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A aplicação da técnica de referenciação (benchmarking) em serviços de medicina laboratorial; Benchmarking applicability in laboratory medicine services

Galoro, César Alex de Oliveira
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 15/09/2008 PT
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56.01%
A prática da Medicina Laboratorial vem mudando em conseqüência do desenvolvimento tecnológico e regulamentações dos Sistemas de Saúde levando à implantação de Sistemas de Qualidade e monitoramento de indicadores. A aplicabilidade e os potenciais benefícios do Benchmarking como instrumento de análise da qualidade foram testados em um grupo de oito laboratórios hospitalares através do recebimento, análise e devolução aos participantes de Relatórios de Acompanhamento relativos a indicadores diversos dos anos de 2005 e 2006. O método 6 foi utilizado, quando aplicável, para avaliar a qualidade dos processos. Foram colhidos dados de indicadores de produção, produtividade, absenteísmo segurança no trabalho, recoletas e tempo para liberação de laudos. O Benchmarking é uma ferramenta útil e aplicável para a gestão de qualidade nos laboratórios clínicos, principalmente quando associado a instrumento independente de avaliação de qualidade de processos, porém é necessária a definição de mecanismos que garantam a confiabilidade dos dados primários utilizados nos programas; Laboratory Medicine practice is changing as a result of technological development and regulations pressures, letting to the implementation of quality systems and monitoring indicators. This study tested Benchmarking applicability and benefits as a tool for quality analysis in brazilian laboratory medicine services. The study was performed with eight hospital laboratories through the receipt...

Impacto da implantação de um programa de acreditação laboratorial, avaliado por meio de indicadores de processo, num laboratório clínico de médio porte; Impact of the implementation of a laboratory accreditation program, evaluated by quality indicators, in a mid-level clinical laboratory

Vieira, Keila Furtado
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 03/12/2012 PT
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46.05%
O trabalho tem como objetivo avaliar a eficácia do processo de implantação de um programa de acreditação laboratorial através de indicadores. O uso dos indicadores vem sendo cada vez mais valorizado na gestão laboratorial por tratar-se de uma poderosa ferramenta para qualificar e quantificar falhas nos diferentes processos laboratoriais, bem como, auxiliar na implantação de medidas preventivas e corretivas, além de apontar a eficácia das ações tomadas. Nesse contexto, foi utilizado o modelo do Programa de Acreditação de Laboratórios Clínicos da Sociedade Brasileira de Patologia Clínica/Medicina Laboratorial (PALC SBPC/ML), o qual foi aplicado no Laboratório Unimed de Sorocaba. O ano de 2008 foi o ponto inicial para adequação do laboratório aos requisitos do PALC. Foram definidos 25 indicadores, sendo 14 focados aos aspectos gerenciais e 11 relacionados ao processo produtivo. Um grupo formado por 19 indicadores pôde ser comparado aos adotados pelo Programa de Indicadores Laboratoriais da SBPC/ML-ControlLab. A coleta de dados corresponde ao período entre 2006 e 2011. Para os indicadores avaliados pelo Programa de Indicadores Laboratoriais da SBPC/ML-ControlLab estabeleceu-se como meta a ser alcançada pelo Laboratório Unimed Sorocaba a mediana dos resultados obtidos pelos laboratórios participantes do programa. A análise estatística revelou que 10 indicadores apresentaram resultados satisfatórios e 4 Keila Furtado Vieira demonstraram piora. Outros 4 não apresentaram mudanças significativas e 7 não foram passíveis de análise estatística. Para os indicadores que se mostraram deficientes foram traçados planos de ação visando elevar a eficiência das respectivas atividades. A melhora dos indicadores refletiu as reestruturações de processo ocorridas para adequação à norma de acreditação escolhida; The aim of the present study was to evaluate the efficacy of implementation of a laboratory certification program by using laboratory quality indicators. The use of such indicators has been increasingly valued in laboratory management because it is a powerful tool to quantitatively and qualitatively measure mistakes in laboratory process...

