While we may think of ourselves as One, we are home to 10 raised to the power of 17 other micro-organisms. That’s a 1 with 17 zeros after i.e. 100,000,000,000,000,000. If we want to say the number, that’s one hundred thousand trillion. This is the world of our personal microbiology and is still being unravelled by the human microbiome project.
This plays into the “Good bacteria/Bad bacteria” debate that many people have heard about and been interested in but has a direct bearing on narrative reporting. The human microbiome project has been trying to unravel what happens to our normal bacterial mix when we are well and when we are ill. Microbiology will grow bacteria that are present at many sites, reflected in the specimens we receive but just because we grow them does not mean they are causing disease, yet if we give sensitivities to antibiotics, the temptation is to think we are saying an antibiotic must be prescribed. Nothing could be further from the truth. Infection has to be diagnosed clinically but microbiology can assist in that, where there are clear signs of infection. This underlies why we are putting so much emphasis on speaking into the patients story with the narrative comment and relegating the antibiotic sensitivities to the bottom of the page. We need the patient and the clinician to look carefully at what is going on in the context of the laboratory report as described in the “What” tab.
Therefore, no matter who you are or what you do, narrative reporting in microbiology will have a context. You can click the submenus under the “You” tab to explore the importance for you if you are a member of the Public, a clinical Professional, one of our Laboratory Peers or a Public Health professional.
You as a member of the public are our primary audience even though at the present time you rarely get to see an individual laboratory report. This is because the results we present have to be considered in your clinical scenario and the same factual result may have different implications, depending on your clinical status.
If you are a professional user of our services, what’s in it for you? We spoke to Carwyn Jones, a GP from Carmarthen about the impact of narrative reporting in his practice:
We also provide details of the implications for our laboratory peers in terms of what they can expect as the quality improvement benefits of narrative reporting.
Finally, we have the public health implications. We spoke to David Heyburn, the Head of Operations for Microbiology and Health Protection in Public Health Wales about why he felt sufficiently strongly about narrative reporting that he and his central team bid for additional funding and the creation of new Clinical Liaison Biomedical Scientists who form the core team now working on this programme and included under the “About Us” tab: