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Sample records for identify quality laboratory

  1. Quality in the molecular microbiology laboratory.

    Science.gov (United States)

    Wallace, Paul S; MacKay, William G

    2013-01-01

    In the clinical microbiology laboratory advances in nucleic acid detection, quantification, and sequence analysis have led to considerable improvements in the diagnosis, management, and monitoring of infectious diseases. Molecular diagnostic methods are routinely used to make clinical decisions based on when and how to treat a patient as well as monitor the effectiveness of a therapeutic regime and identify any potential drug resistant strains that may impact on the long term patient treatment program. Therefore, confidence in the reliability of the result provided by the laboratory service to the clinician is essential for patient treatment. Hence, suitable quality assurance and quality control measures are important to ensure that the laboratory methods and service meet the necessary regulatory requirements both at the national and international level. In essence, the modern clinical microbiology laboratory ensures the appropriateness of its services through a quality management system that monitors all aspects of the laboratory service pre- and post-analytical-from patient sample receipt to reporting of results, from checking and upholding staff competency within the laboratory to identifying areas for quality improvements within the service offered. For most European based clinical microbiology laboratories this means following the common International Standard Organization (ISO9001) framework and ISO15189 which sets out the quality management requirements for the medical laboratory (BS EN ISO 15189 (2003) Medical laboratories-particular requirements for quality and competence. British Standards Institute, Bristol, UK). In the United States clinical laboratories performing human diagnostic tests are regulated by the Centers for Medicare and Medicaid Services (CMS) following the requirements within the Clinical Laboratory Improvement Amendments document 1988 (CLIA-88). This chapter focuses on the key quality assurance and quality control requirements within the

  2. AUTOMATION OF THE SYSTEM OF INTERNAL LABORATORY QUALITY CONTROL

    Directory of Open Access Journals (Sweden)

    V. Z. Stetsyuk

    2015-05-01

    Full Text Available Quality control system base d on the principles of standardi zation of all phases of laboratory testing and analysis of internal laboratory quality control and external quality assessment. For the detection accuracy of the results of laboratory tests, carried out internally between the laboratory and laboratory quality control. Under internal laboratory quality control we understand measurement results of each analysis in each anal ytical series rendered directly in the lab every day. The purpose of internal laboratory control - identifying and eliminating unacceptable deviations from standard perfor mance test in the laboratory, i.e. identifying and eliminating harmful analytical errors. The solutions to these problems by implementing automated systems - software that allows you to optimize analytical laboratory research stage of the procedure by automatically creating process control charts was shown.

  3. Public health laboratory quality management in a developing country.

    Science.gov (United States)

    Wangkahat, Khwanjai; Nookhai, Somboon; Pobkeeree, Vallerut

    2012-01-01

    The article aims to give an overview of the system of public health laboratory quality management in Thailand and to produce a strengths, weaknesses, opportunities and threats (SWOT) analysis that is relevant to public health laboratories in the country. The systems for managing laboratory quality that are currently employed were described in the first component. The second component was a SWOT analysis, which used the opinions of laboratory professionals to identify any areas that could be improved to meet quality management systems. Various quality management systems were identified and the number of laboratories that met both international and national quality management requirements was different. The SWOT analysis found the opportunities and strengths factors offered the best chance to improve laboratory quality management in the country. The results are based on observations and brainstorming with medical laboratory professionals who can assist laboratories in accomplishing quality management. The factors derived from the analysis can help improve laboratory quality management in the country. This paper provides viewpoints and evidence-based approaches for the development of best possible practice of services in public health laboratories.

  4. Laboratory quality assurance

    International Nuclear Information System (INIS)

    Delvin, W.L.

    1977-01-01

    The elements (principles) of quality assurance can be applied to the operation of the analytical chemistry laboratory to provide an effective tool for indicating the competence of the laboratory and for helping to upgrade competence if necessary. When used, those elements establish the planned and systematic actions necessary to provide adequate confidence in each analytical result reported by the laboratory (the definition of laboratory quality assurance). The elements, as used at the Hanford Engineering Development Laboratory (HEDL), are discussed and they are qualification of analysts, written methods, sample receiving and storage, quality control, audit, and documentation. To establish a laboratory quality assurance program, a laboratory QA program plan is prepared to specify how the elements are to be implemented into laboratory operation. Benefits that can be obtained from using laboratory quality assurance are given. Experience at HEDL has shown that laboratory quality assurance is not a burden, but it is a useful and valuable tool for the analytical chemistry laboratory

  5. Laboratory quality assurance and its role in the safeguards analytical laboratory evaluation (SALE) program

    International Nuclear Information System (INIS)

    Delvin, W.L.; Pietri, C.E.

    1981-07-01

    Since the late 1960's, strong emphasis has been given to quality assurance in the nuclear industry, particularly to that part involved in nuclear reactors. This emphasis has had impact on the analytical chemistry laboratory because of the importance of analytical measurements in the certification and acceptance of materials used in the fabrication and construction of reactor components. Laboratory quality assurance, in which the principles of quality assurance are applied to laboratory operations, has a significant role to play in processing, fabrication, and construction programs of the nuclear industry. That role impacts not only process control and material certification, but also safeguards and nuclear materials accountability. The implementation of laboratory quality assurance is done through a program plan that specifies how the principles of quality assurance are to be applied. Laboratory quality assurance identifies weaknesses and deficiencies in laboratory operations and provides confidence in the reliability of laboratory results. Such confidence in laboratory measurements is essential to the proper evaluation of laboratories participating in the Safeguards Analytical Laboratory Evaluation (SALE) Program

  6. 222-S Laboratory Quality Assurance Plan. Revision 1

    International Nuclear Information System (INIS)

    Meznarich, H.K.

    1995-01-01

    This Quality Assurance Plan provides,quality assurance (QA) guidance, regulatory QA requirements (e.g., 10 CFR 830.120), and quality control (QC) specifications for analytical service. This document follows the U.S Department of Energy (DOE) issued Hanford Analytical Services Quality Assurance Plan (HASQAP). In addition, this document meets the objectives of the Quality Assurance Program provided in the WHC-CM-4-2, Section 2.1. Quality assurance elements required in the Guidelines and Specifications for Preparing Quality Assurance Program Plans (QAMS-004) and Interim Guidelines and Specifications for Preparing Quality Assurance Project Plans (QAMS-005) from the US Environmental Protection Agency (EPA) are covered throughout this document. A quality assurance index is provided in the Appendix A. This document also provides and/or identifies the procedural information that governs laboratory operations. The personnel of the 222-S Laboratory and the Standards Laboratory including managers, analysts, QA/QC staff, auditors, and support staff shall use this document as guidance and instructions for their operational and quality assurance activities. Other organizations that conduct activities described in this document for the 222-S Laboratory shall follow this QA/QC document

  7. Review and comparison of quality standards, guidelines and regulations for laboratories

    Directory of Open Access Journals (Sweden)

    Tjeerd A.M. Datema

    2011-12-01

    Full Text Available Background: The variety and number of laboratory quality standards, guidelines and regulations (hereafter: quality documents makes it difficult to choose the most suitable one for establishing and maintaining a laboratory quality management system. Objectives: There is a need to compare the characteristics, suitability and applicability of quality documents in view of the increasing efforts to introduce quality management in laboratories, especially in clinical diagnostic laboratories in low income and middle income countries. This may provide valuable insights for policy makers developing national laboratory policies, and for laboratory managers and quality officers in choosing the most appropriate quality document for upgrading their laboratories. Method: We reviewed the history of quality document development and then selected a subset based on their current use. We analysed these documents following a framework for comparison of quality documents that was adapted from the Clinical Laboratory Standards Institute guideline GP26 Quality management system model for clinical laboratory services. Results: Differences were identified between national and international, and non-clinical and clinical quality documents. The most salient findings were the absence of provisions on occurrence management and customer service in almost all non-clinical quality documents, a low number of safety requirements aimed at protecting laboratory personnel in international quality documents and no requirements regarding ethical behaviour in almost all quality documents. Conclusion: Each laboratory needs to investigate whether national regulatory standards are present. These are preferred as they most closely suit the needs of laboratories in the country. A laboratory should always use both a standard and a guideline: a standard sums up the requirements to a quality management system, a guideline describes how quality management can be integrated in the laboratory

  8. Quality assurance handbook for measurement laboratories

    International Nuclear Information System (INIS)

    Delvin, W.L.

