Quality Indicators in Laboratory Medicine: From theory to practice: Preliminary data from the IFCC Working Group Project "laboratory Errors and Patient Safety"

Department of Laboratory Medicine and Center of Biomedical Research, University Hospital of Padova, Padova, Italy.
Clinical Chemistry and Laboratory Medicine (Impact Factor: 2.71). 02/2011; 49(5):835-44. DOI: 10.1515/CCLM.2011.128
Source: PubMed


The adoption of Quality Indicators (QIs) has prompted the development of tools to measure and evaluate the quality and effectiveness of laboratory testing, first in the hospital setting and subsequently in ambulatory and other care settings. While Laboratory Medicine has an important role in the delivery of high-quality care, no consensus exists as yet on the use of QIs focussing on all steps of the laboratory total testing process (TTP), and further research in this area is required.
In order to reduce errors in laboratory testing, the IFCC Working Group on "Laboratory Errors and Patient Safety" (WG-LEPS) developed a series of Quality Indicators, specifically designed for clinical laboratories. In the first phase of the project, specific QIs for key processes of the TTP were identified, including all the pre-, intra- and post-analytic steps. The overall aim of the project is to create a common reporting system for clinical laboratories based on standardized data collection, and to define state-of-the-art and Quality Specifications (QSs) for each QI independent of: a) the size of organization and type of activities; b) the complexity of processes undertaken; and c) different degree of knowledge and ability of the staff. The aim of the present paper is to report the results collected from participating laboratories from February 2008 to December 2009 and to identify preliminary QSs.
The results demonstrate that a Model of Quality Indicators managed as an External Quality Assurance Program can serve as a tool to monitor and control the pre-, intra- and post-analytical activities. It might also allow clinical laboratories to identify risks that lead to errors resulting in patient harm: identification and design of practices that eliminate medical errors; the sharing of information and education of clinical and laboratory teams on practices that reduce or prevent errors; the monitoring and evaluation of improvement activities.

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Available from: Laura Sciacovelli, Aug 14, 2014
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    • "It has been suggested that along with handling of critical results, correct identification should be given the highest priority in the extra-analytical phases [32]. An IFCC working group has suggested that optimum performance should be a patient identification error percentage of less than 0.4% [9]. Identification errors also include mismatching of the patient identity given on the sample tube and the request form as well as adding an incorrect requesting physician [10] [32]. "
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    • "Nevertheless these criteria represent excellent starting points for laboratories in setting benchmarks for extra-analytical quality monitoring and are a significant step forward in developing consensus standards [81]. The group plans to eliminate and modify some existing indicators and develop new ones over the next year [81]. The project's success depends on the participation and collaboration of laboratories enrolled in the project to help define best practice and improve performance and laboratories interested in participating are encouraged to contact the group through the website mentioned above. "
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