External Quality Assessment: an effective tool for Clinical Governance in Laboratory Medicine
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Laura Sciacovelli
Abstract
The implementation of Clinical Governance will require a redefinition of duties and accountability as a prerequisite to develop and achieve an overall improvement in clinical care through a culture of assessment and monitoring of quality. External Quality Assessment Schemes (EQAS) are the main tool enabling laboratories to measure the quality of their results; they must carefully assess and monitor all elements contributing to the formulation of laboratory information (results, reference ranges/decisional levels, interpretative comments and diagnostic algorithms). There are different ways to design and manage a Scheme and EQAS coordinators are mainly responsible for its effectiveness. The present paper reports, as an example, some experiences of the Centre of Biomedical Research (CRB), which manages EQAS according to high quality specifications and laboratories' needs, that can reflect the Clinical Governance philosophy. Our findings show that EQAS are able to control all the above aspects and, if organisers are committed to fulfilling the responsibility and accountability principles, they will be of great value in quality assessment and in developing an External Quality Assurance Program (EQAP). This is an inter-laboratory comparison designed and conducted to assure the following: evaluation of participants' performance (by evaluating not only analytical performance, but also test interpretation, and advice for clinicians on laboratory requests and diagnosis); evaluation of method performance; and continuous education, training and help. The main aim of the activities of an EQAP in Laboratory Medicine is to sustain improvements in the quality of services provided by participating laboratories for the benefit of patients.
References
1. Donaldson LJ. Clinical Governance: a statutory duty for quality improvement. J Epidemiol Community Health 1998; 52:73–4.10.1136/jech.52.2.73Suche in Google Scholar
2. Kettelhut MM, Chiodini PL, Edwards H, Moody A. External quality assessment schemes raise standards: evidence from UKNEQAS parasitology subschemes. J Clin Pathol 2003; 56:927–32.10.1136/jcp.56.12.927Suche in Google Scholar
3. Halligan A, Donaldson L. Implementing clinical governance: turning vision into reality. Br Med J 2001; 322:1413–7.10.1136/bmj.322.7299.1413Suche in Google Scholar
4. Sciacovelli L, Secchiero S, Zardo L, Plebani M. External Quality Assessment Schemes: need for recognised requirements. Clin Chim Acta 2001; 309:183–99.10.1016/S0009-8981(01)00521-6Suche in Google Scholar
5. Zaninotto M, Sciacovelli L, Pagani F, Panteghini M, Plebani M. External Quality Assessment for biochemical markers of myocardial damage: an Italian experience. Clin Chem Lab Med 2004; 42:1434–41.10.1515/CCLM.2004.266Suche in Google Scholar
6. NCCLS. Evaluation of matrix effects – Approved Guideline EP14-A. Wayne, PA: NCCLS, 2004.Suche in Google Scholar
7. Passing H, Bablok W. A new biometrical procedure for testing the equality of measurements from two different analytical methods. J Clin Chem Clin Biochem 1983; 21:709–20.Suche in Google Scholar
8. Sciacovelli L, Zardo L, Secchiero S, Zaninotto M, Plebani M. Interpretative comments and reference ranges in EQA Programs as a tool for improving laboratory appropriateness and effectiveness. Clin Chim Acta 2003; 333:209–19.10.1016/S0009-8981(03)00188-8Suche in Google Scholar
9. Lim EM, Sikaris KA, Gill J, Calleja J, Hickman PE, Beilby J, et al. Quality assessment of interpretative commenting in clinical chemistry. Clin Chem 2004; 50:632–7.10.1373/clinchem.2003.024877Suche in Google Scholar PubMed
10. Standard of medical care in diabetes. Diabetes Care 2004:27(Suppl 1);S15–35.10.2337/diacare.27.2007.S15Suche in Google Scholar
©2006 by Walter de Gruyter Berlin New York
Artikel in diesem Heft
- Foreword
- Evidence-based policy-making
- Clinical Governance – from rhetoric to reality?
- Realising the developmental potential of Clinical Governance
- Re-energising Clinical Governance through Integrated Governance
- Clinical Governance: from clinical risk management to continuous quality improvement
- Involvement of patients in Clinical Governance
- Teaching and Continuing Professional Development: an Italian experience
- New National Healthcare Information System
- Clinical Governance and Laboratory Medicine: is the Electronic Medical Record our best friend or sworn enemy?
- Technology to improve quality and accountability
- Clinical Governance and evidence-based laboratory medicine
- ISO 15189:2003 – Quality management, evaluation and continual improvement
- External Quality Assessment: an effective tool for Clinical Governance in Laboratory Medicine
- Errors in clinical laboratories or errors in laboratory medicine?
- Laboratory request appropriateness in emergency: impact on hospital organization
- Point-of-care-testing and Clinical Governance
- Integration between the Tele-Cardiology Unit and the central laboratory: methodological and clinical evaluation of point-of-care testing cardiac marker in the ambulance
Artikel in diesem Heft
- Foreword
- Evidence-based policy-making
- Clinical Governance – from rhetoric to reality?
- Realising the developmental potential of Clinical Governance
- Re-energising Clinical Governance through Integrated Governance
- Clinical Governance: from clinical risk management to continuous quality improvement
- Involvement of patients in Clinical Governance
- Teaching and Continuing Professional Development: an Italian experience
- New National Healthcare Information System
- Clinical Governance and Laboratory Medicine: is the Electronic Medical Record our best friend or sworn enemy?
- Technology to improve quality and accountability
- Clinical Governance and evidence-based laboratory medicine
- ISO 15189:2003 – Quality management, evaluation and continual improvement
- External Quality Assessment: an effective tool for Clinical Governance in Laboratory Medicine
- Errors in clinical laboratories or errors in laboratory medicine?
- Laboratory request appropriateness in emergency: impact on hospital organization
- Point-of-care-testing and Clinical Governance
- Integration between the Tele-Cardiology Unit and the central laboratory: methodological and clinical evaluation of point-of-care testing cardiac marker in the ambulance
