scholarly journals The Case for Laboratory Developed Procedures

2017 ◽  
Vol 4 ◽  
pp. 237428951770830 ◽  
Author(s):  
Karen L. Kaul ◽  
Linda M. Sabatini ◽  
Gregory J. Tsongalis ◽  
Angela M. Caliendo ◽  
Randall J. Olsen ◽  
...  
Keyword(s):  
Patient Care ◽  
Clinical Laboratory ◽  
Positive Impact ◽  
Cost Effective ◽  
Effective Manner ◽  
History Of ◽  
Laboratory Procedures ◽  
Improvement Programs ◽  
Quality Improvement Programs ◽  
Clinical Laboratory Improvement Amendments

An explosion of knowledge and technology is revolutionizing medicine and patient care. Novel testing must be brought to the clinic with safety and accuracy, but also in a timely and cost-effective manner, so that patients can benefit and laboratories can offer testing consistent with current guidelines. Under the oversight provided by the Clinical Laboratory Improvement Amendments, laboratories have been able to develop and optimize laboratory procedures for use in-house. Quality improvement programs, interlaboratory comparisons, and the ability of laboratories to adjust assays as needed to improve results, utilize new sample types, or incorporate new mutations, information, or technologies are positive aspects of Clinical Laboratory Improvement Amendments oversight of laboratory-developed procedures. Laboratories have a long history of successful service to patients operating under Clinical Laboratory Improvement Amendments. A series of detailed clinical examples illustrating the quality and positive impact of laboratory-developed procedures on patient care is provided. These examples also demonstrate how Clinical Laboratory Improvement Amendments oversight ensures accurate, reliable, and reproducible testing in clinical laboratories.

Letter to the Editor

PEDIATRICS ◽  
1994 ◽  
Vol 93 (1) ◽  
pp. 154-154
Author(s):  
Alejandro Hoberman ◽  
Ellen R. Wald
Keyword(s):  
Private Practice ◽  
Occupational Safety ◽  
Clinical Laboratory ◽  
Regulatory Agencies ◽  
Health Administration ◽  
Safety And Health ◽  
Effective Care ◽  
Laboratory Procedures ◽  
The One ◽  
Clinical Laboratory Improvement Amendments

Dr Murray correctly points out that the concerns of office-based pediatricians regarding regulations imposed by the Clinical Laboratory Improvement Amendments (CLIA) and Occupational Safety and Health Administration (OSHA) greatly affect the likely implementation of "new laboratory procedures" within the private practice sector. Although these regulatory agencies, on the one hand, intend to assure quality control when evaluating specimens and on the other hand, safety for patients and employees, they are often perceived as obstacles to effective care.

scholarly journals Pre-Test and Post-Test Applications to Shape the Education of Phlebotomists in A Quality Management Program: An Experience in A Training Hospital

2016 ◽  
Vol 35 (3) ◽  
pp. 347-353 ◽  
Author(s):  
Güzin Aykal ◽  
Mustafa Keşapli ◽  
Özgür Aydin ◽  
Hatice Esen ◽  
Ayşenur Yeğin ◽  
...  
Keyword(s):  
Education Program ◽  
Clinical Laboratory ◽  
Positive Impact ◽  
Management Program ◽  
Worker Safety ◽  
Sample Collection ◽  
Before And After ◽  
Post Test ◽  
Laboratory Procedures ◽  
Care Worker

SummaryBackground: After the introduction of modern laboratory instruments and information systems, preanalytic phase is the new field of battle. Errors in preanalytical phase account for approximately half of total errors in clinical laboratory. The objective of this study was to share an experience of an education program that was believed to be successful in decreasing the number of rejected samples received from the Emergency Department (ED).Methods: An education program about laboratory procedures, quality requirements in the laboratory, patient and health-care worker safety was planned by the quality team to be performed on 36 people who were responsible for sample collection in the ED. A questionary which included 11 questions about the preanalytic phase was applied to all the attendees before and after training. The number of rejected samples per million was discovered with right proportion account over the number of accepted and rejected samples to laboratory after and before the training period.Results: Most of the attendees were nurses (n: 22/55%), with over 12 years of experience in general and 2-4 years experience in the ED. Knowledge level of the attendees was calculated before training as 58.9% and after training as 91.8%. While the total rate of sample rejection before training was 2.35% (sigma value 3.37-3.50), the rate after training was 1.56% (sigma value 3.62-3.75).Conclusions: Increasing the knowledge of staff has a direct positive impact on the preanalytic phase. The application of a pre-test was observed to be a feasible tool to shape group specific education programs.

