Performance criteria and quality indicators for the pre-analytical phase

2015 ◽  
Vol 53 (6) ◽  
Author(s):  
Mario Plebani ◽  
Laura Sciacovelli ◽  
Ada Aita ◽  
Michela Pelloso ◽  
Maria Laura Chiozza
Keyword(s):  
Quality Indicators ◽  
Performance Criteria ◽  
Analytical Quality ◽  
Performance Targets ◽  
Laboratory Services ◽  
Quality Specifications ◽  
Analytical Phase ◽  
Total Testing Process ◽  
The Individual

AbstractThe definition, implementation and monitoring of valuable analytical quality specifications have played a fundamental role in improving the quality of laboratory services and reducing the rates of analytical errors. However, a body of evidence has been accumulated on the relevance of the extra-analytical phases, namely the pre-analytical steps, their vulnerability and impact on the overall quality of the laboratory information. The identification and establishment of valueable quality indicators (QIs) represents a promising strategy for collecting data on quality in the total testing process (TTP) and, particularly, for detecting any mistakes made in the individual steps of the pre-analytical phase, thus providing useful information for quality improvement projects. The consensus achieved on the developed list of harmonized QIs is a premise for the further step: the identification of achievable and realistic performance targets based on the knowledge of the state-of-the-art. Data collected by several clinical laboratories worldwide allow the classification of performances for available QIs into three levels: optimum, desirable and minimum, in agreement with the widely accepted proposal for analytical quality specifications.

A pilot study for establishing quality indicators in molecular diagnostics according to the IFCC WG-LEPS initiative: preliminary findings in China

2019 ◽  
Vol 57 (6) ◽  
pp. 822-831 ◽  
Author(s):  
Rui Zhou ◽  
Yali Wei ◽  
Laura Sciacovelli ◽  
Mario Plebani ◽  
Qingtao Wang
Keyword(s):  
Patient Safety ◽  
Quality Indicators ◽  
Molecular Diagnostics ◽  
Clinical Chemistry ◽  
Priority Level ◽  
Laboratory Errors ◽  
Promising Tool ◽  
Laboratory Services ◽  
Total Testing Process

Abstract Background Quality indicators (QIs) are crucial tools in measuring the quality of laboratory services. Based on the general QIs of the Working Group “Laboratory Errors and Patient Safety (WG-LEPS)” of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC), specific QIs have been established in order to monitor and improve the quality of molecular diagnostics, and to assess the detection level of associated disease. Methods A survey was conducted on 46 independent commercial laboratories in China, investigated using questionnaires and on-site inspections. Specific QIs established were mainly based on the specific laboratory work-flow for molecular diagnoses. The specific QI results from three volunteer laboratories were collected and used to validate their effectiveness. Results Of the 46 laboratories participating in the study, 44 (95.7%), conducted molecular diagnostics. Of 13 specific established QIs, six were priority level 1, and seven, priority level 3. At pre-evaluation of data from the three volunteering laboratories, it was found that the newly classified specific QIs had outstanding advantages in error identification and risk reduction. Conclusions Novel specific QIs, a promising tool for monitoring and improving upon the total testing process in molecular diagnostics, can effectively contribute to ensuring patient safety.

scholarly journals Utilization of factor analysis in waterworks engineering

2004 ◽  
Vol 52 (2) ◽  
pp. 121-128
Author(s):  
Petra Nováková
Keyword(s):  
Water Quality ◽  
Factor Analysis ◽  
Quality Indicators ◽  
Water Reservoir ◽  
Statistical Processing ◽  
Point Of View ◽  
Water Quality Indicators ◽  
Quality Of Water ◽  
The Individual

The aim of the work was to elaborate and evaluate the water quality of water reservoir Vranov nad Dyjí. Fresh water was sampled in five different locations of the reservoir (three important tributaries, dam and water captation locality). Ten, the most essential water quality indicators were selected. From the point of view of water quality indicators complexity the most integrated samples were taken in the water captation locality (period 1984 – 2002). At other locations, there were missing dates from the eightieth, but their volume was sufficient for statistical processing.Correlation analyses for the individual locations and dimensions were done as so as determination coefficients for all localities during the time period of 1994 – 2002. The results demonstrate very good allocation of the water captation from the point of view of the water flow.Multiples and factor analysis was done for the period of 1984 – 2002 in the locality Jelení zátoka where the object of water captation is situated. The results of the analysis are nine factors, which influence the water quality of the reservoir. From the point of view of the importance three factors were interpreted.The analyses and results are part of my Ph.D. thesis. The results will be used for other evaluations of the water quality in the reservoir and tributaries, for activities in the catchment’s area and for proposal processing other zones of second level of protected areas.