    1984-10-01

    This handbook provides guidance in the application of quality assurance to measurement activities. It is intended to help those persons making measurements in applying quality assurance to their work activities by showing how laboratory practices and quality assurance requirements are integrated to provide control within those activities. The use of the guidance found in this handbook should help provide consistency in the interpretation of quality assurance requirements across all types of measurement laboratories. This handbook also can assist quality assurance personnel in understanding the relationships between laboratory practices and quality assurance requirements. The handbook is composed of three chapters and several appendices. Basic guidance is provided by the three chapters. In Chapter 1, the role of quality assurance in obtaining quality data and the importance of such data are discussed. Chapter 2 presents the elements of laboratory quality assurance in terms of practices that can be used in controlling work activities to assure the acquisition of quality data. Chapter 3 discusses the implementation of laboratory quality assurance. The appendices provide supplemental information to give the users a better understanding of the following: what is quality assurance; why quality assurance is required; where quality assurance requirements come from; how those requirements are interpreted for application to laboratory operations; how the elements of laboratory quality assurance relate to various laboratory activities; and how a quality assurance program can be developed

  9. Information systems as a quality management tool in clinical laboratories

    Science.gov (United States)

    Schmitz, Vanessa; Rosecler Bez el Boukhari, Marta

    2007-11-01

    This article describes information systems as a quality management tool in clinical laboratories. The quality of laboratory analyses is of fundamental importance for health professionals in aiding appropriate diagnosis and treatment. Information systems allow the automation of internal quality management processes, using standard sample tests, Levey-Jennings charts and Westgard multirule analysis. This simplifies evaluation and interpretation of quality tests and reduces the possibility of human error. This study proposes the development of an information system with appropriate functions and costs for the automation of internal quality control in small and medium-sized clinical laboratories. To this end, it evaluates the functions and usability of two commercial software products designed for this purpose, identifying the positive features of each, so that these can be taken into account during the development of the proposed system.

  10. Information systems as a quality management tool in clinical laboratories

    International Nuclear Information System (INIS)

    Schmitz, Vanessa; Boukhari, Marta Rosecler Bez el

    2007-01-01

    This article describes information systems as a quality management tool in clinical laboratories. The quality of laboratory analyses is of fundamental importance for health professionals in aiding appropriate diagnosis and treatment. Information systems allow the automation of internal quality management processes, using standard sample tests, Levey-Jennings charts and Westgard multirule analysis. This simplifies evaluation and interpretation of quality tests and reduces the possibility of human error. This study proposes the development of an information system with appropriate functions and costs for the automation of internal quality control in small and medium-sized clinical laboratories. To this end, it evaluates the functions and usability of two commercial software products designed for this purpose, identifying the positive features of each, so that these can be taken into account during the development of the proposed system

  11. Quality Indicators in Laboratory Medicine: from theory to practice. Preliminary data from the IFCC Working Group Project "Laboratory Errors and Patient Safety".

    Science.gov (United States)

    Sciacovelli, Laura; O'Kane, Maurice; Skaik, Younis Abdelwahab; Caciagli, Patrizio; Pellegrini, Cristina; Da Rin, Giorgio; Ivanov, Agnes; Ghys, Timothy; Plebani, Mario

    2011-05-01

    The adoption of Quality Indicators (QIs) has prompted the development of tools to measure and evaluate the quality and effectiveness of laboratory testing, first in the hospital setting and subsequently in ambulatory and other care settings. While Laboratory Medicine has an important role in the delivery of high-quality care, no consensus exists as yet on the use of QIs focussing on all steps of the laboratory total testing process (TTP), and further research in this area is required. In order to reduce errors in laboratory testing, the IFCC Working Group on "Laboratory Errors and Patient Safety" (WG-LEPS) developed a series of Quality Indicators, specifically designed for clinical laboratories. In the first phase of the project, specific QIs for key processes of the TTP were identified, including all the pre-, intra- and post-analytic steps. The overall aim of the project is to create a common reporting system for clinical laboratories based on standardized data collection, and to define state-of-the-art and Quality Specifications (QSs) for each QI independent of: a) the size of organization and type of activities; b) the complexity of processes undertaken; and c) different degree of knowledge and ability of the staff. The aim of the present paper is to report the results collected from participating laboratories from February 2008 to December 2009 and to identify preliminary QSs. The results demonstrate that a Model of Quality Indicators managed as an External Quality Assurance Program can serve as a tool to monitor and control the pre-, intra- and post-analytical activities. It might also allow clinical laboratories to identify risks that lead to errors resulting in patient harm: identification and design of practices that eliminate medical errors; the sharing of information and education of clinical and laboratory teams on practices that reduce or prevent errors; the monitoring and evaluation of improvement activities.

  12. Service quality framework for clinical laboratories.

    Science.gov (United States)

    Ramessur, Vinaysing; Hurreeram, Dinesh Kumar; Maistry, Kaylasson

    2015-01-01

    The purpose of this paper is to illustrate a service quality framework that enhances service delivery in clinical laboratories by gauging medical practitioner satisfaction and by providing avenues for continuous improvement. The case study method has been used for conducting the exploratory study, with focus on the Mauritian public clinical laboratory. A structured questionnaire based on the SERVQUAL service quality model was used for data collection, analysis and for the development of the service quality framework. The study confirms the pertinence of the following service quality dimensions within the context of clinical laboratories: tangibility, reliability, responsiveness, turnaround time, technology, test reports, communication and laboratory staff attitude and behaviour. The service quality framework developed, termed LabSERV, is vital for clinical laboratories in the search for improving service delivery to medical practitioners. This is a pioneering work carried out in the clinical laboratory sector in Mauritius. Medical practitioner expectations and perceptions have been simultaneously considered to generate a novel service quality framework for clinical laboratories.

  13. Quality manual for Laboratories of the Nuclear Materials Characterization Division

    International Nuclear Information System (INIS)

    Sabato, S.F.

    1991-05-01

    This publication presents the first Quality Manual for the Laboratories at the Nuclear Materials Characterization Division. The Manual describes the laboratories, its organization structure, fields of activities, personnel records, equipments, maintenance and calibration. The main aspects concerning quality assurance in the analysis were discussed. The whole system of receiving, identifying and processing analysis of the samples is shown. Since there are many information to be contained in several subjects of the Quality Manual, there were produced separate documents that are cross referenced in the manual. (author)

  14. Laboratory quality improvement in Thailand's northernmost provinces.

    Science.gov (United States)

    Kanitvittaya, S; Suksai, U; Suksripanich, O; Pobkeeree, V

    2010-01-01

    In Thailand nearly 1000 public health laboratories serve 65 million people. A qualified indicator of a good quality laboratory is Thailand Medical Technology Council certification. Consequently, Chiang Rai Regional Medical Sciences Center established a development program for laboratory certification for 29 laboratories in the province. This paper seeks to examine this issue. The goal was to improve laboratory service quality by voluntary participation, peer review, training and compliance with standards. The program consisted of specific activities. Training and workshops to update laboratory staffs' quality management knowledge were organized. Staff in each laboratory performed a self-assessment using a standard check-list to evaluate ten laboratory management areas. Chiang Rai Regional Medical Sciences Center staff supported the distribution of quality materials and documents. They provided calibration services for laboratory equipment. Peer groups performed an internal audit and successful laboratories received Thailand Medical Technology Council certification. By December 2007, eight of the 29 laboratories had improved quality sufficiently to be certified. Factors that influenced laboratories' readiness for quality improvement included the number of staff, their knowledge, budget and staff commitment to the process. Moreover, the support of each hospital's laboratory working group or network was essential for success. There was no clear policy for supporting the program. Laboratories voluntarily conducted quality management using existing resources. A bottom-up approach to this kind of project can be difficult to accomplish. Laboratory professionals can work together to illustrate and highlight outcomes for top-level health officials. A top-down, practical approach would be much less difficult to implement. Quality certification is a critical step for laboratory staff, which also encourages them to aspire to international quality standards like ISO. The

  15. Laboratory diagnostic methods, system of quality and validation

    Directory of Open Access Journals (Sweden)

    Ašanin Ružica

    2005-01-01

    Full Text Available It is known that laboratory investigations secure safe and reliable results that provide a final confirmation of the quality of work. Ideas, planning, knowledge, skills, experience, and environment, along with good laboratory practice, quality control and reliability of quality, make the area of biological investigations very complex. In recent years, quality control, including the control of work in the laboratory, is based on international standards and is used at that level. The implementation of widely recognized international standards, such as the International Standard ISO/IEC 17025 (1 and the implementing of the quality system series ISO/IEC 9000 (2 have become the imperative on the grounds of which laboratories have a formal, visible and corresponding system of quality. The diagnostic methods that are used must constantly yield results which identify the animal as positive or negative, and the precise status of the animal is determined with a predefined degree of statistical significance. Methods applied on a selected population reduce the risk of obtaining falsely positive or falsely negative results. A condition for this are well conceived and documented methods, with the application of the corresponding reagents, and work with professional and skilled staff. This process requires also a consistent implementation of the most rigorous experimental plans, epidemiological and statistical data and estimations, with constant monitoring of the validity of the applied methods. Such an approach is necessary in order to cut down the number of misconceptions and accidental mistakes, for a referent population of animals on which the validity of a method is tested. Once a valid method is included in daily routine investigations, it is necessary to apply constant monitoring for the purpose of internal quality control, in order adequately to evaluate its reproducibility and reliability. Consequently, it is necessary at least twice yearly to conduct

  16. Issues ignored in laboratory quality surveillance

    International Nuclear Information System (INIS)

    Zeng Jing; Li Xingyuan; Zhang Tingsheng

    2008-01-01

    According to the work requirement of the related laboratory quality surveillance in ISO17025, this paper analyzed and discussed the issued ignored in the laboratory quality surveillance. In order to solve the present problem, it is required to understand the work responsibility in the quality surveillance correctly, to establish the effective working routine in the quality surveillance, and to conduct, the quality surveillance work. The object in the quality surveillance shall be 'the operator' who engaged in the examination/calibration directly in the laboratory, especially the personnel in training (who is engaged in the examination/calibration). The quality supervisors shall be fully authorized, so that they can correctly understand the work responsibility in quality surveillance, and are with the rights for 'full supervision'. The laboratory also shall arrange necessary training to the quality supervisor, so that they can obtain sufficient guide in time and are with required qualification or occupation prerequisites. (authors)

  17. Indoor Air Quality in Chemistry Laboratories.

    Science.gov (United States)

    Hays, Steve M.

