CEO SUMMARY: It was like a debutante ball for the fledgling Institute for Quality in Laboratory Medicine (IQLM). Over three days, thought leaders in healthcare and laboratory testing tackled the issue of how laboratory medicine can improve patient safety and contribute to higher-quality health outcomes. Key themes emerged with the potential to impact all laboratories and pathology group practices.
WHEN IT FIRST BECAME KNOWN a couple years back that, with the support of the Centers for Disease Control and Prevention (CDC), there was an effort to create an institute to address patient safety and quality in laboratory medicine, THE DARK REPORT considered this to be a significant development.
That prediction was validated in Atlanta on April 29-30, 2005 at the 2005 IQLM Conference “Recognizing Excellence in Practice.” IQLM is the acronym for Institute for Quality in Laboratory Medicine. The April meeting was its “coming out” party.
One of the major goals of this conference was to introduce recommendations on specific ways to assess—from a national perspective—patient safety in labs and to develop indicators about the quality of laboratory practices. These recommendations are the product of almost two years of development effort by working teams within IQLM. (See TDR, July 23, 2003.)
This is not news for clients and regular readers of THE DARK REPORT. Besides coverage on these pages, we’ve hosted presentations by key IQLM leaders at the Executive War College in 2003, 2004, and 2005. THE DARK REPORT believes the creation of the IQLM, with the aid of the Centers for Disease Control and Prevention (CDC), to be a milestone event for the laboratory medicine community.
First, consider the source. The CDC, an initiator of the effort, carries clout within the American healthcare system. Its decision to put considerable resources into creating the Institute for Quality in Laboratory Medicine is a strong statement of how the government health establishment views the importance of laboratory medicine and its ability to contribute to better healthcare outcomes in a cost-effective manner.
Credible, Powerful Force
Second, by launching a public/private partnership organization “formed to engage the healthcare community in improving the use of laboratory tests and services,” the CDC is creating what it expects to be both a credible and powerful force. IQLM aims to drive change and improvement through three primary initiatives.
One initiative is to create an awards program that rewards laboratories which make demonstrable and exceptional gains in patient safety and quality of lab testing services. The second initiative is to issue a national “white paper” report which puts attention on the collective performance of laboratories in patient safety and quality from one year to the next.
The third initiative is the most ambitious. It is to develop national measures/indicators that reasonably gauge the performance of laboratories—and how well clinicians are using lab testing services to improve patient safety and healthcare outcomes.
That is why the IQLM’s 2005 conference is important to the laboratory industry and healthcare. Following two years of development efforts, IQLM’s three work teams formally placed their findings and recommendations before the healthcare community. Over the three-day conference, participants engaged some of the keenest minds in healthcare and laboratory medicine in discussions about one topic: how laboratory medicine should be utilized to make its maximum contribution to solving the host of recognized problems and deficiencies in the American healthcare system.
“Keen minds” is not an understatement. The IQLM awards work group is tasked with developing some type of national laboratory awards process to recognize advances in patient safety and laboratory quality by individual labs. For the 2005 IQLM conference, it chose to recognize ten living individuals for their lifetime achievements in advancing quality in laboratory medicine.
These included James O. Westgard, M.D., Ph.D, Dennis O’Leary, M.D., Kenneth W. Kizer, M.D., and Michael LaPosata, M.D., just to name a few. The complete list of these awardees and their accomplishments can be found at www.iqlm.org. Their presence made this a laboratory industry summit that has no precedent in many years.
Indicators Work Group
Because laboratory testing is integrated into so many aspects of healthcare, it is particularly challenging to identify specific indicators/measures that accurately describe the state of laboratory testing services. That was the task of the indicators work group. It released its first draft of recommendations during the second day of the 2005 IQLM conference.
It has identified 12 promising measures to accomplish that goal. These 12 items are a first attempt to capture the full spectrum of pre-pre-analytical to post-post-analytical elements that play a role in the effective ordering, performing, reporting, and application of lab testing. The indicators work group’s list of 12 measures and two explanatory slides is shown on the page opposite.
From the inception of the Institute for Quality in Laboratory Medicine, the guiding spirit has been Joe Boone, Ph.D., Associate Director for Science at the Office of Public Health Partnerships at the CDC. In his address to the conference, Boone laid out the next phase in IQLM’s development.
“It is important to identify ‘best practices’ and spread that knowledge across not just the laboratory industry, but across the clinical community as well.”
—Joe Boone, Ph.D.
“Working in tandem with the National Quality Forum (NQF), we will produce a series of conferences in 2005 and 2006,” he said. “The first conference will investigate what laboratory quality means to the 260 member organizations of NQF. Using information developed from that conference, a second conference will occur by the end of 2005 with the goal of determining measures that would be useful to access the quality of laboratory services.
“Building on that work, the first conference in 2006 will determine the utility of tests currently used in laboratories,” continued Boone. “This will be followed by a conference later in 2006 to develop appropriate programs that encourage better utilization of laboratory tests across the healthcare system.”
IQLM already has partner councils with over 65 partners that include healthcare organizations and healthcare vendors. “We intend to work with our partners to translate the results from these conferences into tangible programs,” he stated. “In particular, IQLM wants to develop research and mentoring programs. It is important to identify ‘best practices’ and spread that knowledge across, not just the laboratory industry, but throughout the clinical community as well.”
During the 2005 IQLM Conference, discussion and debate was sustained at an unusually high level. This was attributable to two factors. One was the breadth of excellence among the speakers. The other was a thoughtful and challenging audience of over 300 people. Included were laboratorians and participants from a broad cross-section of healthcare. Representatives from several foreign countries were in attendance.
THE DARK REPORT offers three key insights from this meeting. First, health- care policy makers from several prominent organizations were in agreement on one point: the laboratory profession is failing to get its message across at the highest level of debate. Lacking a strong voice at the policy-setting table means that laboratory medicine will struggle to make a more effective contribution in efforts to reform the healthcare system.
Second, information technology (IT) remains the major obstacle in reforming the American healthcare system. Laboratories and providers which bring forth innovations in IT will thereby be best-positioned to add value.
Third, recognition that the American healthcare system currently fails to deliver the high quality of care necessary to meet needs and expectations of all stakeholders has triggered a fundamental change in healthcare. An inexorable march is under way to collect accurate information and use this information to drive improvements in the quality and cost of healthcare services.
Ultimately, the most important news is that the Institute for Quality in Laboratory Medicine is now a player on the national scene. Lab managers and pathologists can expect to see its influence grow during the next 24 months.