scholarly journals Quality Indicators of the Pre-Analytical Phase

2012 ◽  
Vol 31 (3) ◽  
pp. 174-183 ◽  
Author(s):  
Nada Majkić-Singh ◽  
Zorica Šumarac
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Quality Indicators ◽  
Task Force ◽  
Improve Patient Safety ◽  
Laboratory Data ◽  
Sample Collection ◽  
Laboratory Errors ◽  
Analytical Phase ◽  
Total Testing Process

Quality Indicators of the Pre-Analytical PhaseQuality indicatorsare tools that allow the quantification of quality in each of the segments of health care in comparison with selected criteria. They can be defined as an objective measure used to assess the critical health care segments such as, for instance, patient safety, effectiveness, impartiality, timeliness, efficiency, etc. In laboratory medicine it is possible to develop quality indicators or the measure of feasibility for any stage of the total testing process. The total process or cycle of investigation has traditionally been separated into three phases, the pre-analytical, analytical and post-analytical phase. Some authors also include a »pre-pre« and a »post-post« analytical phase, in a manner that allows to separate them from the activities of sample collection and transportation (pre-analytical phase) and reporting (post-analytical phase). In the year 2008 the IFCC formed within its Education and Management Division (EMD) a task force calledLaboratory Errors and Patient Safety (WG-LEPS)with the aim of promoting the investigation of errors in laboratory data, collecting data and developing a strategy to improve patient safety. This task force came up with the Model of Quality Indicators (MQI) for the total testing process (TTP) including the pre-, intra- and post-analytical phases of work. The pre-analytical phase includes a set of procedures that are difficult to define because they take place at different locations and at different times. Errors that occur at this stage often become obvious later in the analytical and post-analytical phases. For these reasons the identification of quality indicators is necessary in order to avoid potential errors in all the steps of the pre-analytical phase.

scholarly journals Pre-Analytical Workstations as a Tool for Reducing Laboratory Errors

2010 ◽  
Vol 29 (4) ◽  
pp. 315-324 ◽  
Author(s):  
Giorgio Rin
Keyword(s):  
Quality Improvement ◽  
Clinical Laboratory ◽  
Error Reduction ◽  
Laboratory Errors ◽  
Continuous Quality ◽  
Complex Process ◽  
Preanalytical Phase ◽  
Analytical Phase ◽  
Total Testing Process

Pre-Analytical Workstations as a Tool for Reducing Laboratory ErrorsReducing errors and improving quality are an integral part of Laboratory Medicine. Laboratory testing, a highly complex process commonly called the total testing process (TTP), is usually subdivided into three traditional (pre-, intra-, and post-) analytical phases. A series of papers published from 1989 drew the attention of laboratory professionals to the pre-analytical phase, which currently appears to be more vulnerable to errors than the other phases. Consequently, the preanalytical phase should be the main target for further quality improvement. Therefore, identifying the critical steps in the pre-analytical phase is a prerequisite for continuous quality improvement, further error reduction and thus for improving patient safety. Use of automated systems where feasible, and use of error reduction/improved quality as a factor when selecting instrumentation are the main tools we have to insure high quality and minimize errors in the pre-analytical phase. The reasons for automation of the pre-analytical phase have become so compelling that it is no longer simply a competitive advantage for laboratories, but rather a competitive necessity. These systems can impact on the clinical/laboratory interface and affect the efficiency, effectiveness and quality of care.

