Posted by Sten Westgard, MS and James O. Westgard, PhD
As reported elsewhere on the website, several of the symposiums this year were on standardization and harmonization for various analytes. This year, however, there was an added note of urgency. For many laboratorians, standardization seems like a somewhat esoteric subject, important but not necessarily pressing. But with the expectation of widespread implementation of electronic medical records, the problems with “comparability” of test results (and analytical methods) are about to become stark.
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Posted by Sten Westgard, MS
A recent abstract from the 2009 IFCC/EFCC (Euromedlab) caught my eye:
Quality Indicators for Laboratory Process; assessment in the Trento Department of Laboratory Medicine.
I Caola, C Pellegrini, N Bergamo, E Saurini, P Caciagli.
CCLM 2009
Examining the quality records of five laboratories, they applied a set of Quality Indicators from the IFCC. Errors were tracked and tabulated. The results are quite interesting.
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Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Some recent articles on the subject of Quality Indicators have reminded me that analytical quality is to laboratory management much like the laboratory is to the hospital: over-worked, under-appreciated, and assumed to be of reliably excellent quality.
- Laboratory Medicine Quality Indicators: A Review of the Literature, Shahram Shahangian, PhD, MS, and Susan R. Snyder, PhD, MBA, Am J Clin Pathol 2009;131:418-431
- A Summary of Deliberations on Strategic Planning for Continuous Quality Improvement in Laboratory Medicine, Dana Marie Grzybicki, MD, PhD, Shahram Shahangian, PhD, Anne M. Pollock and Stephen S. Raab, MD. Am J Clin Pathol 2009;131:315-320.
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Posted by Sten Westgard, MS
This week two Harvard doctors wrote an op-ed for the Wall Street Journal: Why 'Quality' care is dangerous (subscription may be required, depending on time of access). In this essay, they warn of the dangers of what they term the "quality metrics" that provide the basis for "pay-for-performance" systems that may govern physician reimbursement. Under any of the proposed healthcare reforms, P4P schemes may be used as a way to "incentivize" doctors and clinicians to provide the right care to their patients.
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In a recent article in Annals of Clinical Biochemistry, a group over in the UK did an unusual thing - they audited their IQC (internal quality control) practices. The North Thames Audit and Quality Assurance Group use a questionnaire to assess the IQC practices in 54 laboratories in part of the United Kingdom. Here's the specific citation:
Posted by Sten Westgard, MS
James O. Westgard, PhD
[Editor's note: this essay contains some discussion of politics]