    This paper presents air quality and ventilation data from an existing chemical laboratory facility and discusses the work practice changes implemented in response to deficiencies in ventilation. General methods for improving air quality in existing laboratories are presented and investigation techniques for characterizing air quality are…

  18. Quality in laboratory medicine: 50years on.

    Science.gov (United States)

    Plebani, Mario

    2017-02-01

    The last 50years have seen substantial changes in the landscape of laboratory medicine: its role in modern medicine is in evolution and the quality of laboratory services is changing. The need to control and improve quality in clinical laboratories has grown hand in hand with the growth in technological developments leading to an impressive reduction of analytical errors over time. An essential cause of this impressive improvement has been the introduction and monitoring of quality indicators (QIs) such as the analytical performance specifications (in particular bias and imprecision) based on well-established goals. The evolving landscape of quality and errors in clinical laboratories moved first from analytical errors to all errors performed within the laboratory walls, subsequently to errors in laboratory medicine (including errors in test requesting and result interpretation), and finally, to a focus on errors more frequently associated with adverse events (laboratory-associated errors). After decades in which clinical laboratories have focused on monitoring and improving internal indicators of analytical quality, efficiency and productivity, it is time to shift toward indicators of total quality, clinical effectiveness and patient outcomes. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  19. A summary of deliberations on strategic planning for continuous quality improvement in laboratory medicine.

    Science.gov (United States)

    Grzybicki, Dana Marie; Shahangian, Shahram; Pollock, Anne M; Raab, Stephen S

    2009-03-01

    On September 24-26, 2007, the Centers for Disease Control and Prevention convened the 2007 Institute on Critical Issues in Health Laboratory Practice: Managing for Better Health to develop an action plan for change for the immediate and long-term future. A wide variety of stakeholders, including pathologists, pathologist extenders, clinicians, and researchers, examined means to improve laboratory service communication, quality parameters, and potential future laboratory contributions to health care. In this summary document, we present the identified gaps, barriers, and proposed action plans for improvement for laboratory medicine in the 6 quality domains identified by the Institute of Medicine: safety, effectiveness, patient centeredness, timeliness, efficiency, and equity. Five major recommendations emerged from concluding discussions and included focusing on preanalytic and postanalytic processes as areas of potential quality improvement and recruiting a multidisciplinary group of nonlaboratory stakeholders to work with laboratory personnel to achieve improvement goals.

  20. [Quality Management and Quality Specifications of Laboratory Tests in Clinical Studies--Challenges in Pre-Analytical Processes in Clinical Laboratories].

    Science.gov (United States)

    Ishibashi, Midori

    2015-01-01

    The cost, speed, and quality are the three important factors recently indicated by the Ministry of Health, Labour and Welfare (MHLW) for the purpose of accelerating clinical studies. Based on this background, the importance of laboratory tests is increasing, especially in the evaluation of clinical study participants' entry and safety, and drug efficacy. To assure the quality of laboratory tests, providing high-quality laboratory tests is mandatory. For providing adequate quality assurance in laboratory tests, quality control in the three fields of pre-analytical, analytical, and post-analytical processes is extremely important. There are, however, no detailed written requirements concerning specimen collection, handling, preparation, storage, and shipping. Most laboratory tests for clinical studies are performed onsite in a local laboratory; however, a part of laboratory tests is done in offsite central laboratories after specimen shipping. As factors affecting laboratory tests, individual and inter-individual variations are well-known. Besides these factors, standardizing the factors of specimen collection, handling, preparation, storage, and shipping, may improve and maintain the high quality of clinical studies in general. Furthermore, the analytical method, units, and reference interval are also important factors. It is concluded that, to overcome the problems derived from pre-analytical processes, it is necessary to standardize specimen handling in a broad sense.

  1. Introduction to ISO 15189: a blueprint for quality systems in veterinary laboratories.

    Science.gov (United States)

    Freeman, Kathleen P; Bauer, Natali; Jensen, Asger L; Thoresen, Stein

    2006-06-01

    assessments, and processes for identifying and addressing opportunities for improvement. Recommendations were developed for a stepwise approach towards achieving ISO 15189 standards, including 3 levels of quality components. The ISO 15189 standard provides a sound framework for veterinary laboratories aspiring to meet international quality standards.

  2. [Theme: Achieving Quality Laboratory Projects.[.

    Science.gov (United States)

    Shinn, Glen C.; And Others

    1983-01-01

    The theme articles present strategies for achieving quality laboratory projects in vocational agriculture. They describe fundamentals of the construction of quality projects and stress the importance of quality instruction. (JOW)

  3. Quality system for Medical laboratories

    Directory of Open Access Journals (Sweden)

    Shiva Raj K.C.

    2015-03-01

    Full Text Available According to William Edwards Deming “Good quality does not necessarily mean high quality. Instead it means a predicable degree of uniformity and dependability at low cost with a quality suited to the market.” Whereas according to famous engineer and management consultant Joseph M. Juran quality is “fitness for purpose”. It should meet the customers’ expectations and requirements, should be cost effective.ISO began in 1926 as the International Federation of the National Standardizing Associations (ISA. The name, "ISO" was derived from the Greek word "isos" meaning "equal". (The relation to standards is that if two objects meet the same standard, they should be equal. This name eliminates any confusion that could result from the translation of "International Organization for Standardization" into different languages which would lead to different acronyms.In health sector, quality plays pivotal role, as it is directly related to patient’s care. Earlier time, health service was simple, quite safe but ineffective. Now health care system is an organizational system with more complex processes to deliver care. Medical laboratory service is an integral part in patient’s management system. So, for everyone involved in the treatment of the patient, the accuracy, reliability and safety of those services must be the primary concerns. Accreditation is a significant enabler of quality, thereby delivering confidence to healthcare providers, clinicians, the medical laboratories and the patients themselves.ISO announced meeting in Philadelphia to form a technical committee to develop a new standard for medical laboratory quality. It took 7 years for the creation of a new Quality standard for medical laboratories. It was named as “ISO 15189” and was first published in 2003. The ISO has released three versions of the standard. The first two were released in 2003 and 2007. In 2012, a revised and updated version of the standard, ISO 15189

  4. Quality in pathology laboratory practice.

    Science.gov (United States)

    Weinstein, S

    1995-06-01

    Quality refers not only to analytical quality control, a traditional area of laboratory excellence, but to the entire science of quality management. As measures of quality, structural indicators refer to staffing and physical facilities, process indicators to the institutions operations and, perhaps most importantly, outcome indicators address the ultimate patient care uses that pathology information is put to. Comparison of performance to peer laboratories, external quality control, is a practical, if limited, yardstick of performance. Customer satisfaction and turn-around-time of tests are receiving more recent attention as quality measures. Blood banking, because of its inherently complex cycle from donor phlebotomy to product infusion, requires special considerations with regard to quality management. Reporting of anatomical pathology, where the only gold standard is a consensus of experts, also does not lend itself to classical numerical quality assessment.

  5. Preanalytical quality in clinical chemistry laboratory.

    Science.gov (United States)

    Ahmad, M Imteyaz; Ramesh, K L; Kumar, Ravi

    2014-01-01

    Haemolysis is usually caused by inadequate specimen collection or preanalytical handling and is suggested to be a suitable indicator of preanalytical quality. We investigated the prevalence of detectable haemolysis in all routine venous blood samples in OPDs and IPDs to identify differences in preanalytical quality. Haemolysis index (HI) values were obtained from a Vitros 5,1 in the routine clinical chemistry laboratory for samples collected in the outpatient department (OPD) collection centres, a hospital, and inpatient departments (IPD). Haemolysis was defined as a HI > or = 15 (detection limit). Samples from the OPD with the highest prevalence of haemolysis were 6.1 times (95% confidence interval (CI) 4.0 - 9.2) more often haemolysed compared to the center with the lowest prevalence. Of the samples collected in primary health care, 10.4% were haemolysed compared to 31.1% in the IPDs (p = 0.001). A notable difference in haemolysed samples was found between the IPDs section staffed by emergency medicine physicians and the section staffed by primary health care physicians (34.8% vs. 11.3%, p = 0.001). The significant variation in haemolysis indices among the investigated units is likely to reflect varying preanalytical conditions. The HI is a valuable tool for estimation and follow-up of preanalytical quality in the health care laboratory.

