A focus on continuous quality improvement in health care is essential in the advocacy for patient safety.  In 2001, the Institute of Medicine identified the following six aims for improving health care quality:  safe, effective, patient-centered, timely, efficient, and equitable.1  Quality improvement initiatives can be utilized as a means of achieving those aims, individually or collectively, with the goal of reducing laboratory errors and safeguarding patient safety. 

The United States Department of Health and Human Services (DHHS) defines quality improvement as “systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups.”  According to the DHHS, a quality improvement program can yield multiple benefits, including improved patient outcomes, greater efficiency, creation of a proactive workplace culture, and enhanced communication.2 Quality program models including Lean and Six Sigma can be utilized to examine existing procedures and develop new processes.2

Several organizations offer quality improvement guidelines and resources for the clinical laboratory.  The Clinical Laboratory Standards Institute (CLSI) promotes the use and development of both quantitative and qualitative quality indicators.3 The CLSI and the Institute for Healthcare Improvement each provide models for the use of a quality management system, including the development, implementation, data analysis and review of quality improvement initiatives.3, 4

The American Society for Clinical Laboratory Sciences (ASCLS) advocates for quality patient care by focusing on education and product development to address patient safety issues.  The ASCLS Patient Safety Committee has developed several resources that can be utilized for quality improvement programs, including examples of patient safety indicators in the pre-analytic, analytic, and post-analytic phases, as well as guidelines for effectively developing and implementing a quality improvement initiative.  The following steps can be utilized in the development of a quality improvement program:  identify areas of risk, collect data, calculate error rate, data capture, data analysis, intervention, follow-up.5

Quality is influenced not only by process design and knowledge gained via quality monitors and data analysis, but also through work environment and safe work practices.  Success is achieved when motivated and educated staff are engaged in the process.  Quality management programs address personnel oversight and management.  While education, certification, and licensure verify competence it is also important to infuse encouragement and motivation in developing the laboratory’s most valuable asset for quality, the personnel staff.6,7

Patient safety is of utmost importance in improving healthcare outcomes.  The selection and implementation of a quality improvement program can greatly influence patient safety.  A continuous focus on quality within and among healthcare teams can reduce medical errors and associated patient risks. 

References

  1. Institute of Medicine.  (2001) Crossing the Quality Chasm:  A New Health System for the 21st Century.  Washington, D.C.:  National Academy Press.
  • Clinical Laboratory Standards Institute. (2019).  Developing and Using Quality Indicators for Laboratory Improvement.  2nd ed.  CLSI Guideline QMS12.  Wayne, PA. 
  • Quality Laboratory Practice and Its Role in Patient Safety: The American Society for Clinical Pathology Policy Statement (Policy Number 06-01) – Medscape – Nov 02, 2006. https://www.medscape.com/viewarticle/546192

About The Author

Pamela Meadows, Ed.D., MT(ASCP) is a member of the American Society for Clinical Laboratory Science (ASCLS) Patient Safety Committee and President of the West Virginia Society for Clinical Laboratory Science. She is currently an Associate Professor in the Clinical Laboratory Sciences Department at Marshall University in Huntington, West Virginia. Prior to teaching, she spent five years as a general laboratory supervisor and Point of Care testing coordinator. _________________________________________________________________________________________________________________________________________________________________ Anne Gaffney, MS, MLS(ASCP)CM is a member of the American Society for Clinical Laboratory Science (ASCLS) Patient Safety Committee. She is currently employed by Quest Diagnostics as a Hospital Technical Specialist in Point of Care Testing/Safety/UA/Blood Gas and works with the HCA HealthOne Hospitals in Denver, Colorado.