National Assessment of Melanoma Care Using Formally Developed Quality Indicators

2009 ◽  
Vol 27 (32) ◽  
pp. 5445-5451 ◽  
Author(s):  
Karl Y. Bilimoria ◽  
Mehul V. Raval ◽  
David J. Bentrem ◽  
Jeffrey D. Wayne ◽  
Charles M. Balch ◽  
...  
Keyword(s):  
United States ◽  
Los Angeles ◽  
Quality Indicators ◽  
The United States ◽  
National Cancer Data Base ◽  
Hospital Level ◽  
Cancer Data ◽  
Cancer Registry Data ◽  
The Individual

Purpose There is considerable variation in the quality of cancer care delivered in the United States. Assessing care by using quality indicators could help decrease this variability. The objectives of this study were to formally develop valid quality indicators for melanoma and to assess hospital-level adherence with these measures in the United States. Methods Quality indicators were identified from available literature, consensus guidelines, and melanoma experts. Thirteen experts ranked potential measures for validity on the basis of the RAND/University of California, Los Angeles Appropriateness Methodology. Adherence with individual valid indicators and a composite measure of all indicators were assessed at 1,249 Commission on Cancer hospitals by using the National Cancer Data Base (NCDB; 2004 through 2005). Results Of 55 proposed quality indicators, 26 measures (47%) were rated as valid. These indicators assessed structure (n = 1), process (n = 24), and outcome (n = 1). Of the 26 measures, 10 are readily assessable by using cancer registry data. Adherence with valid indicators ranged from 11.8% to 96.5% at the patient level and 3.7% to 83.0% at the hospital level. (Adherence required that ≥ 90% of patients at a hospital receive concordant care.) Most hospitals were adherent with 50% or fewer of the individual indicators (median composite score, five; interquartile range, four to seven). Adherence was higher for diagnosis and staging measures and was lower for treatment indicators. Conclusion There is considerable variation in the quality of melanoma care in the United States. By using these formally developed quality indicators, hospitals can assess their adherence with current melanoma care guidelines through feedback mechanisms from the NCDB and can better direct quality improvement efforts.

National surveys on 15 quality indicators for the total testing process in clinical laboratories of China from 2015 to 2017

2018 ◽  
Vol 57 (2) ◽  
pp. 195-203 ◽  
Author(s):  
Min Duan ◽  
Xudong Ma ◽  
Jing Fan ◽  
Yanhong Guo ◽  
Wei Wang ◽  
...  
Keyword(s):  
Quality Indicators ◽  
Clinical Chemistry ◽  
Turnaround Time ◽  
Laboratory Medicine ◽  
General Information ◽  
Critical Values ◽  
Medical Quality ◽  
Clinical Laboratories ◽  
Analytical Phase ◽  
Total Testing Process

Abstract Background As effective quality management tools, quality indicators (QIs) are widely used in laboratory medicine. This study aimed to analyze the results of QIs, identify errors and provide quality specifications (QSs) based on the state-of-the-art. Methods Clinical laboratories all over China participated in the QIs survey organized by the National Health Commission of People’ Republic of China from 2015 to 2017. Most of these QIs were selected from a common model of QIs (MQI) established by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC). All participants were asked to submit general information and original QIs data through a medical quality control data collection system. The results of QIs were reported in percentages and sigma, except turnaround time (TAT) which was measured in minutes. The 25th, 50th and 75th percentiles were, respectively, calculated as three levels of QSs, which were defined starting from the model proposed during the 1st Strategic Conference of the EFLM on “Defining analytical performance 15 years after the Stockholm Conference on Quality Specification in Laboratory Medicine”. Results A total of 76 clinical laboratories from 25 provinces in China continuously participated in this survey and submitted complete data for all QIs from 2015 to 2017. In general, the performance of all reported QIs have improved or at least kept stable over time. Defect percentages of blood culture contamination were the largest in the pre-analytical phase. Intra-laboratory TAT was always larger than pre-examination TAT. Percentage of tests covered by inter-laboratory comparison was relatively low than others in the intra-analytical phase. The performances of critical values notification and timely critical values notification were the best with 6.0σ. The median sigma level of incorrect laboratory reports varied from 5.5σ to 5.7σ. Conclusions QSs of QIs provide useful guidance for laboratories to improve testing quality. Laboratories should take continuous quality improvement measures in all phases of total testing process to ensure safe and effective tests.

