Financial strategic impact on clinical laboratory managers-A review

The cost of operating a clinical lab where cost containment remains a major challenge is to be maintained in conjunction with smooth running of laboratory operations. This study aimed to account the results of service cost using workload-based costing in clinical laboratories. The review aimed at establishing cost containment strategies of all lab test services based onworkload of the technical team in a clinical lab. Articles were searched in online databases, such as PUBMED, MEDLINE and Google scholar using keywords “ inancial, strategic, impact, clinical laboratory, managers.” Manual Search of Journals were also done. Articles were reviewed and analysed. The relevant articles were reviewedwhich showed the value analysis of lab services and its costs alongwith technical staff workload provides insights on the relationship between variables and the uncertainty of inancial strategic effects.


INTRODUCTION
Financial resources are essential to medicine based laboratories in the operation of services and one of the main concerns to lab managers. (Mouseli et al., 2017) But they are limited, and today in most countries, the medicine-based labs face serious problems. Because of this, there is a need for use of money supplies and managers must be able to provide lab test services at a reasonable cost and also be able to maintain their labs quality standards. Awareness of the cost of lab test services and allocating available resources among lab managers are necessary. (Javid et al., 2015;Mouseli et al., 2017;Su et al., 2016) Cost examination assumes a signi icant job in strategy making and causes research center directors to create suitable methodologies for genuine costing. (Mouseli et al., 2017) Cost control has risen as one of the signi icant dificulties confronting lab activities. (Jayaraj et al., 2015b) The exemptions of top-notch results with diminished pivot time and expanded outstanding tasks at hand with diminished workforce is on the expansion and are signi icant elements in running clinical labs effectively. (Cheah et al., 2018;Sivaramakrishnan and Ramani, 2015) Primarily, the cost factors depend on the type of tests undertaken in the clinical lab, including haematological tests, biochemical tests, pathological tests or microbiological tests. (Jangid et al., 2015) Another central point is how much the lab tests may be manual or computerized, with the volume of test samples. The other signi icant components incorporate the degree of income of the nation, since that in luences compensations and lab zone costs speci ically; however it can mildly affect cost of lab assets utilized in testing lab tests. (Cheah et al., 2018) The outstanding task at hand based costing, by thinking about the causal connection among expenses and remaining burden, and giving administrative data as money related models, is more valuable than traditional accounting methods. Likewise, it unmistakably re lects labor, hardware and exercises of the area, giving the genuine and exact costs which prompts expanded productivity, viability and in the long run accomplishment of the key destinations of the research facility. With this technique, immediate and circuitous expenses for giving research center administrations can be resolved. Besides, lab chiefs ought to recognize the expensive territories and gauge their expenses against picked up bene it. (Mouseli et al., 2017) Several literatures studied the early detection and prompt diagnosis can lead to better prognosis and help in the implementation of successful clinical treatment procedures. (Gheena and Ezhilarasan, 2019;Hannah et al., 2018;Jayaraj and Sherlin, 2015;Sherlin and Ramani, 2015) In this way, prognostic biomarkers can ill in as an apparatus for inding, among boundaries that can without much of a stretch distinguish patients at higher (Sridharan et al., 2017;Swathy et al., 2015;Viveka et al., 2016) risk and adverse result during clinical introduction and furthermore anticipate the risk and identify any progressions. (Gupta and Ramani, 2016;Shree et al., 2019;Jayaraj et al., 2015a;Sridharan et al., 2019;Thangaraj et al., 2016) This study, costing exercise is being reviewed focusing on the work low of clinical laboratories. The inancial independence of the clinical lab tests focuses on individual departments based on lab services such as hematology, pathology, microbiology and biochemistry which are found to be most labour-intensive divisions in the lab and assumed to be inancially burdensome.

Search strategy for identi ication of studies
The pursuit technique was as per the Cochrane rules for precise surveys. Articles were looked and chosen utilizing PUBMED, MEDLINE and Google scholar. All possible studies of inancial strategic impact on clinical lab managers, were included. The article search included just those distributed in the English writing. An Internet search was likewise inished with the keywords " inancial, strategic, impact, clinical laboratory, managers." Literatures also evaluating the ' inancial strategic impact on clinical laboratory managers' in cross-references were also included. The title of the articles and abstracts was explored. Articles that considered ' inancial strategic impact on clinical laboratory managers' were chosen for further appraisal.

Data extraction and analysis
Once the articles to be reviewed are inalized, data extracted from each article were tabulated and was later cross checked. (Table 1) Flow chart for study selection. (Figure 1)

Outcomes
The inancial strategic impacts on clinical lab managers were analyzed for relevance.

Methods of review
The selection and exclusion criteria of the reviewed studies are shown in Figure 1. The search strategy identi ied six studies that evaluated inancial strategic impact on clinical lab managers. The descriptions of the individual studies are shown in (Table 1).

Included studies
Among the six included studies, the inancial strategic impact on clinical lab managers was studied in detail. (Table 1)

Outcomes
There was substantial relevance in the articles studied that had evaluated the impact of inancial strategies on clinical lab managers.
In this study, the cost of lab test services and workload data based on technical staff workload had been reviewed. The expense of every lab remaining task at hand is lower than the one found in the earlier year which was because of the augmentation in the quantity of tests and, simultaneously, to the decrease of lab faculty.
In view of shortage of such examination there was no chance to analyze the expense of individual research center test.
According to literature, the remaining task at hand based costing involves various advantages including the capacity to evaluate the genuine expenses of outstanding task at hand and recognizing the connection between the expenses and remaining task at hand. Studies additionally indicated proof that remaining burden based costing is an appropriate framework for costing in clinical lab tasks. (Javid et al., 2015) The study by Su et al showed no relationship existed between volumes of lab tests and service costs. (Su et al., 2016) Whereas, in the study by Muriheadet al it was found that service costs depend on service function associated with case distribution. The shows proof that outstanding task at hand based costing comprises the circumstances and logical results connection among remaining burden and cost questions henceforth gives data on the real unit cost of offering clinical types of assistance in the labs.
The measure of expenses of each test in the research center of intrigue is by all accounts relative to the quantity of case visits and performed tests; thus the measure of cost has a sane igure and shows the measure of customer's interest for each test. The reason, anticipated results, and explanations behind breakdown of research center administrations additionally are basic for quality improvement.
Laboratory management personnel are into the assignment of principal updating of their test administrations and concentrating on client needs in which the research facility endeavors to help in making quality medicinal services administration thereby creating a sense of con idence in the community which can lead to better use of the laboratory services and thereby indirectly increasing the revenue.
By reviewing the literature we suggest that any laboratory should have a inancial model by analyzing their net present value with a forecast for a minimum of 5 year plan with inancial projections along with risk outlines which can determine the rate at which they will be able to sustain the laboratory.
It is very interesting and also intriguing to note that very limited studies are available on this particular aspect of laboratory management though the success of any laboratory depends on the inancial strategies. For the future, nonetheless, it is sensible to anticipate that labs will vie for constrained capital assets dependent on quanti iable monetary improvement. As the research facility part keeps on growing with automation there will be expanded rivalry.
It is accordingly important to remain updated and applicable to get by in the market. Research facili-ties need to ind some harmony among bene it and obligation to cut over the dif iculties and need to receive ways to deal with start, accomplish, and support productive development for the future.

CONCLUSIONS
Within the limitations of this study, the value analysis of services and its costs along with technical staff workload provides insights on the relationship between variables and the uncertainty of inancial strategic effects on the need to eliminate or include allocated technical teams to handle services ef iciently inside the clinical laboratory. Further, costing studies can provide insights into laboratory operation.