Test Information Quality Assessment/Improvement

Chemistry Lab

Deaconess HospitalDeaconess Hospital

QA Indicator: Many errors in the referral tests sent

out Inconsistencies noticed when

bringing in new tests that previously were sent out, example Microalbumin

Physician complaints, example Free Testosterone

Reference Ranges changed by Reference Lab without notification, example ACTH

QA Indicator: Changing Reference Ranges

Reference Ranges Lined Up as Ref Labs consolidated so that they had one reference range

Resulted in inability to report sendouts as received as many ref ranges did not line up with Deaconess Ref Ranges previously set up

QA Indicator: Delays in reporting

Delay in reporting due to changes needed in Lab Computer before a result could be reported

Change in Reference Labs became confused with human error.– Example: Screening Porphyrin Test

DATA: Survey & verification of test

information Issues:

– Lab computer is cumbersome to update reference ranges in; cannot be done “on the fly” like newer LIS.

– Clinicians expect age/sex ranges interpretive reporting, example estradiol

Learned: New demands of managed care increased the pre-analytical load, causing increased error rate.

DATA: Key Issues

Technical Responsibility of Test Information established

Information Responsibility is still loosely defined or undefined in practice.

Accomplishments:

Test Information Database Set Up All test information has been checked,

verified and expanded to include where appropriate interpretive reporting for Chemistry Tests

Policy has been developed to update laboratory test information

Initiating Steps to develop policy about Information Responsibility