  6. Implementing self sustained quality control procedures in a clinical laboratory.

    Science.gov (United States)

    Khatri, Roshan; K C, Sanjay; Shrestha, Prabodh; Sinha, J N

    2013-01-01

    Quality control is an essential component in every clinical laboratory which maintains the excellence of laboratory standards, supplementing to proper disease diagnosis, patient care and resulting in overall strengthening of health care system. Numerous quality control schemes are available, with combinations of procedures, most of which are tedious, time consuming and can be "too technical" whereas commercially available quality control materials can be expensive especially for laboratories in developing nations like Nepal. Here, we present a procedure performed at our centre with self prepared control serum and use of simple statistical tools for quality assurance. The pooled serum was prepared as per guidelines for preparation of stabilized liquid quality control serum from human sera. Internal Quality Assessment was performed on this sample, on a daily basis which included measurement of 12 routine biochemical parameters. The results were plotted on Levey-Jennings charts and analysed with quality control rules, for a period of one month. The mean levels of biochemical analytes in self prepared control serum were within normal physiological range. This serum was evaluated every day along with patients' samples. The results obtained were plotted on control charts and analysed using common quality control rules to identify possible systematic and random errors. Immediate mitigation measures were taken and the dispatch of erroneous reports was avoided. In this study we try to highlight on a simple internal quality control procedure which can be performed by laboratories, with minimum technology, expenditure, and expertise and improve reliability and validity of the test reports.

  7. Laboratory system strengthening and quality improvement in Ethiopia

    Directory of Open Access Journals (Sweden)

    Tilahun M. Hiwotu

    2014-11-01

    Full Text Available Background: In 2010, a National Laboratory Strategic Plan was set forth in Ethiopia to strengthen laboratory quality systems and set the stage for laboratory accreditation. As a result, the Strengthening Laboratory Management Toward Accreditation (SLMTA programme was initiated in 45 Ethiopian laboratories. Objectives: This article discusses the implementation of the programme, the findings from the evaluation process and key challenges. Methods: The 45 laboratories were divided into two consecutive cohorts and staff from each laboratory participated in SLMTA training and improvement projects. The average amount of supportive supervision conducted in the laboratories was 68 hours for cohort I and two hoursfor cohort II. Baseline and exit audits were conducted in 44 of the laboratories and percent compliance was determined using a checklist with scores divided into zero- to five-star ratinglevels. Results: Improvements, ranging from < 1 to 51 percentage points, were noted in 42 laboratories, whilst decreases were recorded in two. The average scores at the baseline and exit audits were 40% and 58% for cohort I (p < 0.01; and 42% and 53% for cohort II (p < 0.01,respectively. The p-value for difference between cohorts was 0.07. At the exit audit, 61% ofthe first and 48% of the second cohort laboratories achieved an increase in star rating. Poor awareness, lack of harmonisation with other facility activities and the absence of a quality manual were challenges identified. Conclusion: Improvements resulting from SLMTA implementation are encouraging. Continuous advocacy at all levels of the health system is needed to ensure involvement of stakeholders and integration with other improvement initiatives and routine activities.

  8. Internal quality control indicators of cervical cytopathology exams performed in laboratories monitored by the External Quality Control Laboratory.

    Science.gov (United States)

    Ázara, Cinara Zago Silveira; Manrique, Edna Joana Cláudio; Tavares, Suelene Brito do Nascimento; de Souza, Nadja Lindany Alves; Amaral, Rita Goreti

    2014-09-01

    To evaluate the impact of continued education provided by an external quality control laboratory on the indicators of internal quality control of cytopathology exams. The internal quality assurance indicators for cytopathology exams from 12 laboratories monitored by the External Quality Control Laboratory were evaluated. Overall, 185,194 exams were included, 98,133 of which referred to the period preceding implementation of a continued education program, while 87,061 referred to the period following this intervention. Data were obtained from the Cervical Cancer Database of the Brazilian National Health Service. Following implementation of the continued education program, the positivity index (PI) remained within recommended limits in four laboratories. In another four laboratories, the PI progressed from below the limits to within the recommended standards. In one laboratory, the PI remained low, in two laboratories, it remained very low, and in one, it increased from very low to low. The percentage of exams compatible with a high-grade squamous intraepithelial lesion (HSIL) remained within the recommended limits in five laboratories, while in three laboratories it progressed from below the recommended levels to >0.4% of the total number of satisfactory exams, and in four laboratories it remained below the standard limit. Both the percentage of atypical squamous cells of undetermined significance (ASC-US) in relation to abnormal exams, and the ratio between ASC-US and intraepithelial lesions remained within recommended levels in all the laboratories investigated. An improvement was found in the indicators represented by the positivity index and the percentage of exams compatible with a high-grade squamous intraepithelial lesion, showing that the role played by the external quality control laboratory in providing continued education contributed towards improving laboratory staff skills in detecting cervical cancer precursor lesions.

  9. Improving laboratory data entry quality using Six Sigma.

    Science.gov (United States)

    Elbireer, Ali; Le Chasseur, Julie; Jackson, Brooks

    2013-01-01

    The Uganda Makerere University provides clinical laboratory support to over 70 clients in Uganda. With increased volume, manual data entry errors have steadily increased, prompting laboratory managers to employ the Six Sigma method to evaluate and reduce their problems. The purpose of this paper is to describe how laboratory data entry quality was improved by using Six Sigma. The Six Sigma Quality Improvement (QI) project team followed a sequence of steps, starting with defining project goals, measuring data entry errors to assess current performance, analyzing data and determining data-entry error root causes. Finally the team implemented changes and control measures to address the root causes and to maintain improvements. Establishing the Six Sigma project required considerable resources and maintaining the gains requires additional personnel time and dedicated resources. After initiating the Six Sigma project, there was a 60.5 percent reduction in data entry errors from 423 errors a month (i.e. 4.34 Six Sigma) in the first month, down to an average 166 errors/month (i.e. 4.65 Six Sigma) over 12 months. The team estimated the average cost of identifying and fixing a data entry error to be $16.25 per error. Thus, reducing errors by an average of 257 errors per month over one year has saved the laboratory an estimated $50,115 a year. The Six Sigma QI project provides a replicable framework for Ugandan laboratory staff and other resource-limited organizations to promote quality environment. Laboratory staff can deliver excellent care at a lower cost, by applying QI principles. This innovative QI method of reducing data entry errors in medical laboratories may improve the clinical workflow processes and make cost savings across the health care continuum.

  10. LEAN LABORATORY APPROACHES FOR QUALITY ASSURANCE IN FOOD

    Directory of Open Access Journals (Sweden)

    Laxmana Naik

    2011-09-01

    Full Text Available A lean laboratory is one which is focused on testing products and materials to deliver results in the most efficient way in terms of cost or speed or both; primarily focused on improving measurable performance and reducing costs. The goal of a lean laboratory is to use less effort, less resources and less time to test incoming samples. Laboratories have a critical role to play in establishing and improving process capability and key performance indicator (KPI of the organization. There are inevitably many opinions as to what a lean lab actually is; here is one version fr om. Quality assurance laboratories are crucial to the success of organization and this effectiveness needs to be measurable and demonstrable. To facilitate this, a method of measuring a laboratory's progress towards complete deployment has been created by lean tools. These tools allow laboratories to conduct gap analysis and identify opportunities for improvement.

  11. The impact of laboratory quality assurance standards on laboratory operational performance

    Directory of Open Access Journals (Sweden)

    E Ratseou

    2014-01-01

    Full Text Available It has become a trend for companies to implement and be certified to various quality management systems so as to improve consistency, reliability, and quality of product delivery to customers. The most common quality management systems adopted are the ISO 9000 series of standards for manufacturing and services related organisations, with ISO 17025 and Good Laboratory Practices (GLP standards adopted specifically by laboratories as quality assurance initiatives. There are various reports on the impact of the ISO 9000 series on organisational performance but no studies or reports have been done on the performance of laboratory standards. Therefore this article reports on a study conducted to investigate the impact of ISO 17025 and GLP on the operational performance of both commercial and non-commercial laboratories. A qualitative research study was conducted to examine the impact standards on the aspects of health and safety, supplier selection and performance, human resources, customer satisfaction and profitability of the laboratory. The data collected suggest that there is no difference in laboratory operational performance with or without the standards. In other words it appears that the basic fundamental requirements inherent with laboratories are sufficient to perform both operationally and optimally. This leads to the view that standards are implemented as a customer requirement and not as an operational requirement.