The Implementation of Clinical Laboratory Quality Indicators in the Era of the COVID-19 Pandemic

2022 ◽  
pp. 215-229
Author(s):  
Antonia Mourtzikou ◽  
Marilena Stamouli ◽  
Georgia Kalliora ◽  
Ioanna Petraki ◽  
Christina Seitopoulou ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Quality Indicators ◽  
Six Sigma ◽  
Laboratory Testing ◽  
Laboratory Tests ◽  
Clinical Laboratory ◽  
Iso 15189 ◽  
Pareto Method ◽  
Analytical Phase

The use of quality indicators (QIs) and risk assessment are valuable tools for maintaining the quality of laboratory tests. Both are requirements of ISO 15189: 2012 and are usually based on standard statistical and empirical data. In this chapter, the authors focus on evaluating clinical laboratory quality indicators in the era of the COVID-19 pandemic. The goal is to pose and discuss, based on the authors' experience, the quality evaluation and risk assessment through the collection, study, and analysis of quality indicators covering the pre-analytical, analytical, and post-analytical phases of the laboratory testing process. QIs were evaluated using the Six Sigma method. Moreover, FMEA risk analysis was performed, and the degree of risk priority was assessed using the Pareto method. The results show that in the analytical phase, the laboratory's performance is satisfactory, while the pre-and post-analytical phases need further preventive/corrective actions.

Present-Day Requirements for Quality of University Human Resources

2016 ◽  
Vol 5 (4) ◽  
pp. 19-22
Author(s):  
Масалова ◽  
Yuliya Masalova
Keyword(s):  
Human Resources ◽  
Development Strategy ◽  
Performance Indicators ◽  
Performance Criteria ◽  
Key Characteristics ◽  
The Development Strategy ◽  
Individual Achievement ◽  
The Individual ◽  
The University

The article analyzes the conditions under which modern universities function. The main performance criteria of the university are considered. The article describes the requirements for the quality of human resources of the university at present time. the key characteristics quality are analyzed: competence, competitiveness, engagement. It has been established that the competence of the teacher should be consistent with the development strategy of the university. Over the competitiveness influences the individual achievement. Engagement has a direct impact on the effectiveness of the work of the university. The approaches to the formation of a system of performance indicators lecturer are defined. It was determined that the requirements depend on state policy in the field of higher education and the strategy of the university. It was found that a mechanism of quality management of human resources at the university is necessary.

Corrigendum to: Performance criteria and quality indicators for the pre-analytical phase

2015 ◽  
Vol 53 (10) ◽  
Author(s):  
Mario Plebani ◽  
Laura Sciacovelli ◽  
Ada Aita ◽  
Michela Pelloso ◽  
Maria Laura Chiozza
Keyword(s):  
Quality Indicators ◽  
Performance Criteria ◽  
Analytical Phase

Setting performance benchmarks for stroke care delivery: Which quality indicators should be prioritized in quality improvement; an analysis in 500,331 stroke admissions

2020 ◽  
pp. 174749302095860
Author(s):  
Xi Li ◽  
Chao Wang ◽  
Shazia Rehman ◽  
Xinyu Wang ◽  
Wei Zhang ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Quality Indicators ◽  
Stroke Care ◽  
Adherence Rate ◽  
Thrombosis Prophylaxis ◽  
Performance Targets ◽  
Performance Benchmarks

Background and aim Benchmarking is a management approach for implementing best medical practices at the lowest cost. The objectives of this study were to set achievable performance benchmarks for individual quality indicators to determine the predicted quality achievement related to better adherence, and to select optimal quality indicators for improving the quality of acute ischemic stroke care. Methods We analyzed data on 500,331 patients diagnosed with acute ischemic stroke who were treated at 518 hospitals in China from January 2011 to May 2017. The primary outcome was independence (modified Rankin Scale score ≤2) at discharge. Data-driven achievable benchmarking used the “pared-mean” approach to set objective performance targets. Hierarchical logistic regression models were employed to evaluate the process–outcome association, as well as the predicted quality improvement if all hospitals were to operate at the benchmark level. Results Of the overall population, 64.01% were independent patients at discharge. The performance benchmarks were >90% for most of the quality indicators. After adjusting for patient-level and hospital-level characteristics and unifying hospital performance to the benchmark level, the quality indicators with high increase in both overall adherence rate and independence rate were thrombolytic therapy, anticoagulant therapy, venous thrombosis prophylaxis. Conclusions Performance targets for three acute treatments, including thrombolytic therapy, anticoagulant therapy, venous thrombosis prophylaxis, could best motivate improvements in both overall adherence rate and independence rate at discharge. The finding suggests that the above three types of acute treatment should be given priority to improve the quality of acute ischemic stroke care.

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