ACROSS THE AMERICAN HEALTHCARE SYSTEM, numerous trends tug at pathologists and the laboratory medicine services they provide. Both clinical pathologists and anatomic pathologists find themselves confronted with a growing number of demands for change. Increasingly these demands can no longer be ignored or deferred, but require a response.
This issue of THE DARK REPORT provides examples of this quandary. At the Centers for Disease Control and Prevention (CDC), first steps were taken to organize a laboratory Quality Institute (QI). (See pages 2-7.) In keeping with the need to improve patient safety and reduce medical errors, the goal is to identify relevant measures of quality in laboratory testing services, then survey the nation’s labs about these quality parameters. The QI will then issue a national report and launch a monitoring system to track the performance of laboratories in reducing errors and improving quality. If everything goes according to schedule, within 24 months, clinical laboratories may be reporting these quality monitors on a regular basis.
Next is the power blackout that impacted 50 million people in the Eastern United States and Canada last week. Laboratories in affected areas lost power and their emergency response procedures were tested without advance notice. (See page 8.) In just two years, terrorist threats, emerging diseases like SARS, and last week’s reminder about the possibility of power outages have required lab directors and pathologists to devote considerable time and resources to crisis planning and training.
The turbo-charged environment of change at Kaiser Permanente Northwest’s (KP-NW) laboratory division in Portland, Oregon is another example of a trend starting to change lab operations. (See pages 9-14.) After deploying the ISO-9000 quality system in its lab, KP-NW has harvested considerable gains in productivity, quality, and employee morale. This is a real-world validation of how quality management systems can improve lab operations. It will inspire other lab leaders to embrace these management tools.
Finally, following a decade of declining reimbursement, pathology group practices find it tougher to meet demands for compensation, equity, and retirement benefits with existing group business models based on a 1980s fee-for-service healthcare world. (See pages 16-17.) Experts will convene in Atlanta on October 24-25 to present new approaches and business models that help pathology groups enrich their existing cash flows to provide better financial rewards to pathologists in the group.