  12. Quality documentation challenges for veterinary clinical pathology laboratories.

    Science.gov (United States)

    Sacchini, Federico; Freeman, Kathleen P

    2008-05-01

    An increasing number of veterinary laboratories worldwide have obtained or are seeking certification based on international standards, such as the International Organization for Standardization/International Electrotechnical Commission 17025. Compliance with any certification standard or quality management system requires quality documentation, an activity that may present several unique challenges in the case of veterinary laboratories. Research specifically addressing quality documentation is conspicuously absent in the veterinary literature. This article provides an overview of the quality system documentation needed to comply with a quality management system with an emphasis on preparing written standard operating procedures specific for veterinary laboratories. In addition, the quality documentation challenges that are unique to veterinary clinical pathology laboratories are critically evaluated against the existing quality standards and discussed with respect to possible solutions and/or recommended courses of action. Documentation challenges include the establishment of quality requirements for veterinary tests, the use or modification of human analytic methods for animal samples, the limited availability of quality control materials satisfactory for veterinary clinical pathology laboratories, the limited availability of veterinary proficiency programs, and the complications in establishing species-specific reference intervals.

  13. BYU Food Quality Assurance Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The Quality Assurance Lab is located in the Eyring Science Center in the department of Nutrition, Dietetics, and Food Science. The Quality Assurance Lab has about 10...

  14. Selecting clinical quality indicators for laboratory medicine.

    Science.gov (United States)

    Barth, Julian H

    2012-05-01

    Quality in laboratory medicine is often described as doing the right test at the right time for the right person. Laboratory processes currently operate under the oversight of an accreditation body which gives confidence that the process is good. However, there are aspects of quality that are not measured by these processes. These are largely focused on ensuring that the most clinically appropriate test is performed and interpreted correctly. Clinical quality indicators were selected through a two-phase process. Firstly, a series of focus groups of clinical scientists were held with the aim of developing a list of quality indicators. These were subsequently ranked in order by an expert panel of primary and secondary care physicians. The 10 top indicators included the communication of critical results, comprehensive education to all users and adequate quality assurance for point-of-care testing. Laboratories should ensure their tests are used to national standards, that they have clinical utility, are calibrated to national standards and have long-term stability for chronic disease management. Laboratories should have error logs and demonstrate evidence of measures introduced to reduce chances of similar future errors. Laboratories should make a formal scientific evaluation of analytical quality. This paper describes the process of selection of quality indicators for laboratory medicine that have been validated sequentially by deliverers and users of the service. They now need to be converted into measureable variables related to outcome and validated in practice.

  15. Identifying causes of laboratory turnaround time delay in the emergency department.

    Science.gov (United States)

    Jalili, Mohammad; Shalileh, Keivan; Mojtahed, Ali; Mojtahed, Mohammad; Moradi-Lakeh, Maziar

    2012-12-01

    Laboratory turnaround time (TAT) is an important determinant of patient stay and quality of care. Our objective is to evaluate laboratory TAT in our emergency department (ED) and to generate a simple model for identifying the primary causes for delay. We measured TATs of hemoglobin, potassium, and prothrombin time tests requested in the ED of a tertiary-care, metropolitan hospital during a consecutive one-week period. The time of different steps (physician order, nurse registration, blood-draw, specimen dispatch from the ED, specimen arrival at the laboratory, and result availability) in the test turnaround process were recorded and the intervals between these steps (order processing, specimen collection, ED waiting, transit, and within-laboratory time) and total TAT were calculated. Median TATs for hemoglobin and potassium were compared with those of the 1990 Q-Probes Study (25 min for hemoglobin and 36 min for potassium) and its recommended goals (45 min for 90% of tests). Intervals were compared according to the proportion of TAT they comprised. Median TATs (170 min for 132 hemoglobin tests, 225 min for 172 potassium tests, and 195.5 min for 128 prothrombin tests) were drastically longer than Q-Probes reported and recommended TATs. The longest intervals were ED waiting time and order processing.  Laboratory TAT varies among institutions, and data are sparse in developing countries. In our ED, actions to reduce ED waiting time and order processing are top priorities. We recommend utilization of this model by other institutions in settings with limited resources to identify their own priorities for reducing laboratory TAT.

  16. Analytical quality, performance indices and laboratory service

    DEFF Research Database (Denmark)

    Hilden, Jørgen; Magid, Erik

    1999-01-01

    analytical error, bias, cost effectiveness, decision-making, laboratory techniques and procedures, mass screening, models, statistical, quality control......analytical error, bias, cost effectiveness, decision-making, laboratory techniques and procedures, mass screening, models, statistical, quality control...

  17. Quality systems in veterinary diagnostics laboratories.

    Science.gov (United States)

    de Branco, Freitas Maia L M

    2007-01-01

    Quality assurance of services provided by veterinary diagnostics laboratories is a fundamental element promoted by international animal health organizations to establish trust, confidence and transparency needed for the trade of animals and their products at domestic and international levels. It requires, among other things, trained personnel, consistent and rigorous methodology, choice of suitable methods as well as appropriate calibration and traceability procedures. An important part of laboratory quality management is addressed by ISO/IEC 17025, which aims to facilitate cooperation among laboratories and their associated parties by assuring the generation of credible and consistent information derived from analytical results. Currently, according to OIE recommendation, veterinary diagnostics laboratories are only subject to voluntary compliance with standard ISO/IEC 17025; however, it is proposed here that OIE reference laboratories and collaboration centres strongly consider its adoption.

  18. Measurement quality assurance for radioassay laboratories

    Energy Technology Data Exchange (ETDEWEB)

    McCurdy, D.E. [Yankee Atomic Environmental Laboratory, Boston, MA (United States)

    1993-12-31

    Until recently, the quality of U.S. radioassay laboratory services has been evaluated by a limited number of governmental measurement assurance programs (MAPs). The major programs have been limited to the U.S. Department of Energy (DOE), the U.S. Environmental Protection Agency (EPA) and the U.S. Nuclear Regulatory Commission (NRC). In 1988, an industry MAP was established for the nuclear power utility industry through the U.S. Council for Energy Awareness/National Institute of Standards and Technology (USCEA/NIST). This program functions as both a MAP for utility laboratories and/or their commercial contractor laboratories, and as a traceability program for the U.S. radioactive source manufacturers and the utility laboratories. Each of these generic MAPs has been initiated and is maintained to serve the specific needs of the sponsoring agency or organization. As a result, there is diversification in their approach, scope, requirements, and degree of traceability to NIST. In 1987, a writing committee was formed under the American National Standards Institute (ANSI) N42.2 committee to develop a standard to serve as the basis document for the creation of a national measurement quality assurance (MQA) program for radioassay laboratories in the U.S. The standard is entitled, {open_quotes}Measurement Quality Assurance For Radioassay Laboratories.{open_quotes} The document was developed to serve as a guide for MQA programs maintained for the specialized sectors of the radioassay community, such as bioassay, routine environmental monitoring, environmental restoration and waste management, radiopharmaceuticals, and nuclear facilities. It was the intent of the writing committee to develop a guidance document that could be utilized to establish a laboratory`s specific data quality objectives (DQOs) that govern the operational requirements of the radioassay process, including mandated protocols and recommendations.

  19. Extra-analytical quality indicators and laboratory performances.

    Science.gov (United States)

    Sciacovelli, Laura; Aita, Ada; Plebani, Mario

    2017-07-01

    In the last few years much progress has been made in raising the awareness of laboratory medicine professionals about the effectiveness of quality indicators (QIs) in monitoring, and improving upon, performances in the extra-analytical phases of the Total Testing Process (TTP). An effective system for management of QIs includes the implementation of an internal assessment system and participation in inter-laboratory comparison. A well-designed internal assessment system allows the identification of critical activities and their systematic monitoring. Active participation in inter-laboratory comparison provides information on the performance level of one laboratory with respect to that of other participating laboratories. In order to guarantee the use of appropriate QIs and facilitate their implementation, many laboratories have adopted the Model of Quality Indicators (MQI) proposed by Working Group "Laboratory Errors and Patient Safety" (WG-LEPS) of IFCC, since 2008, which is the result of international consensus and continuous experimentation, and updating to meet new, constantly emerging needs. Data from participating laboratories are collected monthly and reports describing the statistical results and evaluating laboratory data, utilizing the Six Sigma metric, issued regularly. Although the results demonstrate that the processes need to be improved upon, overall the comparison with data collected in 2014 shows a general stability of quality levels and that an improvement has been achieved over time for some activities. The continuous monitoring of QI data allows identification all possible improvements, thus highlighting the value of participation in the inter-laboratory program proposed by WG-LEPS. The active participation of numerous laboratories will guarantee an ever more significant State-of-the-Art, promote the reduction of errors and improve quality of the TTP, thus guaranteeing patient safety. Copyright © 2017. Published by Elsevier Inc.

  20. Measurement quality assurance for radioassay laboratories

    International Nuclear Information System (INIS)

    McCurdy, D.E.

