The Healthcare Detectives

Blood, body fluids, and biopsied tissues hold a wealth of information on what is going on inside your body. Working to extract this ‘evidence’ are medical laboratory professionals who work behind the scenes, playing a vital role in the diagnosis, treatment, management and prevention of disease.

Although most diagnostic tests do not take place in front of patients, laboratory science professionals are key members of a modern healthcare team who are vital in providing safe and quality patient care. It is estimated that some 65–70% of clinical decisions are made based on the results of laboratory tests.

Each day, medical laboratory professionals make use of state-of-the-art technology to help doctors and nurses piece together the observations in samples into a complete picture of a patient’s health. This allows treatment and diagnosis to be based on evidence rather than guesswork.

BLOODY TALES

Many modern diagnostic tests are performed using blood samples. Haematology is the study of diseases related to the blood. A commonly requested haematological blood test is the full blood count (FBC), which provides an overview of the quantity and quality of various blood cells in circulation. Even the size, shape and contents of blood cells are measured and scrutinised. Interestingly, all these analyses can take place using just one millilitre of blood.

Another test is the peripheral blood smear, which provides a ‘snapshot’ of the cellular components in blood. This allows laboratory scientists to study the appearance of red blood cells, white blood cells, and platelets with the enhancement of special stains under both conventional and digital microscopy. Biochemistry tests are among the most commonly requested diagnostic tests in a patient’s healthcare journey. Routine kidney and liver function screening panels are used for detection of disease states, while cholesterol and lipid panels are often used in screening for cardiac and vascular risk factors. The detection and measurement of glycated haemoglobin (haemoglobin molecule that has been irreversibly attached to a glucose molecule) have changed how diabetic patients are diagnosed and monitored in recent years.

Due to the sheer quantity of requests for such tests every day at Yishun Health, total laboratory automation has been implemented in the biochemistry laboratory to maximise efficiency and accuracy while reducing the incidence of errors.

WHEN WASTE IS ALSO USEFUL

Another common test is the urine test. Though we may consider it a waste product, it is far from wasted in the hands and under the scientific eye of laboratory technologists. Urine testing goes back to ancient times when urine was tasted for the presence of sugar and visually inspected for colour and clarity. These days, urine testing is carried out using dipsticks that have been designed to detect up to 10 different chemical analytes, such as glucose, bilirubin and even bacterial by-products. Colour and clarity of the urine samples are defined objectively by colour and turbidity detectors, while cells and sediments in the urine samples are accurately identified and counted by fluorescence flow cytometry. The presence of atypical cells and sediments in urine can aid in the diagnosis of infections and other urinary tract disorders.

ESSENTIAL FLUIDS

Aside from blood and urine, laboratory science professionals also perform diagnostic tests on body fluids from various sites, such as peritoneal space, knee joints, and even cerebrospinal fluid. The observation of crystals, abnormal cells and unexpected microorganisms in these fluids can be diagnostic of disorders such as malignancy, inflammation and infection.

There is a patient at the end of every sample. We take pride in knowing that every accurate and reliable result we generate intangibly enhances a patient’s quality of life.

WEE GUAN LIM SENIOR MEDICAL TECHNOLOGIST

QUALITY IS KING

Medical laboratory science has progressed in tandem with improvement in quality processes. Quality management in laboratory testing has always been tightly regulated to ensure patient safety.

Standard operating procedures (SOPs) are in place for every step of the Total Testing Process, from verifying correct specimen collection to ensuring optimal performance of laboratory analysers and timely release of test results to the doctors. Daily quality control checks and participation in international proficiency testing programmes are also implemented to ensure laboratory standards are on par with laboratories all over the world. Yishun Health’s Department of Laboratory Medicine is also accredited by the College of American Pathologists for its compliance with established performance standards.

“There is a patient at the end of every sample. We take pride in knowing that every accurate and reliable result we generate intangibly enhances a patient’s quality of life,” assures Senior Medical Technologist Wee Guan Lim.

Karen Lee, Senior Medical Technologist from Microbiology, examines the agar culture plates for clues to identify the microorganisms responsible for infections

WHAT’S IN A NAME?

At Yishun Health’s Laboratory Medicine Department, a team of more than 90 staff work in a variety of specialty roles and functions 24 hours a day, seven days a week.

Medical technologist:

This is a medical laboratory scientist who performs diagnostic analysis on patient specimens sent to clinical laboratories. A medical technologist can choose to train as a generalist in various core laboratory specialties, such as clinical biochemistry, haematology and transfusion services, or specialise in a specific field of laboratory medicine, such as microbiology.

Cytotechnologist:

Like a cell ‘detective’, a cytotechnologist is specially trained to examine human cells under microscopy and detect cancer, pre-cancer states, and other abnormalities. They work with clinicians and pathologists to provide accurate observations of the cell samples collected.

Histotechnologist:

This is a medical laboratory scientist who is trained in the specific preparation of tissue samples removed from a patient. The tissue samples have to be specially prepared before they are examined under a microscope by pathologists for evidence of disease, such as cancer.

Phlebotomist:

Deploying empathy and skilled hands, a phlebotomist draws blood from patients for clinical testing. Phlebotomists are well versed in the quality requirements of the laboratory, and ensure the specimens they collect meet these requirements.

Laboratory information systems (LIS) officer:

An IT specialist who maintains the laboratory information system that supports data flow and laboratory automation. With increased reliance on IT solutions for patient management, the job of the LIS officer is often not confined within the walls of the laboratory. The LIS officer also works with hospital information system administrators and vendor specialists to ensure secure and continuous IT support for the other medical laboratory professionals.