Division of Clinical Chemistry General Information about the Clinical Chemistry Division: Laboratory Organization and Structure The Division of Clinical Chemistry's service laboratory consists of facilities located on the 5th floor of the Main Tower of the Children's Hospital of Pittsburgh. The laboratory is a part of the Central Laboratory Services, Incorporated (CLSI). This is a non-profit hospital service organization created by the teaching hospitals associated with the University of Pittsburgh School of Medicine with the objective of providing state of the art clinical laboratory services for the member institutions. The structure of the laboratories has evolved with the changes in the hospitals. This is a reflection of the continuing reshaping of the health care delivery in the country, as well as an indication of the impact of rapid developments in the technologies for laboratory analyses. The laboratory is currently organized into two main areas. There is a core laboratory that operates round the clock. This is the Automated Testing Laboratory. All tests requiring rapid analyses are performed in this area. The tests categories include: general chemistry, urine chemistry and microscopy, and blood gas analyses as part of clinical chemistry. Complete blood counts, blood cell differentials and coagulation assays are performed in this area as part of hematopathology service. Bedside testing or point-of-care testing (POCT) is also managed from this area. The developments in automation of analyses have the most readily discernible impact on this part of the laboratory, and this is also the section where ongoing changes are an accepted part of the operation. The recent availability of laboratory robotics will further alter the structure of this area. These continual changes are important because this area handles 60% of the workload in clinical chemistry, most of the assays being performed with a turn-around time of less than 2 hours. Automation of analytical work enables performance of the assays with accuracy, precision and with efficiency of staffing for a 24-hour operation. The second area in Clinical Chemistry is the section of Special Chemistry, the designation as special being a label of convenience rather than a true reflection of the function. The area is comprised of three groups or sub-sections based on functions. These are Biochemical Genetics & Nutrition, Immunoassay & Tumor Markers, and Therapeutic Drug Monitoring & Toxicology. This area is fully operational during the daytime hours with limited functions available in the evenings and nights, and also on a need basis as determined by the clinical situation. These two main areas are under the supervision of a laboratory staff that oversees the daily operations with the help of lead technologists. The areas are organized internally as functional benches or analytical modules. These are physically the parts of the laboratory where all the analytical work is performed by technologists. The clinical work is a service responsibility of the faculty members of the division, who decide the best configuration for the work, select and verify analytical methods, recommend instrumentation, and direct the operations of the laboratories to ensure services compatible with the regulatory requirements as well as the clinical needs. Residents rotate through all areas of the laboratory and are provided in depth exposure to clinical services. The laboratory is licensed by the Commonwealth of Pennsylvania and the Health Care Financing Administration (HCFA, CLIA'88), and is accreditated by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the College of American Pathologists (CAP). Faculty Faculty Service Responsibilities Harry C. Blair, MD Acting Medical Director of Division of Clinical Chemistry; Director, McGee Womens Hospital Laboratory / Medical Director, UPMC Chemistry Standardization Committee Gary E. Blank, Ph.D. Laboratory Informatics (Information Services Division, UPMC) David Finegold, MD, PhD Biochemical Genetics/Nutrition K. Michael Gibson, PhD, FACMG Biochemical Genetics/Nutrition Matthew Krasowski, MD, PhD Toxicology / Therapeutic Drug Monitoring / Pharmacogenetics Mohamed A. Virji, MD, PhD Endocrinology / Tumor Markers / Point-of-Care Testing / Special Functions Laboratories / Reference Laboratory Testing