    1993-01-01

    Until recently, the quality of U.S. radioassay laboratory services has been evaluated by a limited number of governmental measurement assurance programs (MAPs). The major programs have been limited to the U.S. Department of Energy (DOE), the U.S. Environmental Protection Agency (EPA) and the U.S. Nuclear Regulatory Commission (NRC). In 1988, an industry MAP was established for the nuclear power utility industry through the U.S. Council for Energy Awareness/National Institute of Standards and Technology (USCEA/NIST). This program functions as both a MAP for utility laboratories and/or their commercial contractor laboratories, and as a traceability program for the U.S. radioactive source manufacturers and the utility laboratories. Each of these generic MAPs has been initiated and is maintained to serve the specific needs of the sponsoring agency or organization. As a result, there is diversification in their approach, scope, requirements, and degree of traceability to NIST. In 1987, a writing committee was formed under the American National Standards Institute (ANSI) N42.2 committee to develop a standard to serve as the basis document for the creation of a national measurement quality assurance (MQA) program for radioassay laboratories in the U.S. The standard is entitled, open-quotes Measurement Quality Assurance For Radioassay Laboratories.open-quotes The document was developed to serve as a guide for MQA programs maintained for the specialized sectors of the radioassay community, such as bioassay, routine environmental monitoring, environmental restoration and waste management, radiopharmaceuticals, and nuclear facilities. It was the intent of the writing committee to develop a guidance document that could be utilized to establish a laboratory's specific data quality objectives (DQOs) that govern the operational requirements of the radioassay process, including mandated protocols and recommendations

  1. Quality control for diagnostic oral microbiology laboratories in European countries

    Directory of Open Access Journals (Sweden)

    Andrew J. Smith

    2011-11-01

    Full Text Available Participation in diagnostic microbiology internal and external quality control (QC processes is good laboratory practice and an essential component of a quality management system. However, no QC scheme for diagnostic oral microbiology existed until 2009 when the Clinical Oral Microbiology (COMB Network was created. At the European Oral Microbiology Workshop in 2008, 12 laboratories processing clinical oral microbiological samples were identified. All these were recruited to participate into the study and six laboratories from six European countries completed both the online survey and the first QC round. Three additional laboratories participated in the second round. Based on the survey, European oral microbiology laboratories process a significant (mean per laboratory 4,135 number of diagnostic samples from the oral cavity annually. A majority of the laboratories did not participate in any internal or external QC programme and nearly half of the laboratories did not have standard operating procedures for the tests they performed. In both QC rounds, there was a large variation in the results, interpretation and reporting of antibiotic susceptibility testing among the laboratories. In conclusion, the results of this study demonstrate the need for harmonisation of laboratory processing methods and interpretation of results for oral microbiology specimens. The QC rounds highlighted the value of external QC in evaluating the efficacy and safety of processes, materials and methods used in the laboratory. The use of standardised methods is also a prerequisite for multi-centre epidemiological studies that can provide important information on emerging microbes and trends in anti-microbial susceptibility for empirical prescribing in oro-facial infections.

  2. Laboratory quality stepwise implementation tool: National reference TB laboratory of Iran

    OpenAIRE

    Ali Naghi Kebriaee; Donya Malekshahian; Mojtaba Ahmadi; Parissa Farnia

    2015-01-01

    Background and objective: During recent years, the World Health Organization (WHO) proposed new software for improving the tuberculosis (TB) laboratory services. The protocol is known as “quality stepwise implementation tool” and is based on enforcement of quality assurance services through accreditation by the International Organization for Standardization (ISO) 15189. As a national reference TB laboratory (NRL) of Iran, the benefit and challenges of implementing this standard were analyzed....

  3. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1: ASC software quality engineering practices, Version 2.0.

    Energy Technology Data Exchange (ETDEWEB)

    Sturtevant, Judith E.; Heaphy, Robert; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Minana, Molly A.; Hackney, Patricia; Forsythe, Christi A.; Schofield, Joseph Richard, Jr. (,; .); Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2006-09-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR 1.3.2 and 1.3.6 and to a Department of Energy document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines. This document also identifies ASC management and software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  4. Quality assurance programme for isotope diagnostic laboratories

    International Nuclear Information System (INIS)

    Krasznai, Istvan

    1987-01-01

    Quality assurance systems are suggested to be introduced in laboratories, in accordance with the recommendations of IAEA and WHO, taking local circumstances into consideration. It is emphasized that a quantitative enhancement of work must not endanger its quality; diagnostic information must be undistorted, reproducible, and gathered with the minimum of radiation burden. National authorities are requested to strengthen their supervision. Recommendations for quality assurance methods are given for medical isotope diagnostic laboratories. (author)

  5. Quality control activities in the environmental radiology laboratory

    International Nuclear Information System (INIS)

    Llaurado, M.; Quesada, D.; Rauret, G.; Tent, J.; Zapata, D.

    2006-01-01

    During the last twenty years many analytical laboratories have implemented quality assurance systems. A quality system implementation requires documentation of all activities (technical and management), evaluation of these activities and its continual improvement. Implementation and adequate management of all the elements a quality system includes are not enough to guarantee quality of the analytical results generated at a time. That is the aim of a group of specific activities labelled as quality control activities. The Laboratori de Radiologia Ambiental (Environmental Radiology Laboratory; LRA) at the University of Barcelona was created in 1984 to carry out part of the quality control assays of the Environmental Radiology Monitoring Programs around some of the Spanish nuclear power plants, which are developed by the Servei Catala d'Activitats Energetiques (SCAR) and the Consejo de Seguridad Nuclear (CSN), organisations responsible for nuclear security and radiological protection. In these kind of laboratories, given the importance of the results they give, quality control activities become an essential aspect. In order to guarantee the quality of its analytical results, the LRA Direction decided to adopt the international standard UNE-EN ISO/IEC 17025 for its internal quality system and to accreditate some of the assays it carries out. In such as system, it is established, the laboratory shall monitor the validity of tests undertaken and data shall be recorded in such a way that trends are detectable. The present work shows the activities carried out in this way by the LRA, which are: Equipment control activities which in the special case of radiochemical techniques include measurement of backgrounds and blanks as well as periodical control of efficiency and resolution. Activities to assure the specifications settled by method validation, which are testing of reference materials and periodical analysis of control samples. Evaluation of the laboratory work quality

  6. Quality assurance for analitical dairy laboratories

    Directory of Open Access Journals (Sweden)

    Šimun Zamberlin

    2005-04-01

    Full Text Available Quality evaluation of analytical laboratories must be estimated through accuracy, precision and traceability of measurement results. In European countries, acceptable analytical results are those which come from accredited laboratories (EN ISO/IEC 17025:2000. This paper presents examples of traceability, measurement uncertainty, inner quality control and control through the interlaboratory proficiency testing of results for milk fat. Also it demonstrates proficiency testing organization of results for fat, protein, lactose and somatic cells in milk.

  7. The economic impact of poor sample quality in clinical chemistry laboratories: results from a global survey.

    Science.gov (United States)

    Erdal, Erik P; Mitra, Debanjali; Khangulov, Victor S; Church, Stephen; Plokhoy, Elizabeth

    2017-03-01

    Background Despite advances in clinical chemistry testing, poor blood sample quality continues to impact laboratory operations and the quality of results. While previous studies have identified the preanalytical causes of lower sample quality, few studies have examined the economic impact of poor sample quality on the laboratory. Specifically, the costs associated with workarounds related to fibrin and gel contaminants remain largely unexplored. Methods A quantitative survey of clinical chemistry laboratory stakeholders across 10 international regions, including countries in North America, Europe and Oceania, was conducted to examine current blood sample testing practices, sample quality issues and practices to remediate poor sample quality. Survey data were used to estimate costs incurred by laboratories to mitigate sample quality issues. Results Responses from 164 participants were included in the analysis, which was focused on three specific issues: fibrin strands, fibrin masses and gel globules. Fibrin strands were the most commonly reported issue, with an overall incidence rate of ∼3%. Further, 65% of respondents indicated that these issues contribute to analyzer probe clogging, and the majority of laboratories had visual inspection and manual remediation practices in place to address fibrin- and gel-related quality problems (55% and 70%, respectively). Probe maintenance/replacement, visual inspection and manual remediation were estimated to carry significant costs for the laboratories surveyed. Annual cost associated with lower sample quality and remediation related to fibrin and/or gel globules for an average US laboratory was estimated to be $100,247. Conclusions Measures to improve blood sample quality present an important step towards improved laboratory operations.

  8. ISO 15189 accreditation: Requirements for quality and competence of medical laboratories, experience of a laboratory I.

