December 2006

Dr. Westgard reached his fifth continent this year in a tour of South Africa. See what he has to say about this visit and the topic: "QC and Life in the Lab"

I just returned from South Africa and am having a hard time adjusting - from temperatures in the mid 80s in Cape Town to 20 degrees here in Wisconsin. It was my first trip to Africa and a wonderful experience. I’m including a few pictures that capture some of the “wonder” of Africa.

My wife, Joan, was along and we enjoyed a weekend in Cape Town following a week of seminars in Johannesburg, Pretoria, Durban, and Cape Town. I think there were 14 lectures in 8 venues in 5 days. Thankfully, the Bio-Rad people who organized the seminars also maintained good control of the whole process and everything worked according to the plan.

That careful planning itself was supportive of my message on quality planning, which was central to all my lectures. It was also of great help to have Greg Cooper’s presentations on biologic variability and QC, which brought a very practical focus to “QC and life in the lab”. Greg’s stories got better as the week rolled on, and I wish it were possible to recapture them for your enjoyment. I’ve offered to record them and provide a “pod-cast,” but need your requests to convince Greg to do this!

For those of you who have yet to experience a “pod-cast”, you will find a “first” on our website this December . Sten keeps trying to move me forward into the modern age, first with this website and continuing now with the technology of pod-casting. He conducted this interview via telephone the day we were leaving for South Africa. We’ll be exploring digital audio technology in the next year and you can let us know if you think it is helpful in delivering our messages on quality.

I promised to provide some reference materials that would be useful to follow-up to my lectures and provide more practical details. We have recently posted two discussions of statistical QC that are particularly relevant for “doing the right QC right.”

• For selecting the “right QC”.
• For guidance on implementing “QC right”.

For more background on Six Sigma Quality Management and it’s application for quality assessment and planning in the laboratory, some good starting points are the following materials:

• Six Sigma Quality Management and Desirable Laboratory Precision
• Six Sigma Quality Design and Control Processes
• Application of Sigma-metrics for the selection of QC procedures can be found in our CLIA section, particularly Appropriate QC Procedures
• Computer support for QC planning can be provided by a PC program called EZ Rules 3.
• Those who want hard-copy materials on Six Sigma may consider our book on Six Sigma Quality Design and Control, 2nd edition, which was published just a few months ago.

For background to my discussions of the “truth about quality today,” there are many supporting materials on this website:

• The methodology for applying sigma-metrics to assess the quality of laboratory testing from proficiency testing data
• Sigma-metric Applications including cholesterol, glucose, calcium, coagulation tests, PSA testing and Glycated hemoglobin
• Discussion of the US Government Office of Accountability (GAO) report on “Clinical Lab Quality”

There were several queries about the ISO requirement for estimating uncertainty. While I have some strong opinions about this, we have only provided some introductory discussion on this website. We expect to provide more information in the future when detailed guidelines become available from CLSI and the ISO 212 committee.

• “To be uncertain or in error: that is the question?”

My thanks to Bio-Rad for supporting this series of lectures, especially Barry Gray, Anne Slade, Dail Stubbs, Andrew Lyford, and Greg Cooper. I hope you found them helpful and will also find these web materials useful.

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James O. Westgard, PhD, is a professor of pathology and laboratory medicine at the University of Wisconsin Medical School, Madison. He also is president of Westgard QC, Inc., (Madison, Wis.) which provides tools, technology, and training for laboratory quality management.