A position paper of the EFLM Committee on Education and Training and Working Group on Distance Education Programmes/E-Learning: developing an e-learning platform for the education of stakeholders in laboratory medicine

Gruson, D.; Faure, G.; Gouget, B.; Haliassos, A.; Kisikuchin, D.; Reguengo, H.; Topic, E.; Blaton, V.
Fonte: De Gruyter Publicador: De Gruyter
Tipo: Artigo de Revista Científica
Publicado em /04/2013 ENG
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66.19%
The progress of information and communication technologies has strongly influenced changes in healthcare and laboratory medicine. E-learning, the learning or teaching through electronic means, contributes to the effective knowledge translation in medicine and healthcare, which is an essential element of a modern healthcare system and for the improvement of patient care. E-learning also represents a great vector for the transfer knowledge into laboratory practice, stimulate multidisciplinary interactions, enhance continuing professional development and promote laboratory medicine. The European Federation of Laboratory Medicine (EFLM) has initiated a distance learning program and the development of a collaborative network for e-learning. The EFLM dedicated working group encourages the organization of distance education programs and e-learning courses as well as critically evaluate information from courses, lectures and documents including electronic learning tools. The objectives of the present paper are to provide some specifications for distance learning and be compatible with laboratory medicine practices.

Cancer causing viruses and the role of laboratory medicine: literature review and perspectives

Passos,Ana Maria; Granato,Celso Francisco Hernandes
Fonte: Sociedade Brasileira de Patologia Clínica; Sociedade Brasileira de Patologia; Sociedade Brasileira de Citopatologia Publicador: Sociedade Brasileira de Patologia Clínica; Sociedade Brasileira de Patologia; Sociedade Brasileira de Citopatologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2013 EN
Relevância na Pesquisa
55.91%
Cancer-causing viruses are responsible for up to 20% of cancers with infectious etiology, representing a serious public health problem worldwide. Since the discovery of the first human cancer-causing virus, several others have been associated with neoplasias. Recent advances in technologies for the determination of genomic and proteomic profiles have resulted in the discovery and availability of tumor markers with potential application in the screening, diagnosis, prognosis and treatment of cancer. Therefore, laboratory medicine has stood out as a fundamental tool in the prevention and management of these diseases.

Laboratory medicine needs higher profile with medical students, MDs, pathologists say.

Harrison, P
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 15/09/1995 EN
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46.12%
Laboratory medicine is a troubled specialty these days, buffeted by the conflicting pressures of reduced funding for more work and a declining physician population. A consortium of laboratory physicians has produced a report on the future of pathology and laboratory medicine, which explores the problems facing the specialties and some potential solutions. Raising the profile of laboratory medicine among medical students and eventual unification of pathology and the various arms of laboratory medicine are among the suggested solutions.

Institute for Quality in Laboratory Medicine Series - Controversies in Laboratory Medicine: Nursing and the Laboratory: Relationship Issues That Affect Quality Care

Kurec, Anthony; Wyche, Karen L.
Fonte: Medscape Publicador: Medscape
Tipo: Artigo de Revista Científica
Publicado em 30/08/2006 EN
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46.01%

The Future of Laboratory Medicine: Understanding the New Pressures

Panteghini, Mauro
Fonte: The Australian Association of Clinical Biochemists Publicador: The Australian Association of Clinical Biochemists
Tipo: Artigo de Revista Científica
Publicado em /11/2004 EN
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46.08%
Since the future role of Laboratory Medicine is strongly and equally challenged by economic and new technological pressures, it is essential to take a broad view of the discipline and present to the administrators and other decision-makers the full spectrum of activities and benefits Laboratory Medicine can provide. In particular, the importance and the true impact of Laboratory Medicine can only be achieved by adding value to laboratory tests, represented by their effectiveness in influencing the management of patients and related clinical outcomes.

Requirements for Reference (Calibration) Laboratories in Laboratory Medicine

Siekmann, Lothar
Fonte: The Australian Association of Clinical Biochemists Publicador: The Australian Association of Clinical Biochemists
Tipo: Artigo de Revista Científica
Publicado em /11/2007 EN
Relevância na Pesquisa
46%
In addition to reference measurement procedures and reference materials, reference or calibration laboratories play an integral role in the implementation of measurement traceability in routine laboratories. They provide results of measurements using higher-order methods, e.g. isotope dilution mass spectrometry and may assign values to materials to be used for external quality assessment programs and to secondary reference materials. The requirements for listing of laboratories that provide reference measurement services include a statement of the metrological level or principle of measurement, accreditation as a calibration laboratory according to ISO 15195 and the participation in a proficiency testing system (regular inter-laboratory comparisons) for reference laboratories. Ring trials are currently conducted for thirty well-defined measurands and the results are made available to all laboratories. Through the use of reference laboratory services that are listed by the Joint Committee for Traceability in Laboratory Medicine there is the opportunity to further promote traceability and standardisation of laboratory measurements.

