical Biochemistry, Hematology and Immunology
Head of Department: Doc. MUDr. Miroslav Průcha, Ph.D.
Sections of the Department:
- Clinical Biochemistry
- Transfusion unit and blood bank Immunology
- Laboratory of molecular diagnostics
Through cutting-edge instrumentation our laboratory offers the full spectrum of routine and special biochemical examinations, hematological and coagulation analysis, analysis of humoral and cellular immunity, cytological, biochemical and spectrophotometric analysis of cerebrospinal fluid, blood analysis of pharmaceutical levels and subsequent pharmacokinetic interpretation, and analysis in the field of molecular genetics.
An important clinical component of the department is the outpatient investigation of lipid and lipoprotein metabolism disorders, as well as outpatient hematological, neurological, and outpatient immunology and allergology examinations.
Activities of the Department
- Routine measuring and consultation activities within the Na Homolce Hospital and the catchment area (Prague 5, 6 and 7) in the following specializations: clinical biochemistry, clinical haematology, clinical immunology and allergology, blood transfusion, clinical pharmacology, and molecular genetic diagnostics.
- Outpatient unit activities in the field of lipid metabolism disorders (3 units + Club for parents and children who suffer from hypercholesterolemia) and haematology outpatient units.
In 2017, 8 internal audits were performed. No non-conformity card has been issued in these audits. Recommendations were defined, most of which have been accepted and partly or completely introduced i practice. Recommendations related to modifications in request forms and result sheets will be covered by the new laboratory information system (LIS) which will be installed during Q1 of 2018. Acid-base balance analysers located in the ICU were replaced. The Department of Clinical Biochemistry, Hematology and Immunology adhered to the planned budget for this year in economic terms.
The section provides routine biochemical services for clinical units of the hospital concentrating on diagnostics and treatment of critically ill patients of all departments. Bedside examination (POCT – point of care testing) of pH balance, selected minerals and glycaemia are carried out for inpatients in critical conditions. Analysis of minerals, enzyme activity, substrate concentrations, cardio-marker levels, amino acids, selected prohormones, vitamins, full range of lipids, levels of drugs and their metabolites, including pharmacokinetic analysis of concentrations measured, are made for all patients. The Department also provides services for physicians in the catchment area (Prague 5 and 6) within material delivery.
Acid-base balance analysers located in the ICU were replaced. Also these new analysers RapidPoint 1200 (Siemens) are remotely managed by the laboratory using RapidComm software.
Similarly to the clinical biochemistry section, the haematology section provides routine services to clinical departments. It performs specialized examinations of coagulation parameters for hospital departments. The laboratory was involved in tender procedures and their implementation into the current work system in 2017. A new coagulation meter (Sysmex) has been put into sevice.
The unit ensures supply of blood and blood derivatives to hospital clinical departments. The unit was involved in tender procedures and announcement of tenders and their implementation into the current work system in 2016.
The immunology laboratory carries out a wide range of examination methods for both humoral and cellular immunity, autoimmune status of organs and systems, and for allergies. It specializes in the diagnosis of sepsis in patients in critical conditions. The Allergy and Clinical Immunology outpatient unit takes care of patients with allergies, immunodeficiencies and immunopathological conditions. It performs modern outpatient examination method of asthma control in patients who suffer from bronchial asthma out using a non-invasive method where the patient’s exhaling function is tested for bronchial hyperactivity. The physicians provide consulting services to hospital inpatient wards in the field of allergy and clinical immunology.
An accreditation of methods using new devices has been supplemented and a tender for flow cytometer has been awarded.
Consultation activities with regard to drug allergies continued to be performed for all regions of the country, as well as cooperation with the Department of Cardiology (within the IGA grant agency of the Czech Ministry of Health), Department of Vascular Surgery (the BATAPPA study under an internal grant), Clinic of Anesthesiology and Resuscitation of the 1st Medical School (clinical study on sepsis), participation in educational activities of the Institute of the 2nd Medical School, Charles University. Lecturing activities and scientific publications are recorded in the database of publication activities of the Na Homolce Hospital.
Laboratory of molecular diagnostics
The Laboratory of Molecular Diagnostics uses molecular genetics to diagnose hereditary diseases and genetic predisposition to common and serious diseases. Within the hospital, it specializes in issues according to the interest of individual hospital departments and according to the development plan. In addition to routine diagnostics, the laboratory also participates in clinical research projects. Successful external quality audits of molecular diagnostics of selected diseases were performed in the laboratory. A diagnostic method for the detection of 1p/19q codeletions for tumours of the central nervous system was developed in 2017. This diagnostic method should be implemented as a routine examination method used by the laboratory in the next year.
Outlook for 2018
In 2018, the Department plans to introduce a new information system and continue tenders for biochemistry, immunology and hematology analysers. Another plan is to gain at least one research project within the research and science support in the Na Homolce Hospital. The Department will defence the accreditation granted by the Czech Accreditation Institute this year.
Economic results for 2017
In 2017, the Department recorded a decrease in the number of procedures compared to 2016 which, however, was not followed by a decrease of costs. The number of tests/points for inpatients was stable and the number of outpatient points decreased. This is an undesirable development in terms of hospital economy. As this trend has been confirmed also in previous years, it is necessary to take structural and organizational measures. However, economic overviews clearly show that the Department of Clinical Biochemistry, Hematology and Immunology continues to be profitable thanks to a higher refund of a point for individual laboratories.