    Science.gov (United States)

    Guzel, Omer; Guner, Ebru Ilhan

    2009-03-01

    Medical laboratories are the key partners in patient safety. Laboratory results influence 70% of medical diagnoses. Quality of laboratory service is the major factor which directly affects the quality of health care. The clinical laboratory as a whole has to provide the best patient care promoting excellence. International Standard ISO 15189, based upon ISO 17025 and ISO 9001 standards, provides requirements for competence and quality of medical laboratories. Accredited medical laboratories enhance credibility and competency of their testing services. Our group of laboratories, one of the leading institutions in the area, had previous experience with ISO 9001 and ISO 17025 Accreditation at non-medical sections. We started to prepared for ISO 15189 Accreditation at the beginning of 2006 and were certified in March, 2007. We spent more than a year to prepare for accreditation. Accreditation scopes of our laboratory were as follows: clinical chemistry, hematology, immunology, allergology, microbiology, parasitology, molecular biology of infection serology and transfusion medicine. The total number of accredited tests is 531. We participate in five different PT programs. Inter Laboratory Comparison (ILC) protocols are performed with reputable laboratories. 82 different PT Program modules, 277 cycles per year for 451 tests and 72 ILC program organizations for remaining tests have been performed. Our laboratory also organizes a PT program for flow cytometry. 22 laboratories participate in this program, 2 cycles per year. Our laboratory has had its own custom made WEB based LIS system since 2001. We serve more than 500 customers on a real time basis. Our quality management system is also documented and processed electronically, Document Management System (DMS), via our intranet. Preparatory phase for accreditation, data management, external quality control programs, personnel related issues before, during and after accreditation process are presented. Every laboratory has

  9. Research report 1987-1989: Environmental Quality Laboratory and Environmental Engineering Science, W. M. Keck Laboratories

    OpenAIRE

    Brooks, Norman H.

    1990-01-01

    This research biennial report for 1987-89 covers the activities of both the Environmental Engineering Science program and the Environmental Quality Laboratory for the period October 1987-November 1989. Environmental Engineering Science is the degree-granting academic program housed in the Keck Laboratories, with associated research projects. The Environmental Quality Laboratory is a research center focusing on large scale problems of environmental quality and natural resources. All the facult...

  10. Quality assurance on the Idaho National Engineering Laboratory Buried Waste Program

    International Nuclear Information System (INIS)

    Rasmussen, T.L.

    1989-01-01

    This paper discusses the clean-up of an Idaho National Engineering Laboratory (INEL) site utilized for disposal of transuranic contaminated waste from 1954 until 1970. The author presents requirements of the environmental protection statutes that have generated quality assurance requirements in addition to those historically implemented as a part of facility design, construction and operation. A hierarchy of program guidance quality documentation and procedures is discussed. Data qualification and computer database management are identified as requirements

  11. Quality assurance system in gamma spectrometry laboratory

    International Nuclear Information System (INIS)

    Mielnikow, A.; Michalik, B.; Chalupnik, S.; Lebecka, J.

    1996-01-01

    On basis of guidelines for development of QUALITY SYSTEM for a testing laboratory (European Standard Series EN 45000) a quality assurance system was implemented in gamma spectroscopy laboratory, where routine measurements of natural (mainly Ra-226, Ra-228, Ra-224, K-40) and artificial (mainly Cs-137 and Cs-134) isotopes are performed. We measure a variety of samples, but mainly coal, vaste rock, ashe, deposits, vegetation and air filters. Laboratory of gamma spectroscopy in Central Mining Institute has three HPGe detectors. There is one coaxial detector with 45% relative efficiency, one detector for low energy region and one detector with extended range). We have also two Ge(Li) detectors from former Czechoslovakia. Shielding is made mainly of steel (40 cm) with the interior covered with lead and copper. The electronics and software (Genie-PC) was bought at 'Canberra' and 'Silena'. The paper describes not only the system of quality assurance but also main problems met by its implementation and results of intercomparison measurements. The QAS has been introduced in 1992. In 1993 the Accreditation Certificate of Testing Laboratory for our Laboratory has been obtained from the Polish Bureau of Research and Certification as a fifth laboratory in Poland. (author)

  12. Implementing a Quality Management System in the Medical Microbiology Laboratory.

    Science.gov (United States)

    Carey, Roberta B; Bhattacharyya, Sanjib; Kehl, Sue C; Matukas, Larissa M; Pentella, Michael A; Salfinger, Max; Schuetz, Audrey N

    2018-07-01

    This document outlines a comprehensive practical approach to a laboratory quality management system (QMS) by describing how to operationalize the management and technical requirements described in the ISO 15189 international standard. It provides a crosswalk of the ISO requirements for quality and competence for medical laboratories to the 12 quality system essentials delineated by the Clinical and Laboratory Standards Institute. The quality principles are organized under three main categories: quality infrastructure, laboratory operations, and quality assurance and continual improvement. The roles and responsibilities to establish and sustain a QMS are outlined for microbiology laboratory staff, laboratory management personnel, and the institution's leadership. Examples and forms are included to assist in the real-world implementation of this system and to allow the adaptation of the system for each laboratory's unique environment. Errors and nonconforming events are acknowledged and embraced as an opportunity to improve the quality of the laboratory, a culture shift from blaming individuals. An effective QMS encourages "systems thinking" by providing a process to think globally of the effects of any type of change. Ultimately, a successful QMS is achieved when its principles are adopted as part of daily practice throughout the total testing process continuum. Copyright © 2018 American Society for Microbiology.

  13. Los Alamos National Laboratory Yucca Mountain Site Characterization Project 1994 quality program status report

    International Nuclear Information System (INIS)

    Bolivar, S.L.

    1996-03-01

    This status report is for calendar year 1994. It summarizes the annual activities and accomplishments of the Los Alamos National Laboratory Yucca Mountain Site Characterization Project (YMP or Project) quality assurance program. By identifying the accomplishments of the quality program, a baseline is established that will assist in decision making, improve administrative controls and predictability, and allow us to annually identify adverse trends and to evaluate improvements. This is the fourth annual status report

  14. Los Alamos National Laboratory Yucca Mountain Site Characterization Project 1994 quality program status report

    Energy Technology Data Exchange (ETDEWEB)

    Bolivar, S.L.

    1996-03-01

    This status report is for calendar year 1994. It summarizes the annual activities and accomplishments of the Los Alamos National Laboratory Yucca Mountain Site Characterization Project (YMP or Project) quality assurance program. By identifying the accomplishments of the quality program, a baseline is established that will assist in decision making, improve administrative controls and predictability, and allow us to annually identify adverse trends and to evaluate improvements. This is the fourth annual status report.

  15. 7 CFR 58.523 - Laboratory and quality control tests.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Laboratory and quality control tests. 58.523 Section... Service 1 Operations and Operating Procedures § 58.523 Laboratory and quality control tests. (a) Quality control tests shall be made on samples as often as necessary to determine the shelf-life and stability of...

  16. The quality of veterinary in-clinic and reference laboratory biochemical testing.

    Science.gov (United States)

    Rishniw, Mark; Pion, Paul D; Maher, Tammy

    2012-03-01

    Although evaluation of biochemical analytes in blood is common in veterinary practice, studies assessing the global quality of veterinary in-clinic and reference laboratory testing have not been reported. The aim of this study was to assess the quality of biochemical testing in veterinary laboratories using results obtained from analyses of 3 levels of assayed quality control materials over 5 days. Quality was assessed by comparison of calculated total error with quality requirements, determination of sigma metrics, use of a quality goal index to determine factors contributing to poor performance, and agreement between in-clinic and reference laboratory mean results. The suitability of in-clinic and reference laboratory instruments for statistical quality control was determined using adaptations from the computerized program, EZRules3. Reference laboratories were able to achieve desirable quality requirements more frequently than in-clinic laboratories. Across all 3 materials, > 50% of in-clinic analyzers achieved a sigma metric ≥ 6.0 for measurement of 2 analytes, whereas > 50% of reference laboratory analyzers achieved a sigma metric ≥ 6.0 for measurement of 6 analytes. Expanded uncertainty of measurement and ± total allowable error resulted in the highest mean percentages of analytes demonstrating agreement between in-clinic and reference laboratories. Owing to marked variation in bias and coefficient of variation between analyzers of the same and different types, the percentages of analytes suitable for statistical quality control varied widely. These findings reflect the current state-of-the-art with regard to in-clinic and reference laboratory analyzer performance and provide a baseline for future evaluations of the quality of veterinary laboratory testing. © 2012 American Society for Veterinary Clinical Pathology.

  17. Data analysis considerations for pesticides determined by National Water Quality Laboratory schedule 2437

    Science.gov (United States)

    Shoda, Megan E.; Nowell, Lisa H.; Stone, Wesley W.; Sandstrom, Mark W.; Bexfield, Laura M.