scholarly journals MGMP Teacher Organization Empowerment in Improving Students' Problem Solving Ability

2020 ◽  
Vol 10 (1) ◽  
pp. 152
Author(s):  
Daryanto ◽  
Iskandar Agung ◽  
Siswantari
Keyword(s):  
Teacher Learning ◽  
Positive Impact ◽  
Positive Influence ◽  
Group Discussions ◽  
Teacher Organizations ◽  
Total Data ◽  
Improvement Programs ◽  
The Government ◽  
Quality Improvement Programs

This study aims to determine the effect of MGMP teacher organization empowerment on the quality of teacher learning, and its impact on improving students' ability to solve problems. The writing is part of a study on the empowerment of MGMP conducted in five cities in Indonesia in mid-2019. The sample of this study was teachers with each MGMP taken 25 of those classified as seniors (more than 10 years) as teachers (125 people in total). Data collection was carried out through questionnaires, focus group discussions (FGD) and interviews. The results showed that the empowerment of MGMP was influenced by the training variables of increasing competency and parents' participation. The empowerment of MGMP itself has a positive influence on the quality of teacher learning, so that it has a positive impact on improving students' ability to solve problems. On that basis the government must encourage the empowerment of teacher organizations on an ongoing basis, not temporary. In addition, the government needs to review the regulations prohibiting schools from raising funds from parents, because it is indeed necessary to encourage the implementation of quality improvement programs in schools, including assisting teachers in participating in MGMP activities and forming professional communities.

scholarly journals Neobladder creation is still a conduit to peritoneal dialysis – Successful use of peritoneal dialysis after invasive bladder cancer

2021 ◽  
pp. 089686082110658
Author(s):  
Alexandre Cosmatos ◽  
Brendan McCormick ◽  
Pierre Antoine Brown
Keyword(s):  
Peritoneal Dialysis ◽  
Abdominal Surgery ◽  
Positive Impact ◽  
Cost Effective ◽  
Catheter Placement ◽  
Major Abdominal Surgery ◽  
Advanced Laparoscopy ◽  
History Of ◽  
Muscle Invasive ◽  
New Research

Peritoneal dialysis (PD) is as safe and more cost-effective than haemodialysis (HD). It also allows patients to undergo renal replacement therapy (RRT) from home. However, PD remains underutilised in many parts of the world. This is true in part because of many perceived relative contraindications to PD, including a history of prior major abdominal surgery. Prior major abdominal surgery is a concern for standard bedside or surgical catheter placement since these patients are at risk of having adhesions, which can complicate catheter placement. However, with laparoscopic advancements, prior major abdominal surgery is no longer even a relative contraindication to PD for skilled and experienced surgeons. We report the case of a male in his 70s with a history of cystoprostatectomy which was curative for a muscle invasive bladder carcinoma 5 years prior to his RRT. The patient had longstanding chronic kidney disease which worsened gradually. After receiving RRT education, the patient favoured PD. The catheter was placed despite the surgeon noting abdominal adhesions and the patient successfully underwent 12 months of PD which had a positive impact on his quality of life. He transferred to HD after contracting a complex PD-associated peritonitis. Thus, new research should be conducted to better understand the real impact of prior abdominal surgeries as a contraindication to PD, especially in centres where the surgeons have experience with advanced laparoscopy.

Hepatology

2012 ◽  
Author(s):  
John J. Poterucha
Keyword(s):  
Liver Disease ◽  
Cost Effective ◽  
Biliary Cirrhosis ◽  
Test Results ◽  
Liver Test ◽  
Effective Manner ◽  
Chief Complaints ◽  
History Of ◽  
Abnormal Liver Test ◽  
Cholestatic Diseases

The evaluation of patients who have abnormal liver test results includes many clinical factors: the chief complaints of the patient, patient age, risk factors for liver disease, personal or family history of liver disease, medications, and physical examination findings. Because of these many factors, designing a standard algorithm for the evaluation of abnormal liver test results is difficult and often inefficient. Nevertheless, with basic information, abnormalities can be evaluated in an efficient, cost-effective manner. Diseases that predominantly affect the biliary system are called cholestatic diseases. They can affect the microscopic ducts (eg, primary biliary cirrhosis) or the large bile ducts (eg, pancreatic cancer causing obstruction of the common bile duct), or both (eg, primary sclerosing cholangitis).

