Posted by Sten Westgard, MS
A recent op-ed in the New York Times by Dr. Robert Wachter as well as an interview with Don Berwick in HealthLeaders Media broached a taboo topic: is healthcare measuring too much?
'[T]he measurement fad has spun out of control. There are so many different hospital ratings that more than 1,600 medical centers can now lay claim to being included on a “top 100,” “honor roll,” grade “A” or “best” hospitals list. Burnout rates for doctors top 50 percent, far higher than other professions. A 2013 study found that the electronic health record was a dominant culprit. Another 2013 study found that emergency room doctors clicked a mouse 4,000 times during a 10-hour shift. The computer systems have become the dark force behind quality measures.'How Measurement Fails Doctors and Teachers, New York Times, January 16, 2016
As the global debate over establishing the best error models and performance specifications rages, laboratories are probably asking themselves the same questions that the doctors are asking: how many metrics are too much?
A possible answer, or at least some more questions, after the jump...
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Posted by Sten Westgard, MS
An interesting question came from one of our readers, about how to interpret certain outliers.
So let's take one example, just two control values, expressed in z-scores. If the low control is -3.1 and the high control is + 2.3, which rule is violated? the 1:3s rule? The R:4s rule? Both?
An answer, after the jump...
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Posted by Sten Westgard, MS
An important new study was published in the International Journal of Laboratory Hematology, on the QC practices of coagulation laboratories.
But here's a question for you: of all these activities, how many of them occur greater than 90% of the time - and which one doesn't?
Repeat the QC, and if it passes, report results
Open [and run] new QC
Look for trending
Discontinue testing until controls are within limits
Repeat all patient samples from the last acceptable QC
To find out which one of the activities occurs at a frequency not like the others, follow the jump...
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