![]() It is finally highlighted that the most appropriate reference interval for the population (e.g., according to age, sex, ethnicity) should be provided, otherwise laboratory data would be of limited value for the clinicians.Īssay interferences have long been underestimated and unfortunately too often overlooked in the daily laboratory practice. The quality control process in the clinical laboratory is also necessary for preventing errors, although the accurate selection of the material is mandatory for commutability. An increase in the knowledge of calibration process is also necessary to reduce the costs for extra testing or mishandled therapies. Accurate statistical analysis and appropriate approaches for comparing results of different methods are necessary for a better interpretation of data. For examples, an extensive database dealing with drug interferences, effects of herbs and has been developed, and will be helpful to prevent misleading interpretation of lab results. As such, Oswald Sonntag discusses valuable options on how to further improve the analytical phase. ![]() Due to both an increasing consciousness of this important problem and a pervasive policy of education, the laboratory error rate has undergone a further reduction during the past 10 years (e.g., from 0.47% in 1997 to 0.33% in 2007) (4,5), a trend particularly accentuated for analytical errors, so that the analytical variability is now frequently less than 1/20 th of what it was 40 years ago (6,7).Īlthough the analytical process has a minor impact on the total number of errors in laboratory medicine as compared with the pre- and post-analytical phases, these mistakes should be minimized as much as possible. Of these errors, three-fourth generate ‘‘normal’’ results, one-sixth produce “absurd” results (which would be thereby identified before translating into a real harm for the patient), but approximately one-sixth might be so significant to have an adverse impact on patient care (3). Since these extreme limits do not probably mirror closely the reality, a more probable error rate is that ranging from 0.3 to 0.6%. In the filed of laboratory medicine, the error rate ranges widely, from 0.1 to 3.0% of laboratory results. At the practice level of pathology, the error rate is comprised between 13 and 14% (2). In radiology, the level of error varies depending on the type of the investigation, but the range is 2–20% for clinically significant or major errors (1). This does not mean, however, that the various branches of diagnostics are completely free from errors. While several areas of healthcare are still struggling with the issue of patient safety, diagnostics has been forerunner in pursuing this issue, so that the concept and practice of Total Quality Management (TQM) has now become commonplace throughout radiology, pathology and laboratory medicine. In other words, according to the current definition of the US Institute of Medicine (IOM) healthcare quality is the degree to which health services increase the likelihood of desired health outcomes and are consistent with current professional knowledge. Accordingly, healthcare quality can be seen as receiving the most appropriate care, whilst minimizing the risk of side effects and adverse events not directly related to the presence of the original disease (e.g., medication errors, wrong site surgery or retained instrument after an operation, wrong drug or wrong route of administration of drugs, adverse drugs reactions, hospital acquired infections, etc). Getting quality healthcare is like taking a car to the mechanic the people in the garage can be pleasant and take note of complaints, but the most important thing is whether they can be able to fix the problems and, hopefully, to return the car timely and with no additional malfunctioning. ![]() Department of Health & Human Services brings a helpful example to define healthcare quality. The Agency for Healthcare Research and Quality (AHRQ) of the U.S. While all these things are important, the “clinical” quality of healthcare is indeed much more pervasive. Someone thinks that getting quality healthcare means seeing the doctor right away, being treated courteously by the doctor’s staff, or having the doctor spend a lot of time with him/her. ![]() Quality is generally defined as “a high degree or grade of excellence”, but the translation of this concept in healthcare is somehow challenging, since we all know that “quality” means rather different things to different people. The very issue we have to face is natural to the real meaning of “healthcare quality”.
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