Limited Adverse Occurrence Screening: A Program with Significant Benefits for the Medical Record Department

1992 ◽  
Vol 22 (3) ◽  
pp. 98-101 ◽  
Author(s):  
Catherine Dooling ◽  
Alan Wolff
Keyword(s):  
Patient Care ◽  
Medical Record ◽  
Screening Program ◽  
Cost Effective ◽  
Effective Control ◽  
Screening Process ◽  
Daily Work ◽  
Medical Quality ◽  
Effective Manner ◽  
Care Problems

Quality is a major issue in industry. However, the performance of hospitals is predominantly measured by quantity. There is little accurate measurement of, and control over, the quality of patient care provided. Traditional medical quality assurance methods do not meet the basic criteria of an effective control system as defined in management theory. Occurrence screening is a method of medical quality control that overcomes many of these deficiencies. It detects adverse patient occurrences by screening medical records using outcome criteria and selective medical record review. The implementation of an occurrence screening program using a small number of criteria and retrospective review in the Medical Record Department of a 200 bed base hospital is described. Screening has been integrated into daily work practices in an efficient and cost effective manner. Medical record staff have become more aware of the importance of complete documentation and the profile of the department in the hospital has risen. Significant patient care problems have been detected by the screening process.

Spatial Evaluation of Roadway Infrastructure for Safety Improvement on Expressways

2015 ◽  
Vol 764-765 ◽  
pp. 1366-1369
Author(s):  
Shin Hyoung Park ◽  
Ki Tae Jang ◽  
Dong Kyu Kim ◽  
Seung Mo Kang
Keyword(s):  
Traffic Accidents ◽  
Spatial Relationship ◽  
Cost Effective ◽  
Scientific Basis ◽  
Crash Frequency ◽  
Crash Data ◽  
Safety Improvement ◽  
Effective Manner ◽  
Improvement Programs

Identifying hazardous locations on highways is an essential step for safety improvement programs and projects since it provides decision makers with a logical and scientific basis for the allocation of resources in a cost-effective manner. There have been numerous studies conducted to develop suitable methodologies for identifying hazardous locations; however, most of them have not considered spatial interactions which are inherent in traffic accidents. In this paper, we use the GIS-based geographically weighted regression (GWR) that can model crash outcomes and identify hazardous locations on expressways while reflecting the effect of spatial dependency and heterogeneity on the outbreak of traffic accidents. This method has been applied to a case study at Gyeongbu Expressway in Korea with 3-year crash data. Koenker's studentized Bruesch-Pagan and Moran’s I tests confirm the spatial relationship among crash data. The findings indicate that it is proper to model crash frequency with GWR for identifying hazardous locations.

Hepatic Disorders

2016 ◽  
pp. 251-270
Author(s):  
William Sanchez ◽  
John J. Poterucha
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Family History ◽  
Physical Examination ◽  
Cost Effective ◽  
Test Results ◽  
Liver Test ◽  
Effective Manner ◽  
History Of ◽  
Abnormal Liver Test

The evaluation of patients who have abnormal liver test results includes many clinical factors: the patient’s symptoms, age, risk factors for liver disease, personal or family history of liver disease, medications, and physical examination findings. A standard algorithm can aid in evaluating abnormal liver test results in an efficient, cost-effective manner.

Detection of Pre-Analytical Laboratory Testing Errors

2016 ◽  
pp. 1223-1244
Author(s):  
Wafa Al-Zahrani ◽  
Mohamud Sheikh
Keyword(s):  
Clinical Laboratory ◽  
Care Service ◽  
Health Care Service ◽  
The Public ◽  
Laboratory Errors ◽  
Critical Issues ◽  
Improvement Programs ◽  
The Individual ◽  
Quality Improvement Programs ◽  
Analytical Errors

A Few years later, after the publication of ‘To Err is Human: building a Safer Health System', patient safety became the major concern of the medical services and for the public. The clinical laboratory is not completely empty of errors, and these errors may affect the patient's health and the health care service. Evidence from studies indicate that a large percentage of laboratory errors occur in the pre-analytical and post-analytical phases. Based on reliable data, laboratories that established ongoing quality monitoring system have low percentage of errors. Most of laboratory errors are attributed to ineffective systems and less attributed to the individual malpractice, thus the laboratory quality improvement programs should focus more on the system in a holistic manner. This chapter aims to explore the critical issues that underpin laboratory errors and in particular the pre-analytical errors and provides some recommendations of ways to overcome such critical domains.

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