The freckle plot (daily turnaround time chart): a technique for timely and effective quality improvement of test turnaround times

1993 ◽  
Vol 39 (6) ◽  
pp. 1054-1059 ◽  
Author(s):  
T G Pellar ◽  
P J Ward ◽  
J F Tuckerman ◽  
A R Henderson
Keyword(s):  
Quality Assurance ◽  
Quality Improvement ◽  
Confidence Interval ◽  
Turnaround Time ◽  
Daily Basis ◽  
Time Limit ◽  
Remedial Action ◽  
Monthly Basis ◽  
Conventional Tests ◽  
Test Delay

Abstract Test turnaround times are often monitored on a monthly basis. However, such an interval usually means that not all causes for delay in test reporting can be unequivocally identified for institution of remedial action. We have devised a daily chart--the freckle plot--that graphically displays the test turnaround times by laboratory receipt time. Different symbols are used to designate specimens reported within the test's turnaround time limit, those within 10 min beyond that limit, and those well outside the limit. These categories are adjustable to suit different limits of stringency. Freckle plots are produced on a daily basis and can be used to track down causes for test delays. Using the 1-h turnaround time "stat" potassium test as a model, we found 16 causes for test delay, of which 9 were potentially remediable. By applying these remedies, we were able to increase test compliance, in the day shift, from 91.5% (95% confidence interval 88.8%-93.7%) to 97.6% (95% confidence interval 96.4-98.55%), which is significant at P < 10(-7). This daily plot is a useful quality assurance tool, supplementing the more conventional tests used to ensure laboratory quality improvement.

Exploiting Soft Constraints within Decomposition and Coordination Methods for Sub-hourly Unit Commitment

2020 ◽  
Author(s):  
Niranjan Raghunathan ◽  
Mikhail Bragin ◽  
Bing Yan ◽  
Peter Luh ◽  
Khosrow Moslehi ◽  
...  
Keyword(s):  
Unit Commitment ◽  
Daily Basis ◽  
Time Limit ◽  
Soft Constraints ◽  
Problem Complexity ◽  
Surrogate Optimization ◽  
Parallel Version ◽  
Improved Performance ◽  
Coordination Methods ◽  
Relaxed Problem

Unit commitment (UC) is an important problem solved on a daily basis within a strict time limit. While hourly UC problems are currently considered, they may not be flexible enough with the fast-changing demand and the increased penetration of intermittent renewables. Sub-hourly UC is therefore recommended. This, however, will significantly increase problem complexity even under the deterministic setting, and current methods may not be able to obtain good solutions within the time limit. In this paper, deterministic sub-hourly UC is considered, with the innovative exploitation of soft constraints – constraints that do not need to be strictly satisfied, but with predetermined penalty coefficients for their violations. The key idea is the “surrogate optimization” concept that ensures multiplier convergence within “surrogate” Lagrangian relaxation as long as the “surrogate optimality condition” is satisfied without the need to optimally solve the “relaxed problem.” Consequently, subproblems can still be formed and optimized when soft constraints are not relaxed, leading to a drastically reduced number of multipliers and improved performance. To further enhance the method, a parallel version is developed. Testing results on the Polish system demonstrate the effectiveness and robustness of both the sequential and parallel versions at finding high-quality solutions within the time limit.

scholarly journals Convalescent plasma therapy for COVID-19 patients: a protocol of a prospective meta-analysis of randomized controlled trials

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lajos Szakó ◽  
Nelli Farkas ◽  
Szabolcs Kiss ◽  
Szilárd Váncsa ◽  
Noémi Zádori ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Organ Failure ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Plasma Therapy ◽  
Monthly Basis ◽  
Randomized Controlled

Abstract Background Coronavirus disease 2019 (COVID-19) is an infection with possible serious consequences. The plasma of recovered patients might serve as treatment, which we aim to assess in the form of a prospective meta-analysis focusing on mortality, multi-organ failure, duration of intensive care unit stay, and adverse events. Methods A systematic search was conducted to find relevant registered randomized controlled trials in five trial registries. A comprehensive search will be done continuously on a monthly basis in MEDLINE (via PubMed), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science to find the results of previously registered randomized controlled trials. The selection will be done by two independent authors. Data extraction will be carried out by two other independent reviewers. Disagreements will be resolved by a third investigator. An update of the search of the registries and the first search of the databases will be done on the 21st of July. Data synthesis will be performed following the recommendations of the Cochrane Collaboration. In the case of dichotomous outcomes (mortality and organ failure), we will calculate pooled risk ratios with a 95% confidence interval (CI) from two-by-two tables (treatment Y/N, outcome Y/N). Data from models with multivariate adjustment (hazard ratios, odds ratio, risk ratio) will be preferred for the analysis. P less than 0.05 will be considered statistically significant. In the case of ICU stay, weighted mean difference with a 95% confidence interval will be calculated. Heterogeneity will be tested with I2, and χ2 tests. Meta-analysis will be performed if at least 3 studies report on the same outcome and population. Discussion Convalescent plasma therapy is a considerable alternative in COVID-19, which we aim to investigate in a prospective meta-analysis.

