Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
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
Posted by Sten Westgard, MS
An interesting abstract was published at the Paris IFCC meeting. It detailed the EQA performance of a set of 12 public laboratories in Catalonia. Can you guess what the failure rate for these labs for biochemistry EQA?
- 14.5%
- 14%
- 3%
- none of the above
The answer, after the jump...
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Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Last month, Advance for the Laboratory published a three part series on Six Sigma in the Clinical Laboratory, written by David Plaut, Nathalie Lepage, and Kim Przekop:
While it's great that Advance has invested in in-depth coverage of the Six Sigma topic, unfortunately one of their examples in part 2 demonstrates a misunderstanding of the application.
See the mistake, after the jump...
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Posted by Sten Westgard, MS
A recent question came in from a technical support consultant for a major diagnostic manufacturer:
"It is for Free T4 analyte. Customer [has] establihed a QC range after 20 QC runs. Mean and SD were derived from 20 runs and %CV achieved from 20 runs is 1.2%. Allowable interassay precision criteria according to CLIA is 6%.
"Now when customer [applies] Mean and SD according to the established range many...times they face QC rules violations of 41s and 10x.
"So can you please suggest, when the SD is too narrow is it necessary to apply these two rules to immunoassays?"
What's your guess? I'll take a stab at an answer, after the jump.
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Posted by Sten Westgard, MS
I came across a very valuable paper in Clinica Chimica Acta on the stability of hematology controls for MCV. (Some of you are already guessing what this is going to be about...)
If you take a hematology control, how many SDs should you expect to see it shift at week 5 of use versus the first week of use? In other words, what is the SDI you should expect?
- 1 SDI
- 2 SDI
- 3 SDI
- 4 SDI
- 5 SDI
- higher than 5 SDI
The answer, after the jump...
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Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Diagnostic errors are one of the "new" hot topics in the healthcare field. A new study from British Medical Journal of Quality and Safety has a chilling estimate of just how common diagnostic errors are occurring in outpatient settings.
So what's your guess? How often in the US are diagnostic errors being made in outpatient settings?
- about 1 in 5 visits
- about 1 in 10 visits
- about 1 in 20 visits
- about 1 in 50 visits
- about 1 in 100 visits
The study's conclusion, after the jump...
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Posted by Sten Westgard, MS
Earlier this month (July) I came across a series of revealing posts on a listserv about the quality of glucose meters. For me, it raised the question, just what defect rate is acceptable at the point of care?
- 0.00034%
- 1%
- 5%
- 10%
- 40%
- 75%
- 100%
What level of defect rate do you believe is being seen at the point of care? the answer (after the jump) might astonish you...
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