Organization of Laboratory Hemostasis Diagnostics in Polandand Worldwide: A Functional Model Proposal as a StartingPoint for National Guidelines

The organization of laboratory hemostasis diagnostics is undergoing substantial transformation. The traditional model of local, partly self-sufficient laboratories is being replaced by a functional model based on levels of competence, consolidation of specialized testing, hub-and-spoke systems, supervised point-of- care testing, and harmonization of preanalytical, analytical, and postanalytical procedures. The aim of this discussion paper is to initiate a professional debate on the Polish model of laboratory hemostasis diagnostics as a prerequisite for the development of future guideline-based documents. The manuscript highlights the need to link local and specialist laboratories with the clinical network of centers managing bleeding disorders, thromboembolic disease, inherited and acquired thrombophilia, and antiphospholipid syndrome. It emphasizes that Poland has elements of an organized clinical network, particularly in the field of hemophilia and related bleeding disorders, but lacks an equally explicit national network of hemostasis laboratories. A two-level model is proposed, consisting of a local level responsible for urgent and basic testing and a specialist level responsible for extended diagnostics, expert interpretation, consultation, and quality supervision. Agreement on such a model should precede the preparation of detailed diagnostic algorithms, sample referral rules, interpretative comments, and recommendations for point-of-care testing.