Med capstone Chapter 28 Quality Control 1. Quality control is defined as the process by which one monitors analytical procedures in order to ensure the accuracy and precision of test results and thus the validity of patient results prior to their reporting. 2. Internal quality control involves establishing the mean and standard deviation for the QC material, verifying the accuracy and precision of the control material, and establishing acceptable statistical limits for each analytical method using that control.
In contrary to that, external QC involves the comparison of a lab’s assay results from unknown test samples with the mean of those obtained on the same samples by other labs. 3. a. Accuracy: measure of how closely a test result agrees with the true value for that sample. b. Precision: measure of how closely repeated measurements of a sample agree with each other. c. Reliability: measure of both the accuracy and precision of a method. d. Mean: Average of all data points e. Median: middle data point of all data points f.
Mode: most frequent number g. Range: the difference between high and low values in a data set h. Variance: mathematical representation of dispersion of data points i. Standard deviation: mathematical representation of dispersion of data points around the mean or peak in a data set j. Confidence intervals: refers to the limits between which a specified proportion of the data points in a data set will fall. k. Coefficient of variation: the standard deviation divided by the mean and multiplied by 100 to obtain a percentage. l.
Trend: a small but steady and continuous change of the control values in one direction m. Shift: A change of the mean for the control material. n. Central tendency: represents a large group of data points that are equal to or very nearly the same as one data point and are represented by a peak on a frequency diagram. o. Normal distribution: Implies that there are approximately the same number and distribution of data points to either side of the peak. p. Skewed distribution: refers to the asymmetrical spread of data points around the peak. q.
Imprecision: measurement does not closely replicate, and the standard deviation will be larger r. Westgard rules: sets of criteria by which one can monitor test performance and accept or reject the run s. Random error: error occurring on a unique sample or without any defined pattern. t. Systematic error: error that is present in all samples and affects those samples approximately equally. Chapter 29 Quality Management 1. Quality is considered as a value. Quality is the process of doing the right things and making continuous improvements. 2. B.
Information, choice, participation, coordination of transitions, and knowing preferences. 3. The patient ultimately evaluates the quality of health care provided by the professional. 4. The components of the health care delivery process are: – a) Accessing is the process of acquiring the information, communicating, with a knowledgeable provider, getting an appointment, or entering a care site. b) Accessing and diagnosing include clinical laboratory, radiologic and other diagnostic processes. c) Planning includes strategic or quality plans and the patient plan of care. ) Treating includes drugs, procedures, counseling, teaching, and care in support of patient oxygenation, circulation, behavior, perception, mobility, nutrition, elimination, and immunity. e) Reentering is the process of an informed patient moving to another level of care, site of care, agency, or provider relationship. f) Evaluating is the process used to determine whether interventions were effective and helpful to the patient and family served. 5. C. Complexity includes mistake and defects, breakdowns and delays, insufficiencies, and variation but not cost controls. 6. ) By getting everyone to use the same procedures, materials, equipment, and so forth. ii) Similarly, by studying the process as it now operates, look for potential sources of variation, and gather data to see if these factors do affect the output. 7. Westgard delineates a quality management framework that involves quality laboratory process, quality control, quality assessment, quality improvement, quality planning, and quality goals. He also points that quality assurance is the outcome of this whole quality management process rather than being a component in the process.
Furthermore, Westgard suggests that these components work together like a feedback loop. 8. Langley and associates three questions that drive continuous quality improvements are: – a. What are we trying to accomplish? b. How will we know that a change is an improvement? c. What changes can we make that will result in improvement? 9. The five characteristics that the laboratory personnel need in order to contribute to quality are: – 1. Personal mastery of the clinical competencies required to practice clinical laboratory science 2. mental “big picture” of the health care delivery system and a close up view of the processes that make it happen. 3. A working definition of quality from the perspective of what matters to the patient. 4. Team skills that allow for team learning and contribution to improvement initiatives. 5. Tool and techniques for active participation in process improvements to eliminate errors and waste. Chapter 30 Problem Solving 1. 1. The steps in problem solving include all except E. Publish employee’s problem. 2. The step of problem solving process are: – ) Define problem: – The first order of business is to determine if a problem exists and what it is exactly. b) Create scenarios: – As an individual, brainstorm the potential approaches that might be considered with regard to the specified conclusion. Then discuss with others affected by the problem what they might consider the desired outcome to the problem. c) Solution implementation: – Choosing the most appropriate answer to the problem is hard. If at all possible, test the solution on an individual or small group before allowing full-scale implementation. ) Examine resolution: – Consider the following questions when examining the resolution. Why the resolution is effective? Are there any new conflicts that have developed since the resolution? What might be the most effective part of the solution? Is the fix permanent or temporary? Dose more work need to be done to completely resolve the problem? e) Reflection: – After a period of time, reconsider the original conflict. Look at the possible resolution scenarios developed. Chapter 31 Preanalytical, Analytical, and Postanalytical Phases 1. D. Preanalytical – formulation of clinical question and choices made regarding clinical testing 2.
E. Analytical – specimen preparation, analysis of specimen, and quality control 3. A. Post analytical – analysis of effect of testing data on patient outcomes 4. The example of a preanalytical phase are : – selection of the test for the specific purpose, finding out the efficiency and cost of the different type of tests and requirement of specimen. Specimen preparation, specimen analysis, and quality control are considered as analytical phase of preforming a test in the laboratory. Consultation of the lab report with the physician is an example of post analytical phase of the laboratory testing.