scholarly journals Education and training programmes of the IFCC in clinical chemistry and laboratory medicine: Improving the quality of professional practice in laboratory medicine

2005 ◽  
Vol 24 (3) ◽  
pp. 181-186 ◽  
Author(s):  
Gerard Sanders

When quality is referred to in clinical chemistry and laboratory medicine, the focus is mainly on the analytical process. But good professional quality starts with a sound education. In an attempt to describe the practice of clinical chemistry and laboratory medicine in the 15 member states of the "old" European Union, it was noticed that (sometimes) large differences existed in the way professionals are being trained (see: Sanders et al, Clin Chem Lab Med 2002; 40: 196-204). With that outcome, a survey of the Websites of the different Member Societies and Corporate Members of IFCC was conducted. It showed that less than one third of either two groups paid attention to, or offered, education. This led to a series of questions to a non-representative group of colleagues outside the former EU who were willing to give more insight in the educational system of their country. All colleagues were known to be involved actively in clinical chemistry and laboratory medicine. The outcome did not give a uniform pattern, since every country regulates health care in its own way, according to its own historical development, needs, social vision, etc. From that a number of conclusions have been drawn: a. Proper University Training is required to enter vocational training b. Regulated Vocational Training seems to be necessary (4 years) c. A clear Syllabus as an indicative guide to the vocational training is important d. Management training should be included since a clinical chemist will have organizational responsibilities as well e. Examinations may help in improving the quality of the education f. Official Register, recognized by Law, is essential, but not always existing h. Re-Registration can be seen as part of the Quality Cycle. Finally, some attention is being paid to the activities of the EMD. This Division of the IFCC provides the membership of IFCC and the health-care community with education which it considers relevant to Clinical Chemistry and Laboratory Medicine. It is the intention of EMD to improve the quality of the profession by educational activities in molecular biology, evidence based laboratory medicine, quality assurance, distance education, and laboratory management. Specific projects are a Master Course in Laboratory Science, a course in Flowcytometry, and the Visiting Lecturer Program which supports national societies in inviting lecturers on specific topics. More information can be found on the IFCC Web-site (www.ifcc.org). In the future, it is to be expected that emphasis on education in our profession will be on the clinical use of tests, modern media and e-learning, and specific courses in new technologies. EMD works continuously to improve the quality of clinical chemistry and laboratory medicine. The input from all National Societies is appreciated to discern topics most relevant to the membership of IFCC. .

Author(s):  
Blánaid Daly ◽  
Paul Batchelor ◽  
Elizabeth Treasure ◽  
Richard Watt

In the last 40 years, the needs of and demands for health care both in the UK and worldwide have increased dramatically. These increases are related to the population ageing, the development of new technologies and knowledge, rising patient expectations, and associated increases in professional expectations about the possibilities and potential of health care (Muir Gray 1997 ). In this period, the key policy concerns of the international health care community have been about containing costs and enabling equitable access to high quality health care, while also ensuring greater accountability, patient satisfaction, and improved public health (Lohr et al. 1998). Health care resources are finite and must be shared equitably on the basis of need, capacity to benefit, and effectiveness. The use of high quality research evidence and guidelines to inform individual patient care and population health care have become central to this process. In the mid-1970s, various writers began to question the effectiveness of medicine and the increasingly wider influence exerted by the medical profession on society. For example, McKeown (1976) mapped mortality rates for the main killer airborne diseases (tuberculosis, whooping cough, scarlet fever, diptheria, and smallpox) against contemporary advances in medicine from the mid-19th century to the early 1970s. He found that the declines in the incidence and prevalence of communicable diseases had occurred before their microbial cause had been identified and before an effective clinical intervention had been developed. McKeown concluded that the declines in mortality rates were not attributable to immunization and therapy and suggested the declines could more reasonably be attributed to better nutrition and improved housing conditions which had occurred over the period. Allied to McKeown’s historical analysis was the work of Archie Cochrane who evaluated contemporary clinical practice in the 1970s. In his seminal work Effectiveness and Efficiency , Cochrane (1972) showed that many medical treatments provided in the NHS were ineffective, inefficient, and founded on medical opinion rather than on a rigorous assessment of efficacy and effectiveness. Box 7.1 defines the terms efficacy, effective, and efficiency.


