The quality indicator paradox

Plebani, Mario

doi:10.1515/cclm-2015-1080

Cited by 26 publications

(22 citation statements)

References 26 publications

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“…In recent decades a body of evidence has been collected to highlight the vulnerability of the extra-analytical phases of the testing process and to identify reliable quality indicators (QIs) to identify and reduce the risk of errors [2][3][4][5][6]. More recently, the chasm between the current interest in extra-analytical QIs and the limited number of clinical laboratories that collect regular and comprehensive data on QIs has been described as "the quality indicator paradox" [7]. To overcome the paradox, a series of initiatives has been promoted and in particular, the European Federation of Laboratory Medicine (EFLM) has established a Task Force on "Performance specifications for the extra-analytical phases" (TFG-PSEP) with the aim of identifying reliable performance specifications for the extra-analytical phases.…”

mentioning

confidence: 99%

The use of extra-analytical phase quality indicators by clinical laboratories: the results of an international survey

Plebani¹,

O’Kane²,

Vermeersch³

et al. 2016

Clinical Chemistry and Laboratory Medicine (CCLM)

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confidence: 99%

The use of extra-analytical phase quality indicators by clinical laboratories: the results of an international survey

Plebani¹,

O’Kane²,

Vermeersch³

et al. 2016

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…Quality indicators have also been established in Australia, New Zealand, the United States, Brazil, Spain and the United Kingdom, and there are established extraanalytical error‐monitoring services offered through EQA/PT providers, for example the College of American Pathologists Q‐Probes system, the Key Incident Management and Monitoring System (KIMMS) of the Royal College of Pathologists in Australasia Quality Assurance Program and the UK National External Quality Assessment Scheme's PREPQ pre‐ and postanalytical quality monitoring service. A common finding from error‐monitoring services is that laboratories struggle to collect data despite the general support for error reduction in the extraanalytical phases by the laboratory professions . Collecting good quality data through the use of fewer, standardised indicators incorporated into the laboratory information management system may be the way forward.…”

Section: Managing What We Struggle To Measure: Monitoring Extraanalytmentioning

confidence: 99%

Pre‐ and postanalytical errors in haematology

Salle

2019

Int J Lab Hematology

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The majority of errors in laboratory medicine occur in the pre‐ and postanalytical phases of the testing process. Although the causes of these errors are largely common to all laboratory medicine specialties, it is important for the haematology laboratory to understand the particular impact of some on automated counting. The preanalytical phase is the stage of greatest risk but preanalytical errors may go undetected until postanalytical validation and interpretation. The challenges in the postanalytical phase include the standardisation of reference intervals against which results can be interpreted and the impact of just a small difference in reference interval for a key analyte such as haemoglobin concentration. Quality indicators against which pre‐ and postanalytical error incidence are measured are a source of information that can be used to improve services but laboratories struggle to collect good quality data.

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“…Despite the criteria defined by the EN-ISO 15189 ([…]the laboratory shall establish QIs to monitor and evaluate performance throughout critical aspects of pre-examination, examination and post-examination processes […]) and the availability of some standardised QIs, including a guideline on how to measure them, the number of clinical laboratories participating in benchmarking programs is rather limited. This gap led to the term "quality indicators paradox" (72). The best and easiest system is not of much use if it is not utilized.…”

Section: Are These Tools Used?mentioning

confidence: 99%

How do we use the data from pre-analytical quality indicators and how should we?

Cadamuro¹,

Gaksch²,

Mrazek³

et al. 2018

J. Lab. Precis. Med.

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It is impossible to imagine a modern medical laboratory without a structured quality management system in place. Nevertheless, this system usually focuses mostly on the analytical part of the total testing process (TTP), despite being aware of the fact that most errors occur in the pre-and post-analytical phases. There are many reasons possibly explaining this fact, one of them being that extra-analytical processes are hard to grasp, since they occur mostly outside of the laboratory and include many different parties. Despite these obstacles, it is mandatory to keep all steps of TTP, potentially influencing the analytical test result or their interpretation, under meticulous quality control and to improve them as much as possible, involving all health care workers contributing to sample quality. Additionally, it is necessary to collect and evaluate all data in a standardized manner, not only within one laboratory, but nationwide and internationally. This is a perquisite for valid data comparison over time (trend analysis) and benchmarking, the basis for threshold definition and continuous improvement. A widely accepted method to meet all these requirements is the concept of quality indicators (QIs). In this review, we provide an overview over this topic and we discuss an easy to use and freely available tool, aiming to aid laboratories in data collection and comparison: The QIs project of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Working Group on "Laboratory errors and patient safety" (WG-LEPS). Additionally, we provide practical suggestions on how to successfully implement QIs within any laboratory.

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The quality indicator paradox

Cited by 26 publications

References 26 publications

The use of extra-analytical phase quality indicators by clinical laboratories: the results of an international survey

The use of extra-analytical phase quality indicators by clinical laboratories: the results of an international survey

Pre‐ and postanalytical errors in haematology

How do we use the data from pre-analytical quality indicators and how should we?

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