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The hematology laboratory traditionally performs testing for blood and fluid cell counts, coagulation, and often urinalysis.Optimizing utilization of the automated and manual components of hematology testing requires distinct approaches.This dichotomy has a significant effect on the approach to utilization management as the hematology laboratory shares features in common with other highly automated compo- nents of the core laboratory, especially chemistry, but also more manual sections of the laboratory such as special coag- ulation testing.Thus, there is a divide in the hematology laboratory menu characterized by some of the most automated tests (e.g., hemoglobin/hematocrit) and the least automated tests (e.g., manual microscopic review of leukocyte differential).

The hematology laboratory traditionally performs testing for blood and fluid cell counts, coagulation, and often urinalysis. Many hematology laboratories have been consolidated with chemistry to form centralized core laboratories. The modern hematology laboratory has undergone a major and continued transition to increasing automation over the past 50 years. Though nearing a state of total automation, there are still a select number of highly manual and skilled tasks to be per- formed in the hematology laboratory, especially those per- taining to microscopy. Thus, there is a divide in the hematology laboratory menu characterized by some of the most automated tests (e.g., hemoglobin/hematocrit) and the least automated tests (e.g., manual microscopic review of leukocyte differential).

This dichotomy has a significant effect on the approach to utilization management as the hematology laboratory shares features in common with other highly automated compo- nents of the core laboratory, especially chemistry, but also more manual sections of the laboratory such as special coag- ulation testing. Optimizing utilization of the automated and manual components of hematology testing requires distinct approaches. As such, this chapter is divided into two sections to address the management of each component separately. Key examples of utilization management in hematology are shown in Table 10.1. Utilization management in the special coagulation laboratory is discussed in more detail in the chapter by Van Cott