Posted by Sten Westgard, MS
A lot of interesting studies coming out this month, unfortunately none of them with encouraging news about the US healthcare system.
The latest, from Sunil Eappen, MD, Atul Gawande, MD et al, Relationship Between Occurence of Surgical Complications and Hospital Finances, JAMA, April 17, 2013, Vol. 309, No. 15 1599-1606
Take a guess: do US hospitals make more money when things go wrong, or less?
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Posted by Sten Westgard, MS
There was some very interesting testimony given in front of the US Congress this week. Boeing and other FAA officials discussed their failure to adequately test the lithium-ion batteries found in the 787 Dreamliner. As you probably already know, on two of the Dreamliners, those batteries malfunctioned and caused fires, which then caused the entire fleet to be grounded.
In the New York Times, it was reported "Boeing’s chief engineer on the 787, Mike Sinnett, said the calculation
that a battery would fail only once every 10 million flight hours
applied to the design of the battery and did not include possible
manufacturing flaws."
In fact, two battery failures and serious fires occurred after less than 52,000 flight hours. The risk was actually over 350 times higher than their estimate!
How could they be so wrong? More after the jump...
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Posted by Sten Westgard, MS
Can you guess which of these categories is the leading source of successful malpractice claims?
Surgical mishaps
Obstetrical problems
Medication errors
Anesthesia disasters
Diagnostic errors
Treatment errors
Something else entirely?
The answer, after the jump...
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Posted by Sten Westgard, MS
More evidence of pre-analytical error rates, this time for the Journal of Clinical Pathology. This is from a study back in 2010, my apologies for only finding it this year:
A Six Sigma approach to the rate and clinical effect of registration error in a laboratory, Naadira Vanker, Johan van Wyk, Annalise E. Zemlin, Rajiv T Erasmus, J Clin Pathol 2010:63:434-437.
In this study, they reviewed 47,543 test request forms from a 3 month period of November 2008 to February 2009. The study was conducted at the "chemical pathology laboratory at Tygerberg Hospital - an academic tertiary hospital in the Western Cape Province of South Africa. The laboratory is a division of the National Health Laboratory Services, which is a network of 265 pathology laboratories in South Africa."
Can you guess how many errors they found? And what was the impact of those errors?
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Posted by Sten Westgard, MLO
In the November 2012 MLO magazine there is an intriguing article by Roy Midyett, a hematology supervisor, titled "Empty QC"
Here's how Mr. Midyett defines "Empty QC":
"Empty QC is any nominal QC that does not give techs performing the
test any more confidence than they would have without the QC, and has by
logic or experience, no influence on the reporting of the test."
Is Mr. Midyett correct? Have our QC procedures become meaningless gestures? More after the jump.
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Posted by Sten Westgard, MS
I recently got a smart question from a concerned laboratory scientist. After reviewing one of the Sigma-metric studies on the website, he noted that while a particular method had a bad Sigma-metric, the main reason was due to the bias. His question was essentially (and I am paraphrasing here), "If the bias component comes from a particular difference between the instrument or kit and a reference system, shouldn't it be excluded from the Sigma-metric calculation?"
The reasoning is that the bias problem could be (1) eliminated through recalibration, (2) it may be a bias against a method that is not a reference method, so the difference might not be "real", or (3) if the reference range is adjusted and the method is used in exclusion, bias doesn't matter anyway.
We've had a lot of discussion about bias in our statistics lately. Is this a case where the Sigma-metric is "skewed"? What's your verdict? A discussion after the jump.
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