We want to thank the hundreds of people who came to visit the Westgard QC booth at the AACC/ASCLS convention in Chicago last week (July 25-27).

This convention is always a rewarding experience for us. It helps us put faces to the people who visit, read, and embrace the website. For our visitors, it's a chance to look at our books in hardcopy (instead of reading free excerpts online), watch a live demonstration of the software, or just ask questions.

You would be amazed at the questions we get, some very simple and others quite complex. One visitor asked about rule interpretations of the 10:x rule for certain specific situations in their laboratory. Another person asked, "Is Dr. Westgard still alive?" - that's a question we get every year, actually. And we're always happy to dispel the rumors.

What encourages us is the fact that the energy and interest in quality is never lacking. In other fields, people turn their backs on quality, from the highest CEO to the lowest entry worker. But in the laboratory industry, people know they have to get their job done right the first time.

If you weren't at the conference, but have wanted to contact us about quality, now is the time. Email us at "westgard at westgard.com", call us at 608-833-0640, or just add a comment.

We want to hear from you.

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Originally July 14, 2006.

The GAO developed thirteen recommendations based on their investigation of CMS, CAP, JCAHO, COLA and the other state agencies. The recommendations are aimed at CMS and what it should do and how it should change. Here's a quick list in plain English:

1. Standardize survey findings
2. Ensure consistent advance notice by state survey agencies
3. Ensure identifying deficiences comes before education
4. Impose sanctions on labs with consecutive failures
5. Require all survey organizations to require whistle-blower posters
6. Require quarterly proficiency testing
7. Ensure timely evaluation of survey organizations
8. Ensure that new survey rules are reviewed in a timely manner
9. Hire more staff
10. Perform more validation inspections of state survey organizations
11. Require more independent validation of survey organizations
12. Collect and review more survey data
13. Establish an enforcement database

Some of these recommendations are common sense. Some of them are bizarre. Most of them will do nothing to address the real problem with the quality of laboratory testing.

To read in detail - and see the recommendations in the original bureaucratese - read the essay we've posted.
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Remember the Maryland General laboratory scandal of two years ago? Part of the outcome of the media circus and the Congressional Hearings on Maryland General was a request by Congress for an investigation of CMS by the GAO (Government Accountability Office). The GAO was asked to examine (1) the quality of lab testing; (2) the effectiveness of surveys, complaint investigations, and enforcement actions in detecting and addressing lab problems; and (3) the adequacy of CMS's CLIA oversight.

Well, that report is finally out - and it's not kind to CMS.

The titles say it all:

• Testimony to Congress: CMS and Survey Organization Oversight Is Not Sufficient to Ensure Lab Quality
• Full Report: CMS and Survey Organization Oversight Should Be Strengthened

Westgard Web will provide some detailed analysis of the reports (both what is in the reports and what got left out) in the coming days, but the first thing we want to do is encourage you to read the reports directly. Go straight to the source and see what they found, and see if their conclusions match your own. In July, we'll tell you what we think of the reports - and you can judge us as well.

Let me pull a few highlights just from the one page summary:

Originally posted June 20, 2008

You've probably noticed that new JCAHO National Patient Safety Goals are out. Some new goals have been added this year. These goals are some of the most prominent new measures, metrics, and indcators that are being introduced to healthcare. At the Westgard Workshops, Teresa Darcy, MD, MMM, gave a presentation on this recent proliferation of Quality Indicators.

Do you know how many Indicators are out there? Here's just a short list of what Dr. Darcy discussed:

Originally posted June 14, 2006.

originally posted June 13, 2006

Originally posted on June 12, 2006
First of all, we want to thank all of our participants who came from all directions to learn and share. The most rewarding part of this continuing series is that some of our speakers this year were the participants only a few years ago. Clearly, we have seen people absorb the material, put it into action, and go even further with it. Lookingat the "class of 2006", it's going to be very interesting to see who emerges as the new leaders and teachers.

I’ve been intrigued by some of the reasoning that is guiding laboratory priorities and directions, particularly the emphasis on pre-analytic and post-analytic processes along with a disregard for the quality of analytic processes. You can see this emphasis in the IQLM recommendations for laboratory quality indicators.

Originally posted April 21st, 2006

To:
    Those who will influence the future quality of laboratory testing
CLSI Area Committee on Evaluation Protocols
CLSI Subcommittee on Establishment of Manufacturer’s QC Recommendations
CLSI Subcommitee on Laboratory Quality Control Procedures

I want to call your attention to an article on “The Quality of Laboratory Testing Today” that was published in the American Journal of Clinical Pathology in March 2006 (v125:pp343-354). This article was prepared for the “QC for the Future” workshop, which was held in March 2005 in Baltimore. Because you attended this conference and/or are involved in the ongoing project work to develop QC for the Future, I hope you will have some interest in the results of this study.

Hello World.