2019 ◽  
Vol 57 (7) ◽  
pp. 967-973 ◽  
Author(s):  
Federica Braga ◽  
Mauro Panteghini

Abstract Traceability to a common reference ensures equivalence of results obtained by different assays. Traceability is achieved by an unbroken sequence of calibrations, using reference materials (RMs) that must be commutable. Using non-commutable RMs for calibration will introduce a bias in the calibrated method producing incorrect results for clinical samples (CS). Commutability was defined in 1973 as “the ability of an enzyme material to show inter-assay activity changes comparable to those of the same enzyme in human serum” and later extended as a characteristic of all RMs. However, the concept is still poorly understood and appreciated. Commutability assessment has been covered in CLSI guidelines and requires: (a) selection of 20 CS spanning the relevant concentration range; (b) analysis of both RM and CS with the pair of procedures; (c) data elaboration using regression analysis and calculation if RM fall within the 95% prediction interval defined by CS. This approach has been criticized and to improve it The International Federation of Clinical Chemistry and Laboratory Medicine established a working group that recently finalized recommendations. Commutability is also a requirement for the applicability of external quality assessment (EQA) results in the evaluation of the performance of participating laboratories in terms of standardization of their measurements. Unfortunately, EQA materials are usually not validated for commutability.


Author(s):  
Graham Beastall ◽  
Desmond Kenny ◽  
Paivi Laitinen ◽  
Joop ten Kate

AbstractA definition has been agreed for the most senior professional (consultant) in clinical chemistry and laboratory medicine. A model job description for a consultant has been determined, which is intended to act as a toolkit to assist employing authorities and professional bodies to define the role of individual consultant posts. A total of 86 competences for a consultant have been designated and expressed in the form of simple generic proficiency standards. These competences have been allocated to six broad areas: clinical [13]; scientific [15]; technical [12]; communication [12]; management and leadership [20]; professional autonomy and accountability [14]. The competences are intended to be illustrative rather than definitive and to enable the duties of any consultant post to be defined. Assessment of competence is likely to entail consideration of qualifications, registration status, continuing professional development and performance review. The project is intended as a guide to European societies of clinical chemistry and laboratory medicine. The guide should be capable of local interpretation to encourage a greater degree of commonality in the role of the consultant whilst protecting national identity. The guide should stimulate international understanding and collaboration and contribute to an overall improvement in the quality of practice.


Author(s):  
Anna Carobene ◽  
Marta Strollo ◽  
Niels Jonker ◽  
Gerhard Barla ◽  
William A. Bartlett ◽  
...  

AbstractBackground:Biological variation (BV) data have many fundamental applications in laboratory medicine. At the 1st Strategic Conference of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) the reliability and limitations of current BV data were discussed. The EFLM Working Group on Biological Variation is working to increase the quality of BV data by developing a European project to establish a biobank of samples from healthy subjects to be used to produce high quality BV data.Methods:The project involved six European laboratories (Milan, Italy; Bergen, Norway; Madrid, Spain; Padua, Italy; Istanbul, Turkey; Assen, The Netherlands). Blood samples were collected from 97 volunteers (44 men, aged 20–60 years; 43 women, aged 20–50 years; 10 women, aged 55–69 years). Initial subject inclusion required that participants completed an enrolment questionnaire to verify their health status. The volunteers provided blood specimens once per week for 10 weeks. A short questionnaire was completed and some laboratory tests were performed at each sampling consisting of blood collected under controlled conditions to provide serum, KResults:Samples from six out of the 97 enroled subjects were discarded as a consequence of abnormal laboratory measurements. A biobank of 18,000 aliquots was established consisting of 120 aliquots of serum, 40 of EDTA-plasma, and 40 of citrated-plasma from each subject. The samples were stored at –80 °C.Conclusions:A biobank of well-characterised samples collected under controlled conditions has been established delivering a European resource to enable production of contemporary BV data.


2003 ◽  
Vol 17 (2) ◽  
pp. 125-148 ◽  
Author(s):  
Sherry Glied

Since 1999, health care costs have been growing faster than national income. This rapid growth has occurred as the ability of private and public purchasers to reduce service utilization and bargain for lower prices has fallen, insurers have recouped lost profits through higher premiums, and new technologies have driven up costs throughout the sector. Private insurance market responses to these rising costs may lead to reductions in the number of people with insurance and to increased fragmentation of the insurance market. Over time, technological change in medicine both increases costs and improves the quality of care. The challenge for public policy is to maintain insurance and some degree of equity in the face of these rising costs.


2000 ◽  
Vol 28 (2) ◽  
pp. 144-158 ◽  
Author(s):  
E. Haavi Morreim

In recent years a number of commentators have discussed the importance of measuring quality of life (QL) in health care. We want to know whether an intervention will help people to live better, not just longer, and whether some treatments cause more trouble than they are worth. New technologies promise wondrous benefits. But when millions of people have no insured access to health care, and when many others face increasingly stringent limits on care, technologies’ high costs require us to choose what we should do from the broader universe of what we can do.The challenges to measuring QL are formidable. Researchers debate whether to measure general QL or disease-specific QL; whether to focus on functional status such as the patient's ability to walk and dress himself, or on the value people ascribe to that functional status; whether to seek the values of the general public, or to concentrate on people actually affected by a given disease or disability.


