Naslov
Quality indicators of continuous quality improvement in clinical laboratories

Autori
Topić, Elizabeta ; Šimundić, Ana-Maria ; Vukasović, Ines

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
Clin Chem Lab Med 2009 ; 47, Special Supplement, pp S1 – S409, June 2009 / Siest, Gerhard - Innsbruck : Walter de Gruyter, 2009, 40-40

Skup
Euromedlab 2009 ; 18th IFCC - EFCC European Congress of Clinical Chemistry and Laboratory Medicine

Mjesto i datum
Innsbruck, Austrija, 07.06.2009. - 11.06.2009

Vrsta sudjelovanja
Pozvano predavanje

Vrsta recenzije
Nije recenziran

Ključne riječi
quality; accreditation; indicators
(kvaliteta; akreditacija; pokazatelji)

Sažetak
Quality indicators (QI) are defined as specially chosen, measurable criteria for a laboratory performance giving a base for evaluation and improvement of the laboratory performance quality. The QI should measure the laboratory performance in the key function related to patient care and satisfaction and are usually selected as parts of the total testing process, such as preanalytical, analytical and postanalytical phase of laboratory activities. QI for preanalytical phase may include error in patient identification, erroneous request, test order appropriateness, inadequate sample (hemolytic, lipemic, clotted, etc.), missing sample (sample lost or not received), needle stick injuries, etc. For analytical phase, QI may include external quality assurance results, internal quality control results, imprecision, inaccuracy, total error ; and for postanalytical phase number of tests not completed, reports with wrong patient or physician data, average time for critical results reporting, number of critical results successfully reported, reports exceeding TAT, customer satisfaction (patients and clinical staff), number of reports corrected or withdrawn, LIS downtime episodes, technical errors, etc. Each phase of the testing process should be monitored by at least one indicator. However, besides key laboratory function, strategy and support processes important for successful functioning, related to laboratory organization, communication, education, environmental safety, resolving of complaints and nonconformities have substantial effects on the quality of laboratory performance. These processes should also be monitored by some indicators such as goals reached ; referred tests and projects carried out as strategic processes indicators, and physician and patient satisfaction ; written and verbal complaints ; corrective instrument maintenance ; nonconformities to providers, evaluation of training as a support process. It is also recommended to monitor some financial indicators and indicators of laboratory effectiveness. For exact and precise definition of QI and its successful implementation in overall laboratory performance, the following issues should be clearly defined: what do we want to measure ; can we collect the data ; how shall we collect and analyze data ; who is going to keep records of data needed for QI ; reporting intervals ; acceptance limits for the indicator ; the meaning of one wrong result for our system ; what is our corrective action when QI falls outside the acceptance limit ; for how long are we going to monitor the indicator. It is also important to consider repercussions of particular error on result traceability in the preanalytical, analytical or postanalytical phase, and specific opportunities for improvement. The choice and number of QI monitored in laboratory may vary. They can be monitored either for a certain period of time or permanently, depending on their nature and what they refer to. They are liable to change since they need to optimize decisions related to corrective actions and to move from a subjective criterion to systematic and comparative management. However, continuous monitoring and trend analysis of quality indicators is of utmost importance as a concept of continuous improvement in total quality system in laboratory performance.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA