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Daria Pašalić
Editor-in-Chief
Department of Medical Chemistry, Biochemistry and Clinical Chemistry
Zagreb University School of Medicine
Šalata ul 2.
10 000 Zagreb, Croatia
Phone +385 (1) 4590 205; +385 (1) 4566 940
E-mail: dariapasalic [at] gmail [dot] com

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Mario Plebani. State of the art of laboratory quality indicators. Biochemia Medica 2015;25(Suppl 1):S8-S9.

Department of Laboratory Medicine, University Hospital of Padova, Padova, Italy

 

The definition, implementation and monitoring of valuable analytical quality specifications have played a fundamental role in improving the quality of laboratory services and reducing the rates of analytical errors. The dramatic reduction of analytical errors experienced in the last decades, in fact, can be explained not only by improvements in automation, method standardization and training of the laboratory staff but, also, by the adoption of valuable quality indicators and performance criteria.

However, a body of evidence has been accumulated on the relevance of the extra-analytical phases, namely the pre-analytical steps, their vulnerability and impact on the overall quality of the laboratory information. The state-of-the-art highlights the evidence that pre-analytical errors account for around 70% of laboratory mistakes. In the post-analytical phase, errors due to delay in acknowledging laboratory information, as well as in the interpretation and utilization of laboratory results have been described in primary care, internal medicine and emergency departments. Therefore, there is the need of a patient-centred approach to measuring and improving the quality of all steps of the total testing process (TTP) to ultimately assure patient safety and optimal clinical outcomes. The identification and establishment of valuable quality indicators (QIs) represents a promising strategy for collecting data on quality in the TTP and, particularly, for detecting any mistakes made in the individual steps of the pre-analytical phase, thus providing useful information for quality improvement projects. The consensus achieved on the developed list of harmonized QIs developed by the Laboratory Errors and Patient Safety Working Group (LEPS-WG) of the International federation of Clinical Chemistry and Laboratory Medicine (IFCC) represented a premise for the further step: the identification of achievable and realistic performance targets based on the knowledge of the state-of-the-art. Data collected by several clinical laboratories worldwide should allow the classification of performances for available QIs into three levels: optimum, desirable and minimum, in agreement with the widely accepted proposal for analytical quality specifications. Further steps in the project are the enrolment and active participation of a huge number of clinical laboratories at an international level to provide more data on the usefulness and practicability of current QIs and related quality specifications and the possible revision/update of the QIs list on the basis of data collected.

 

e-mail: mario [dot] plebani [at] unipd [dot] it