Meeting the Curriculum Needs for Different Career Paths in Laboratory Medicine

Smith, Brian R.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
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46.08%
There are a number of career paths in Laboratory Medicine and several clinical practice models for the discipline. This article summarizes the state of current training at the medical student and residency/post-graduate levels, emphasizing practice in the U.S., and the challenges of education in the discipline to meet the needs of diverse career paths. Data regarding effectiveness of current pedagogical Approaches are discussed along with a brief review of evolving didactic methodologies. The recently published curriculum in Laboratory Medicine (Clinical Pathology) by the Academy of Clinical Laboratory Physicians and Scientists is reviewed, including its major emphases and the importance of competency assessment. Finally, the future of Laboratory Medicine and Pathology and the need to train for that future is expanded upon.

Hematology and Plasma Chemistry Reference Intervals for Mature Laboratory Pine Voles (Microtus pinetorum) as Determined by Using the Nonparametric Rank Percentile Method

Harvey, Stephen B; Krimer, Paula M; Correa, Maria T; Hanes, Martha A
Fonte: American Association for Laboratory Animal Science Publicador: American Association for Laboratory Animal Science
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.01%
Plasma biochemical and hematologic values are important parameters for assessing animal health and experimental results. Although normal reference values for many rodent species have been published, there is a dearth of similar information for the genus Microtus. In addition, most studies use a mean and standard deviation to establish reference intervals, but doing so is not the recommendation of the Clinical and Laboratory Standards Institute (formerly the National Committee on Clinical Laboratory Standards) or the International Federation of Clinical Chemistry and Laboratory Medicine. The purpose of this study was to establish normal reference parameters for plasma biochemistry and hematology in mature pine voles (Microtus pinetorum) by using the nonparametric rank percentile method as recommended by the 2 laboratory medicine organizations mentioned. Samples of cardiac blood from a closed colony of pine voles were collected at euthanasia and evaluated under rodent settings on 2 automated hematology analyzers from 2 different manufacturers and on the same type of automated biochemistry analyzer. There were no sex-associated clinically significant differences between the sexes; younger animals had a lower hematocrit, higher mean corpuscular volume...

Evidence-Based Laboratory Medicine: Is It Working in Practice?

Price, Christopher P
Fonte: The Australian Association of Clinical Biochemists Publicador: The Australian Association of Clinical Biochemists
Tipo: Artigo de Revista Científica
Publicado em /02/2012 EN
Relevância na Pesquisa
46.05%
The principles of Evidence-Based Medicine have been established for about two decades, with the need for evidence-based clinical practice now being accepted in most health systems around the world. These principles can be employed in laboratory medicine. The key steps in evidence-based practice, namely (i) formulating the question; (ii) searching for evidence; (iii) appraising evidence; (iv) applying evidence; and (v) assessing the experience are all accepted but, as yet, translation into daily clinical and laboratory practice has been slow. Furthermore, the demand for evidence-based laboratory medicine (EBLM) has been slow to develop.

Croatian Society of Medical Biochemistry and Laboratory Medicine: national recommendations for venous blood sampling

Nikolac, Nora; Šupak-Smolčić, Vesna; Šimundić, Ana-Maria; Ćelap, Ivana
Fonte: Croatian Society of Medical Biochemistry and Laboratory Medicine Publicador: Croatian Society of Medical Biochemistry and Laboratory Medicine
Tipo: Artigo de Revista Científica
Publicado em 15/10/2013 EN
Relevância na Pesquisa
55.95%
Phlebotomy is one of the most complex medical procedures in the diagnosis, management and treatment of patients in healthcare. Since laboratory test results are the basis for a large proportion (60–80%) of medical decisions, any error in the phlebotomy process could have serious consequences. In order to minimize the possibility of errors, phlebotomy procedures should be standardised, well-documented and written instructions should be available at every workstation. Croatia is one of the few European countries that have national guidelines for phlebotomy, besides the universally used CLSI (Clinical Laboratory Standards Institute) H3-A6 Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; approved Standard-Sixth Edition (CLSI, 2007) and WHO (World Health Organization) guidelines on drawing blood: best practices in phlebotomy (WHO, 2010). However, the growing body of evidence in importance of preanalytical phase management resulted in a need for evidence based revision and expansion of existing recommendations.

Why would medical publishers not incorporate core bioethical values into their Ethics Guidelines?

Watine, Joseph
Fonte: Croatian Society of Medical Biochemistry and Laboratory Medicine Publicador: Croatian Society of Medical Biochemistry and Laboratory Medicine
Tipo: Artigo de Revista Científica
Publicado em 15/02/2014 EN
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46.01%
It is quite universally acknowledged by bioethicists, at least in the western world, that respect for the patients’ autonomy, non-malevolence, beneficence, and justice (also called equity) are four core ethical values in medicine. The Ethics Guidelines of key journals in laboratory medicine are not explicit about the first three of these values, and even implicitly, they seem to miss values of justice. Health equity being one of the main objectives of public health policy across the world, we suggest that values of equity explicitly become part of the Ethics Guidelines of laboratory medicine journals. Biochemia Medica could show the way to other medical publishers by incorporating into its Ethics Guidelines these very important core bioethical values.

