Posted by Sten Westgard, MS
With sincere thanks to Carolyn Maurer, the Director of the CAP 15189 program.
As the new IQCP regulations kick in, it's been interesting to see the international reaction to them.
I admit that I thought the IQCP impact would be contained within the US, that contagion would not spread to the international community. After all, IQCP is only a required option for labs within the US, and then only required for labs that seek to find a replacement to their now-outdated EQC policies. For labs that don't want to reduce their QC frequency below once a day, there's no need to create an IQCP at all.
But the situation appears to be more complicated. CAP, which has a significant international presence, is rolling out IQCP to all of its members, not just its US customers.
In light of that, I asked CAP how it balances the IQCP reduced QC frequency with the ISO 15189 standards. Their answers, after the jump...
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Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
I had the pleasure of taking part (albeit remotely) in the Quality at the Crossroads conference in Alexandria, Egypt.
As part of my session, we took questions from the audience, and I thought I would share a few of them with you, as well as a few of the "wrinkles" that labs in Egypt experience that we in the US do not. So here are the questions:
- How frequently should I measure Total Error and Measurement Uncertainty?
- Can I resort to comparing my EQA result to allowable bias when EQA result is violated and declared incorrect due to tight SD of comparator group?
- When using a new manufacturer’s QC, we should establish our own mean and CV, but it would result in tight CV and shift after 20 days. What are the recommendations for this? Is it better to wait more days to establish CV?
Some answers, after the jump...
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Posted by Sten Westgard, MS
The IATA (International Air Transport Association), whose 260 member airlines comprise 83% of global air travel, released their statistics on 2015 airline safety.
Can you guess how safe it is to travel? What was the global jet accident rate?
- 0.32 per million flights
- 0.22 per million flights
- 0.12 per million flights
- 0 per million flights
The answer, after the jump...
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Posted by Sten Westgard, MS
Now that the age of the IQCP is here, laboratories are grappling with the time and effort it takes to build their Individualized Quality Control Plans. How long should it take to build an appropriate IQCP?
- 40+ hours
- 21-40 hours
- 11-20 hours
- 5-10 hours
- Less than 5 hours?
How much time has it taken for you? How much time do you think it should take?
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Posted by Sten Westgard, MS
A recent op-ed in the New York Times by Dr. Robert Wachter as well as an interview with Don Berwick in HealthLeaders Media broached a taboo topic: is healthcare measuring too much?
'[T]he measurement fad has spun out of control. There are so many different hospital ratings that more than 1,600 medical centers can now lay claim to being included on a “top 100,” “honor roll,” grade “A” or “best” hospitals list. Burnout rates for doctors top 50 percent, far higher than other professions. A 2013 study found that the electronic health record was a dominant culprit. Another 2013 study found that emergency room doctors clicked a mouse 4,000 times during a 10-hour shift. The computer systems have become the dark force behind quality measures.'
How Measurement Fails Doctors and Teachers, New York Times, January 16, 2016
As the global debate over establishing the best error models and performance specifications rages, laboratories are probably asking themselves the same questions that the doctors are asking: how many metrics are too much?
A possible answer, or at least some more questions, after the jump...
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Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
An interesting question came from one of our readers, about how to interpret certain outliers.
So let's take one example, just two control values, expressed in z-scores. If the low control is -3.1 and the high control is + 2.3, which rule is violated? the 1:3s rule? The R:4s rule? Both?
An answer, after the jump...
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Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
An important new study was published in the International Journal of Laboratory Hematology, on the QC practices of coagulation laboratories.
But here's a question for you: of all these activities, how many of them occur greater than 90% of the time - and which one doesn't?
- Repeat the QC, and if it passes, report results
- Open [and run] new QC
- Look for trending
- Discontinue testing until controls are within limits
- Repeat all patient samples from the last acceptable QC
To find out which one of the activities occurs at a frequency not like the others, follow the jump...
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Posted by Sten Westgard, MS