A Primer on the Cost of Quality for Improvement of Laboratory and Pathology Specimen Processes

Carlson, Richard O.; Amirahmadi, Fazlollaah; Hernandez, James S

doi:10.1309/ajcpsmqyaf6x1hut

Cited by 33 publications

(25 citation statements)

References 6 publications

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“…However, the scope of harmonization in laboratory medicine is more far-reaching than method harmonization and should cover a wider range of topics, namely all steps of the " brain-to-brain loop " , currently also referred to as the " end-to-end laboratory testing process " [1] . Some projects aiming to optimize laboratory services through global harmonization activities involving test names, reporting units and reference intervals are underway Table 4 Indicators of post-analytical phase.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, aggregate test result data are used for public health surveillance, healthcare performance measurement, and quality improvement [1] . The quality of laboratory testing, therefore, may greatly affect the quality and affordability of patient care and any defects or errors impact on the care of each patient as well as the costs incurred by the healthcare system [2] .…”

Section: Introductionmentioning

confidence: 99%

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Towards harmonization of quality indicators in laboratory medicine

Plebani

Chiozza²,

Sciacovelli

2012

Clinical Chemistry and Laboratory Medicine (CCLM)

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The identification of reliable quality indicators (QIs) in the total testing process (TTP) represents a crucial step in enabling users to quantify the quality of laboratory services, but the current lack of attention to extra-laboratory factors is in stark contrast with the body of evidence showing the multitude of errors that continue to occur in the pre-and post-analytical phases. Although interesting programs on indicators of the extra-analytical phases have been developed in some countries, there is no consensus on the production of joint recommendations for the adoption of universal QIs and the use of common terminology in the total testing process. In view of the different QIs and terminologies currently used, there an urgent need to harmonize proposed QIs, which should comply with three main principles: they must be patient-centered, consistent with the requirements of the International Standard for medical laboratories accreditation, and address all stages of the TTP. A model of quality indicators (MQI), consensually developed by a group of clinical laboratories according to a project launched by a working group of the International Federation of Clinical Chemistry and Labo ratory Medicine (IFCC), includes 56 QIs related to key processes (34 pre-, 7 intra-and 15 postanalytical phase) and three to support processes. The scope of harmonization in laboratory medicine, more far-reaching than method harmonization, should cover a wider range of topics, namely all steps of the " brain-to-brain loop " . The identification of valuable QIs is a key step in paving the way towards quality and patient safety in laboratory medicine.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Towards harmonization of quality indicators in laboratory medicine

Plebani

Chiozza²,

Sciacovelli

2012

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…Although the literature of money-savings in an ISO 15189 system is sparse, cost-of-quality models have demonstrated potential cost savings [678]. Such models consider the cost of trying to be the best you can be (cost of pathologists' continuing medical education or money spent on process design), the cost of maintaining a quality operation (eg, accreditation program expenses or enrollment of pathologists in PT programs), the cost of correcting process failures before the result is reported (eg, cost of histology having to recut skin biopsies to obtain a full face), and the cost of resolving problems after reporting results (eg, cost of pathologist's time to amend a report because operating room staff indicated the wrong site on a requisition form).…”

Section: Justifying Iso 15189 With Return On Investmentmentioning

confidence: 99%

International Organization for Standardization (ISO) 15189

2017

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The College of American Pathologists (CAP) offers a suite of laboratory accreditation programs, including one specific to accreditation to the international organization for standardization (ISO) 15189 standard for quality management specific to medical laboratories. CAP leaders offer an overview of ISO 15189 including its components, internal audits, occurrence management, document control, and risk management. The authors provide a comparison of its own ISO 15189 program, CAP 15189, to the CAP Laboratory Accreditation Program. The authors conclude with why laboratories should use ISO 15189.

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“…The quality management techniques collectively known as "Six Sigma" have been practiced in health care for several decades, and for even longer in manufacturing, business, and industry (3,5,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). The implementation of Sigma metrics has mostly occurred in laboratory subspecialties, such as chemistry, hematology, and immunology.…”

Section: A "Traditional" Approach To Quality: Six Sigmamentioning

confidence: 99%