Harmonization: the Sample, the Measurement, and the Report

Miller, W. Greg; Tate, Jillian R.; Barth, Julian H.; Jones, Graham R. D.
Fonte: The Korean Society for Laboratory Medicine Publicador: The Korean Society for Laboratory Medicine
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.01%
Harmonization of clinical laboratory results means that results are comparable irrespective of the measurement procedure used and where or when a measurement was made. Harmonization of test results includes consideration of pre-analytical, analytical, and post-analytical aspects. Progress has been made in each of these aspects, but there is currently poor coordination of the effort among different professional organizations in different countries. Pre-analytical considerations include terminology for the order, instructions for preparation of the patient, collection of the samples, and handling and transportation of the samples to the laboratory. Key analytical considerations include calibration traceability to a reference system, commutability of reference materials used in a traceability scheme, and specificity of the measurement of the biomolecule of interest. International organizations addressing harmonization include the International Federation for Clinical Chemistry and Laboratory Medicine, the World Health Organization, and the recently formed International Consortium for Harmonization of Clinical Laboratory Results (ICHCLR). The ICHCLR will provide a prioritization process for measurands and a service to coordinate global harmonization activities to avoid duplication of effort. Post-analytical considerations include nomenclature...

Advantages and Limitations of Anticipating Laboratory Test Results from Regression- and Tree-Based Rules Derived from Electronic Health-Record Data

Mohammad, Fahim; Theisen-Toupal, Jesse C.; Arnaout, Ramy
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
46.06%
Laboratory testing is the single highest-volume medical activity, making it useful to ask how well one can anticipate whether a given test result will be high, low, or within the reference interval (“normal”). We analyzed 10 years of electronic health records—a total of 69.4 million blood tests—to see how well standard rule-mining techniques can anticipate test results based on patient age and gender, recent diagnoses, and recent laboratory test results. We evaluated rules according to their positive and negative predictive value (PPV and NPV) and area under the receiver-operator characteristic curve (ROC AUCs). Using a stringent cutoff of PPV and/or NPV≥0.95, standard techniques yield few rules for sendout tests but several for in-house tests, mostly for repeat laboratory tests that are part of the complete blood count and basic metabolic panel. Most rules were clinically and pathophysiologically plausible, and several seemed clinically useful for informing pre-test probability of a given result. But overall, rules were unlikely to be able to function as a general substitute for actually ordering a test. Improving laboratory utilization will likely require different input data and/or alternative methods.

Characterization and Qualification of Commutable Reference Materials for Laboratory Medicine - Approved Guideline

VESPER Hubert; EMONS Hendrik; GNEZDA Matthew; JAIN Chandra P.; MILLER W. Gregory; REJ Robert; SCHUMANN Gerhard; TATE Jill; THIENPONT Linda; VAKS Jeffrey E.
Fonte: Clinical and Laboratory Standards Institute (CLSI), International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Publicador: Clinical and Laboratory Standards Institute (CLSI), International Federation of Clinical Chemistry and Laboratory Medicine (IFCC)
Tipo: Articles in Journals Formato: Printed
ENG
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Reference materials are an important requisite for ensuring reliable laboratory measurements and this appropriate patient care. To ensure that a reference material is suitable for its intended purpose, its characteristics need to be assessed in a defined manner, production and characterization of commutable reference materials as well as assist assay manufacturers, proficiency testing providers, and laboratorians in the appropriate use of these materials for calibration and trueness assessment of in vitro diagnostics medical devices. Guidance on qualification requirements of reference materials related to the definition of the measurand, the intended use of the material, and other material specifications is provided. Information on study designs, data evaluation, and uncertainty assessment is included that is supplemental to existing guidance documents about the assessment of homogeneity, stability, and property values. This document provides a revised definition of the term 'commutability' and provides guidance on how to perform commutability evaluation.; JRC.DG.D.2-Reference materials

