A new study in Clinical Chemistry investigated the errors rates for Point-of-Care (POC) devices:
Can you guess what the error rates were?
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(Or, if only some surveys are based on accuracy, then what are the other surveys based on?)
Posted by Sten Westgard, MS
There's an article that appeared in the October 2010 issue of CAP Today that probably didn't get enough attention. It covers a subject that's been gnawing at us for a while:
Accuracy-based Surveys carve higher QA Profile, by Anne Paxton
For those of you who thought all proficiency testing was "accuracy-based", this article may give you a bit of a shock. In fact, most PT surveys - indeed most EQA programs and even peer-group programs - are not based in accuracy. Instead, those surveys are only based on "consensus."
What's the difference, What does it mean - and how did it come to be this way?
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Posted by Sten Westgard, MS
In the iconic western film, The Magnificent Seven, there is a famous scene about marksmanship. [Quick set up: The Magnificent Seven are - you guessed it, seven - gunmen hired to protect a peasant village from a much larger group of bandits] Early in the film, the heroic gunmen detect three bandit scouts and want to capture them. In an abrupt exchange of gunfire, two bandits are killed, but the third bandit mounts his horse and attempts to escape. As the bandit flees, one of the gunmen, Britt, steadies his pistol and takes aim. The escaping bandit gallops farther and farther away. But just as he is about to disappear behind a hill, Britt shoots, hitting the bandit square in the back, killing him. The youngest of the gunmen, Chico, shouts:
Chico: (in awe) That was the greatest shot I've ever seen!
Britt: (sternly) The worst! I was aiming at the horse.
This scene reminds us that even when what one person thinks is great performance may not be acceptable by another person's standards. Indeed, what appears like an accomplishment may actually be an error.
And what, you may ask, does this have to do with Six Sigma?
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Posted by Sten Westgard, MS
As we write, the National Basketball Playoffs are underway. The home team for Westgard QC, the Milwaukee Bucks, just went down to defeat in the final game of a 7-game series.
Those who follow basketball know that in a series like this, the teams basically alternate home court advantage. The Bucks went to Atlanta to play the Hawks for two game,s then the Hawks came to Milwaukee to play the Bucks for two games, etc. But while there is a home court advantage in the audience (which didn't work: both teams won away games), the courts in every stadium are the same. The basketball hoop in Atlanta is the same as the basketball hoop in Milwaukee. Why is that?
Because the rules specify a consistent goal. The NBA has a rule book which states the precise size of the court, equipment and basket size. A basket, for example, "shall consist of a pressure-release NBA approved metal safety ring 18" in inside diameter with a white cord net 15" to 18" in length." Every stadium must comply with this rule.
Likewise, there is a single standard for the basketball: "The National Basketball Association (NBA) allows only one official ball: The ball must be the official NBA game ball manufactured by Spalding. The ball is orange in color, 29.5 inches in circumference and weighs 22 ounces (size 7). It must also be inflated to between 7.5 and 8.5 pounds per square inch."
Sorry for the long prologue. But wouldn't it be nice if labs were the same?
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Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
While we recently got a study that estimated the (frightenly high) number of Adverse Events caused by US hospitals, it looks like other countries are not content to let us stand alone. Now Sweden is doing us one better. Guess what the Adverse Event rate is in one hospital in Sweden?
- 28.2%
- 20.5%
- 6.3%
- 3.32%
Which number would you choose?
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Posted by James O. Westgard, PhD
Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Now that the age of the IQCP is here, laboratories are grappling with the time and effort it takes to build their Individualized Quality Control Plans. How long should it take to build an appropriate IQCP?
- 40+ hours
- 21-40 hours
- 11-20 hours
- 5-10 hours
- Less than 5 hours?
How much time has it taken for you? How much time do you think it should take?
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Posted by Sten Westgard, MS
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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Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
An interesting abstract was published at the Paris IFCC meeting. It detailed the EQA performance of a set of 12 public laboratories in Catalonia. Can you guess what the failure rate for these labs for biochemistry EQA?
- 14.5%
- 14%
- 3%
- none of the above
The answer, after the jump...
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Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Last month, Advance for the Laboratory published a three part series on Six Sigma in the Clinical Laboratory, written by David Plaut, Nathalie Lepage, and Kim Przekop:
While it's great that Advance has invested in in-depth coverage of the Six Sigma topic, unfortunately one of their examples in part 2 demonstrates a misunderstanding of the application.
See the mistake, after the jump...
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