What's to Be Done About Laboratory Quality? Process Indicators, Laboratory Stewardship, the Outcomes Problem, Risk Assessment, and Economic Value: Responding to Contemporary Global Challenges

American Journal of Clinical Pathology
Frederick A MeierKenneth A Sikaris

Abstract

For 50 years, structure, process, and outcomes measures have assessed health care quality. For clinical laboratories, structural quality has generally been assessed by inspection. For assessing process, quality indicators (QIs), statistical monitors of steps in the clinical laboratory total testing, have proliferated across the globe. Connections between structural and process laboratory measures and patient outcomes, however, have rarely been demonstrated. To inform further development of clinical laboratory quality systems, we conducted a selective but worldwide review of publications on clinical laboratory quality assessment. Some QIs, like seven generic College of American Pathologists Q-Tracks monitors, have demonstrated significant process improvement; other measures have uncovered critical opportunities to improve test selection and result management. The College of Pathologists of Australasia Key Indicator Monitoring and Management System has deployed risk calculations, introduced from failure mode effects analysis, as surrogate measures for outcomes. Showing economic value from clinical laboratory testing quality is a challenge. Clinical laboratories should converge on fewer (7-14) rather than more (21-35) process moni...Continue Reading

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Citations

May 31, 2018·Diagnosis·Mario Plebani
Mar 9, 2020·Clinical Chemistry and Laboratory Medicine : CCLM·Yong XiaLing Ji
Feb 9, 2021·Clinical Chemistry and Laboratory Medicine : CCLM·Christa CobbaertJudith Gillis
May 10, 2021·Clinical Biochemistry·Tony Badrick

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