Managing the Pre- and Post-analytical Phases of the Total Testing Process

Hawkins, Robert
Fonte: The Korean Society for Laboratory Medicine Publicador: The Korean Society for Laboratory Medicine
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.07%
For many years, the clinical laboratory's focus on analytical quality has resulted in an error rate of 4-5 sigma, which surpasses most other areas in healthcare. However, greater appreciation of the prevalence of errors in the pre- and post-analytical phases and their potential for patient harm has led to increasing requirements for laboratories to take greater responsibility for activities outside their immediate control. Accreditation bodies such as the Joint Commission International (JCI) and the College of American Pathologists (CAP) now require clear and effective procedures for patient/sample identification and communication of critical results. There are a variety of free on-line resources available to aid in managing the extra-analytical phase and the recent publication of quality indicators and proposed performance levels by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) working group on laboratory errors and patient safety provides particularly useful benchmarking data. Managing the extra-laboratory phase of the total testing cycle is the next challenge for laboratory medicine. By building on its existing quality management expertise, quantitative scientific background and familiarity with information technology...

Capillary blood sampling: national recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine

Krleza, Jasna Lenicek; Dorotic, Adrijana; Grzunov, Ana; Maradin, Miljenka
Fonte: Croatian Society of Medical Biochemistry and Laboratory Medicine Publicador: Croatian Society of Medical Biochemistry and Laboratory Medicine
Tipo: Artigo de Revista Científica
Publicado em 15/10/2015 EN
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66.04%
Capillary blood sampling is a medical procedure aimed at assisting in patient diagnosis, management and treatment, and is increasingly used worldwide, in part because of the increasing availability of point-of-care testing. It is also frequently used to obtain small blood volumes for laboratory testing because it minimizes pain. The capillary blood sampling procedure can influence the quality of the sample as well as the accuracy of test results, highlighting the need for immediate, widespread standardization. A recent nationwide survey of policies and practices related to capillary blood sampling in medical laboratories in Croatia has shown that capillary sampling procedures are not standardized and that only a small proportion of Croatian laboratories comply with guidelines from the Clinical Laboratory Standards Institute (CLSI) or the World Health Organization (WHO). The aim of this document is to provide recommendations for capillary blood sampling. This document has been produced by the Working Group for Capillary Blood Sampling within the Croatian Society of Medical Biochemistry and Laboratory Medicine. Our recommendations are based on existing available standards and recommendations (WHO Best Practices in Phlebotomy, CLSI GP42-A6 and CLSI C46-A2)...

Laboratory medicine and the identity change of veterinary medicine in Spain at the turn of the twentieth century

Gutiérrez García, José Manuel
Fonte: Universidade Autônoma de Barcelona Publicador: Universidade Autônoma de Barcelona
Tipo: Artigo de Revista Científica Formato: application/pdf
Publicado em //2010 ENG
Relevância na Pesquisa
56.11%
This paper analyses the impact of laboratory medicine on veterinary medicine in Spain at the turn of the twentieth century. It is considered from a perspective that places the laboratory at the centre of a strategy for introducing the ideal of progress into veterinary medicine at a sensitive moment in its history. In the adverse context created by the steady replacement of horses —the principal recipients of veterinary care— by motor vehicles, an awareness grew that the time had come to reinvent the profession. The arrival of experimental veterinary medicine, especially the area linked to bacteriological laboratories, opened the door to explore new prospects for the future and became one of the bases for the discipline’s modernisation. A new professional was envisaged to attain this objective, the «scientific laboratory veterinarian», whose knowledge would be based on experimentation and who would master highly specialised technical skills. This vision of a profession in search of prestige would bring to light conflicting interests among the different healthcare professions and would emphasise the importance of adopting patterns of behaviour that led to identification of these new veterinary surgeons with the elite of society.

Laboratory medicine and the identity change of veterinary medicine in Spain at the turn of the twentieth century

Gutiérrez García,José Manuel
Fonte: Dynamis Publicador: Dynamis
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/01/2010 ENG
Relevância na Pesquisa
56.11%
This paper analyses the impact of laboratory medicine on veterinary medicine in Spain at the turn of the twentieth century. It is considered from a perspective that places the laboratory at the centre of a strategy for introducing the ideal of progress into veterinary medicine at a sensitive moment in its history. In the adverse context created by the steady replacement of horses -the principal recipients of veterinary care- by motor vehicles, an awareness grew that the time had come to reinvent the profession. The arrival of experimental veterinary medicine, especially the area linked to bacteriological laboratories, opened the door to explore new prospects for the future and became one of the bases for the discipline's modernisation. A new professional was envisaged to attain this objective, the "scientific laboratory veterinarian", whose knowledge would be based on experimentation and who would master highly specialised technical skills. This vision of a profession in search of prestige would bring to light conflicting interests among the different healthcare professions and would emphasise the importance of adopting patterns of behaviour that led to identification of these new veterinary surgeons with the elite of society.