2017 ◽  
Vol 72 (3) ◽  
pp. 191-197 ◽  
Author(s):  
Matthias Orth ◽  
Maria Averina ◽  
Stylianos Chatzipanagiotou ◽  
Gilbert Faure ◽  
Alexander Haushofer ◽  
...  

The role of clinical pathologists or laboratory-based physicians is being challenged on several fronts—exponential advances in technology, increasing patient autonomy exercised in the right to directly request tests and the use of non-medical specialists as substitutes. In response, clinical pathologists have focused their energies on the pre-analytical and postanalytical phases of Laboratory Medicine thus emphasising their essential role in individualised medical interpretation of complex laboratory results. Across the European Union, the role of medical doctors is enshrined in the Medical Act. This paper highlights the relevance of this act to patient welfare and the need to strengthen training programmes to prevent an erosion in the quality of Laboratory Medicine provided to patients and their physicians.


Author(s):  
Mauro Panteghini ◽  
Ferruccio Ceriotti ◽  
Graham Jones ◽  
Wytze Oosterhuis ◽  
Mario Plebani ◽  
...  

AbstractMeasurements in clinical laboratories produce results needed in the diagnosis and monitoring of patients. These results are always characterized by some uncertainty. What quality is needed and what measurement errors can be tolerated without jeopardizing patient safety should therefore be defined and specified for each analyte having clinical use. When these specifications are defined, the total examination process will be “fit for purpose” and the laboratory professionals should then set up rules to control the measuring systems to ensure they perform within specifications. The laboratory community has used different models to set performance specifications (PS). Recently, it was felt that there was a need to revisit different models and, at the same time, to emphasize the presuppositions for using the different models. Therefore, in 2014 the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) organized a Strategic Conference in Milan. It was felt that there was a need for more detailed discussions on, for instance, PS for EQAS, which measurands should use which models to set PS and how to set PS for the extra-analytical phases. There was also a need to critically evaluate the quality of data on biological variation studies and further discussing the use of the total error (TE) concept. Consequently, EFLM established five Task Finish Groups (TFGs) to address each of these topics. The TFGs are finishing their activity on 2017 and the content of this paper includes deliverables from these groups.


2007 ◽  
Vol 18 (7) ◽  
pp. 440-445 ◽  
Author(s):  
J D C Ross ◽  
A Copas ◽  
J Stephenson ◽  
L Fellows ◽  
G Gilleran

Information and communication technology (ICT) has the potential to improve the quality of care and efficiency in sexual health clinics, but its introduction requires input not only from health-care professionals and ICT specialists but also from service users and potential future users. In this study, views on ICT in relation to the delivery of sexual health services were assessed using a structured interview in two groups – a community sample of young people and a clinic sample of existing patients. In all, 542 community interviewees and 202 clinic patients participated. About 75% of respondents had access to the Internet and overall 60% reported that the self-collection of a sexual history on an electronic form was acceptable. Black Caribbean individuals had significantly less access to the Internet and a lower acceptance of electronic data collection. For booking an appointment, the majority of patients reported the telephone (community sample 93%, clinic sample 96%) or attending in person (community sample 77%, clinic sample 54%) to be acceptable, with a smaller proportion choosing email (community sample 10%, clinic sample 27%) or the Internet (community sample 7%, clinic sample 11%). Electronic booking was significantly less acceptable to Black Caribbean respondents. Although new technologies offer the opportunity to improve the quality of sexual health services, patient preferences and differences between groups in access to technology also need to be considered when services are reconfigured.


2004 ◽  
Vol 50 (12) ◽  
pp. 2415-2458 ◽  
Author(s):  
Robert Rej

Abstract The establishment of the modern discipline of clinical chemistry was concurrent with the foundation of the journal Clinical Chemistry and that of the American Association for Clinical Chemistry in the late 1940s and early 1950s. To mark the 50th volume of this Journal, I chronicle and highlight scientific milestones, and those within the discipline, as documented in the pages of Clinical Chemistry. Amazing progress has been made in the field of laboratory diagnostics over these five decades, in many cases paralleling—as well as being bolstered by—the rapid pace in the development of computer technologies. Specific areas of laboratory medicine particularly well represented in Clinical Chemistry include lipids, endocrinology, protein markers, quality of laboratory measurements, molecular diagnostics, and general advances in methodology and instrumentation.


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