Gauging The Impact Of Lab Patient Safety

Plans to collect and report on patient safety in the nation's labs will trigger big changes

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CEO SUMMARY: Within 18 months, the Laboratory Quality Institute plans to issue a national report on the quality of laboratory services. Not only will this bring a new level of public attention and scrutiny to clinical laboratory operations, but it will require everyone involved in delivery, use, or payment for laboratory services to respond. Labs will need to take tangible steps to reduce errors and improve quality.

WHEN THE FIRST-EVER National Report on the Quality of Laboratory Services is formally released by the Quality Institute, it will have significant impact on the safety and quality of laboratory testing services.

That’s because the National Report will be accompanied by implementation of a national system of laboratory quality monitors. At the Executive War College in New Orleans last May, the 2003 Quality Institute Conference Co- Chair Ana K. Stankovic, M.D., Ph.D. made the first public statements about the shape and direction of this initiative.

Industry-Wide Monitors

“Succinctly, one outcome for our effort is that the Laboratory Quality Institute is to develop and monitor indicators that will be continuously reported in the National Report,” said Stankovic. “The objective is to pro- mote changes in the laboratory community that directly improve patient safety and healthcare outcomes.”

The Quality Institute intends to stimulate fundamental changes in the way the nation’s laboratory services are incorporated into the patient safety movement.

Release of the first National Report on the quality of laboratory services will be a landmark event for the laboratory industry, for several reasons. First, it will be the first influential national authority to issue findings about the quality of laboratory testing services across the United States, based on a measurement process that will be transparent to the public.

Second, it begins the process of: 1)collecting specific data about the performance of laboratory testing services to help identify best practices; then, 2)compiling these data into a national number; and, 3) regularly reporting the results to the public. Among other goals, these reports are aimed at educating the public about the important role that laboratory services have within the healthcare system, as well as helping the public understand that their laboratory tests are safe and of high quality.

Third, these national laboratory quality monitors will directly motivate laboratory directors and pathologists to change the operational structure of their laboratory organization. The need to demonstrate acceptable levels of patient safety—and to improve that performance over time—will require laboratory managers and those using laboratory services to rethink work processes and effect changes in their laboratory so it performs to the level of best practices.

Almost two years ago, THE DARK REPORT was first in the lab industry to predict that the Institute of Medicine’s (IOM) report on deaths in hospitals from medical errors would trigger intense pressure for reform by payers, employers, and government health officials.

From the Leapfrog Group to the Joint Commission on Accreditation of Healthcare Organization’s (JCAHO) persistent drive to initiate outcomes-based patient safety goals, THE DARK REPORT has given laboratory administrators and pathologists early warning about the shape and direction of the patient safety movement. The Laboratory Quality Institute is another development of significance in this ongoing trend.

Affects Every Laboratory

The quality monitors developed for the clinical laboratory profession by the Quality Institute will require a strategic response from every laboratory organization in the United States. These monitors accelerate the timeline for measurement—and public accountability—for the performance of laboratory testing services. Since many errors in the delivery of laboratory services occur outside of the laboratory, this will require a renewed effort to communicate and collaborate with users of laboratory testing services and those that provide reimbursement for such services.

THE DARK REPORT already sees evidence that the patient safety movement is accelerating the adoption of quality management principles in laboratories. That’s because these quality systems, such as ISO-9000, Lean, and Six Sigma, were developed specifically to continuously reduce the rate of errors in work processes while improving quality and lowering costs. Those outcomes were certainly one result of the ISO-9000 certification by the Kaiser Permanente Northwest Laboratory in Portland, Oregon, reported on pages 9-14.

JCAHO Releases 2004 Patient Safety Initiatives

BEGINNING JANUARY 1, 2004, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) will emphasize seven primary patient safety initiatives.

Just released last week, the seven initiatives include areas, such as nosocomial infections and accurate patient identification, that will directly involve hospital-based laboratories. Here are JCAHO’s seven patient safety initiatives for 2004:

GOAL 1: Improve the accuracy of patient identification.
GOAL 2: Improve the effectiveness of communication among caregivers.
GOAL 3: Improve the safety of using high-alert medications.
GOAL 4: Eliminate wrong-site, wrong-patient and wrong-procedure surgery.
GOAL 5: Improve the safety
of using infusion pumps.
GOAL 6: Improve the effectiveness of clinical alarm systems.
GOAL 7: Reduce the risk of health care-acquired infections.

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