Turnaround times and modes of reporting critical results in Asian laboratories

2021 ◽  
pp. 000456322198936
Author(s):  
Tony Badrick ◽  
Mohamed Saleem ◽  
Wesley Wong
Keyword(s):  
Quality Improvement ◽  
Performance Index ◽  
Clinical Chemistry ◽  
Reporting Quality ◽  
Turnaround Time ◽  
Timely Manner ◽  
Phone Calls ◽  
Key Performance Index ◽  
Critical Results

Background Reporting critical results in a timely manner is a crucial role of clinical laboratories. Traditionally, these results were reported using the phone or fax system. However, there are now other modes of communication for this reporting. Quality improvement in any organization is driven by detection of errors and benchmarking against peers. In the case of critical result reporting, there are few current widely used Benchmarking schemes. Methods The Roche Clinical Chemistry Benchmarking Survey in 2019 added questions about critical result reporting including the mode of communication and turnaround time key performance index. This survey includes over 1100 laboratories from 20 countries. Results The survey revealed a range of communication strategies with phone calls still the commonest followed by email. The key performance index for most laboratories was less than 10 min. Conclusion Benchmarking can provide key information for quality improvement activities, particularly pre- and postanalytical.

From Quality Assurance to Quality Improvement

1992 ◽  
Vol 10 (3) ◽  
pp. 477-492
Author(s):  
Dennis S. O'Leary ◽  
Margaret R. O'Leary
Keyword(s):  
Quality Assurance ◽  
Quality Improvement

Physician Satisfaction With Clinical Laboratory Services: A College of American Pathologists Q-Probes Study of 138 Institutions

2009 ◽  
Vol 133 (1) ◽  
pp. 38-43
Author(s):  
Bruce A. Jones ◽  
Leonas G. Bekeris ◽  
Raouf E. Nakhleh ◽  
Molly K. Walsh ◽  
Paul N. Valenstein
Keyword(s):  
Quality Improvement ◽  
Clinical Laboratory ◽  
Turnaround Time ◽  
Physician Satisfaction ◽  
Reliability Of Results ◽  
Improvement Program ◽  
Valuable Component ◽  
Laboratory Services ◽  
Survey Results ◽  
High Level

Abstract Context.—Monitoring customer satisfaction is a valuable component of a laboratory quality improvement program. Objective.—To survey the level of physician satisfaction with hospital clinical laboratory services. Design.—Participating institutions provided demographic and practice information and survey results of physician satisfaction with defined aspects of clinical laboratory services, rated on a scale of 1 (poor) to 5 (excellent). Results.—One hundred thirty-eight institutions participated in this study and submitted a total of 4329 physician surveys. The overall satisfaction score for all institutions ranged from 2.9 to 5.0. The median overall score for all participants was 4.1 (10th percentile, 3.6; 90th percentile, 4.5). Physicians were most satisfied with the quality/reliability of results and staff courtesy, with median values of excellent or good ratings of 89.9%. Of the 5 service categories that received the lowest percentage values of excellent/good ratings (combined scores of 4 and 5), 4 were related to turnaround time for inpatient stat, outpatient stat, routine, and esoteric tests. Surveys from half of the participating laboratories reported that 96% to 100% of physicians would recommend the laboratory to other physicians. The category most frequently selected as the most important category of laboratory services was quality/reliability of results (31.7%). Conclusions.—There continues to be a high level of physician satisfaction and loyalty with clinical laboratory services. Test turnaround times are persistent categories of dissatisfaction and present opportunities for improvement.

A review of plant analysis in Australia

1993 ◽  
Vol 33 (8) ◽  
pp. 1029 ◽  
Author(s):  
PD Handson ◽  
BC Shelley
Keyword(s):  
Quality Assurance ◽  
Sample Preparation ◽  
Turnaround Time ◽  
Plant Analysis ◽  
Nutrient Analysis ◽  
Testing Laboratories ◽  
Australian Plant ◽  
Analytical Accuracy ◽  
Plant Sap

This review of plant analysis in Australia examines sample preparation, instrumentation, problem analytes, calibration, detection limits, and quality assurance. The issue of turnaround time v. analytical accuracy is discussed and the role of 'plant sap quick tests' in nutrient analysis is assessed. Results of a survey of Australian plant-testing laboratories are included.

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