    2018-04-02

    In 2013, the U.S. Geological Survey National Water Quality Laboratory (NWQL) made a new method available for the analysis of pesticides in filtered water samples: laboratory schedule 2437. Schedule 2437 is an improvement on previous analytical methods because it determines the concentrations of 225 fungicides, herbicides, insecticides, and associated degradates in one method at similar or lower concentrations than previously available methods. Additionally, the pesticides included in schedule 2437 were strategically identified in a prioritization analysis that assessed likelihood of occurrence, prevalence of use, and potential toxicity. When the NWQL reports pesticide concentrations for analytes in schedule 2437, the laboratory also provides supplemental information useful to data users for assessing method performance and understanding data quality. That supplemental information is discussed in this report, along with an initial analysis of analytical recovery of pesticides in water-quality samples analyzed by schedule 2437 during 2013–2015. A total of 523 field matrix spike samples and their paired environmental samples and 277 laboratory reagent spike samples were analyzed for this report (1,323 samples total). These samples were collected in the field as part of the U.S. Geological Survey National Water-Quality Assessment groundwater and surface-water studies and as part of the NWQL quality-control program. This report reviews how pesticide samples are processed by the NWQL, addresses how to obtain all the data necessary to interpret pesticide concentrations, explains the circumstances that result in a reporting level change or the occurrence of a raised reporting level, and describes the calculation and assessment of recovery. This report also discusses reasons why a data user might choose to exclude data in an interpretive analysis and outlines the approach used to identify the potential for decreased data quality in the assessment of method recovery. The

  18. Quality control of parasitology stool examination in Tabriz clinical laboratories

    Directory of Open Access Journals (Sweden)

    shahram Khademvatan

    2011-06-01

    Full Text Available The purpose of quality control program was to make doctors and laboratory personnel trust in laboratory results and consequently increasing confidence in laboratory achievements. The quality assurance means raising the level of quality in all tests that lead to raising the level of work efficiency and laboratories including minimum expense for society and minimum time for lab personnel. This study aimed to assess and determine the accuracy and precision of results in Tabriz medical diagnostic laboratories. Materials and Methods: In this retrospective study, 790 stool samples were selected randomly and tested by standard methods.Student t- test, SPSS software and sensitivity and accuracy formulas were used for data analysis. Results: The sensitivity was 62%, 22% and 8% with 95% confidence intervals for worm's eggs, protozoan cysts and trophozoite detection respectively. Conclusion: To elevate quality assurance in clinical diagnostic laboratory, monitoring and check of the laboratories by standard methods continually should be done.

  19. Radioanalytical laboratory quality control: Current status at Tennessee Valley Authority's western area radiological laboratory

    International Nuclear Information System (INIS)

    Rogers, W.J.

    1986-01-01

    The Tennessee Valley Authority operates a laboratory for radiological analysis of nuclear plant environmental monitoring samples and also for analysis of environmental samples from uranium mining and milling decommissioning activities. The laboratory analyzes some 9,000 samples per year and employs approximately 20 people as analysts, sample collectors, and supervisory staff members. The laboratory is supported by a quality control section of four people involved in computer support, production of radioactive standards, quality control data assessment and reporting, and internal reviews of compliance. The entire laboratory effort is controlled by 60 written procedures or standards. An HP-1000 computer and data base software are used to schedule samples for collection, assign and schedule samples within the laboratory for preparation and analysis, calculate sample activity, review data, and report data outside the laboratory. Gamma spectroscopy systems with nine germanium detectors, an alpha spectroscopy system, five alpha/beta counters, two liquid scintillation counters, four beta-gamma coincidence systems, two sodium iodide single-channel systems, and four photomultipliers for counting Lucas cells are all employed. Each device has various calibration and quality control checks performed on it routinely. Logbooks and control charts are in use for each instrument

  20. Medical laboratories in sub-Saharan Africa that meet international quality standards.

    Science.gov (United States)

    Schroeder, Lee F; Amukele, Timothy

    2014-06-01

    A recent survey of laboratories in Kampala, Uganda, demonstrated that only 0.3% of laboratories (3/954) met international quality standards. To benchmark laboratory quality throughout the rest of sub-Saharan Africa (SSA), we compiled a list of SSA laboratories meeting international quality standards. Accrediting bodies were queried via online registries or direct communication in May 2013. There were 380 laboratories accredited to international standards in SSA. Ninety-one percent were in South Africa. Thirty-seven of 49 countries had no laboratories accredited to international quality standards. Accredited laboratory density (per million people) in South Africa, Namibia, and Botswana were similar to those in many European countries. Single variable linear regression showed a correlation between accredited laboratory density and health expenditures per person (adjusted R(2) = 0.81, P clinical laboratory. For those that do, there is a strong correlation between country-specific accredited laboratory density and per-capita health expenditures. Copyright© by the American Society for Clinical Pathology.

  1. Laboratory quality management system: Road to accreditation and beyond

    Directory of Open Access Journals (Sweden)

    V Wadhwa

    2012-01-01

    Full Text Available This review attempts to clarify the concepts of Laboratory Quality Management System (Lab QMS for a medical testing and diagnostic laboratory in a holistic way and hopes to expand the horizon beyond quality control (QC and quality assurance. It provides an insight on accreditation bodies and highlights a glimpse of existing laboratory practices but essentially it takes the reader through the journey of accreditation and during the course of reading and understanding this document, prepares the laboratory for the same. Some of the areas which have not been highlighted previously include: requirement for accreditation consultants, laboratory infrastructure and scope, applying for accreditation, document preparation. This section is well supported with practical illustrations and necessary tables and exhaustive details like preparation of a standard operating procedure and a quality manual. Concept of training and privileging of staff has been clarified and a few of the QC exercises have been dealt with in a novel way. Finally, a practical advice for facing an actual third party assessment and caution needed to prevent post-assessment pitfalls has been dealt with.

  2. Troubles for the sustainability of the quality assurance in the laboratories of radiological control in Peru

    International Nuclear Information System (INIS)

    Gonzales, Susana; Lopez, Edith

    2008-01-01

    Full text: The Nuclear Energy Peruvian Institute (IPEN) has laboratories which offer services of radiological control. Radiometric analysis in raw and processed foodstuff is requested by several enterprises of both public and private sectors which uses the results for trading purposes like exportation, importation and licitations. The service of assays and calibration with reliable results has become a need due to the external audits performed by accredited laboratories to fulfil the requirements of the Peruvian standard organism. With the support of the International Atomic Energy Agency (IAEA), the IPEN laboratory of radiometric analysis implemented its quality system in 2001 under the ISO IEC 17025 Standard 'General Requirements for the Competence of the Calibration and Testing Laboratories' with the purpose to organize the activities and offer an enhanced service to the clients. The implementation of the quality system has allowed giving a better service with enhanced efficiency to the clients, assuring the reliability of the final output, the analytical results. It had been possible since the laboratories have participated in worldwide proficiency tests sponsored by the IAEA and currently work with reference material. The quality system allows identifying potential faults in any stage of the process in order to prevent any problem in the final output, assuring the appropriate quality of the issued analytical results and to take the necessary corrective actions to avoid those events to happen again. This study has identified and assessed several difficulties and troubles which prevent to fulfil the requirements of the Quality Standard and as a consequence, disable the sustainability of the quality systems and prevent the accreditation. Several proposals and solution alternatives which involve the Executive Staff and the proactive participation of the personnel are presented. (author)

  3. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan : ASC software quality engineering practices Version 3.0.

    Energy Technology Data Exchange (ETDEWEB)

    Turgeon, Jennifer L.; Minana, Molly A.; Hackney, Patricia; Pilch, Martin M.

    2009-01-01

    The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in the US Department of Energy/National Nuclear Security Agency (DOE/NNSA) Quality Criteria, Revision 10 (QC-1) as 'conformance to customer requirements and expectations'. This quality plan defines the SNL ASC Program software quality engineering (SQE) practices and provides a mapping of these practices to the SNL Corporate Process Requirement (CPR) 001.3.6; 'Corporate Software Engineering Excellence'. This plan also identifies ASC management's and the software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals. This SNL ASC Software Quality Plan establishes the signatories commitments to improving software products by applying cost-effective SQE practices. This plan enumerates the SQE practices that comprise the development of SNL ASC's software products and explains the project teams opportunities for tailoring and implementing the practices.

  4. Phlebotomy and quality in the African laboratory

    Directory of Open Access Journals (Sweden)

    Henry A. Mbah

    2014-08-01

    Full Text Available Phlebotomy, the act of drawing blood through venepuncture, is one of the most common medical procedures in healthcare, as well as being a basis for diagnosis and treatment. A review of the available research has highlighted the dearth of information on the phlebotomy practice in Africa. Several studies elsewhere have shown that the pre-analytical phase (patient preparation, specimen collection and identification, transportation, preparation for analysis and storage is the most error-prone process in laboratory medicine. The validity of any laboratory test result hinges on specimen quality; thus, as the push for laboratory quality improvement in Africa gathers momentum, the practice of phlebotomy should be subjected to critical appraisal. This article offers several suggestions for the improvement of phlebotomy in Africa.

  5. Practices for Identifying and Rejecting Hemolyzed Specimens Are Highly Variable in Clinical Laboratories.

    Science.gov (United States)

    Howanitz, Peter J; Lehman, Christopher M; Jones, Bruce A; Meier, Frederick A; Horowitz, Gary L

    2015-08-01

    Hemolysis is an important clinical laboratory quality attribute that influences result reliability. To determine hemolysis identification and rejection practices occurring in clinical laboratories. We used the College of American Pathologists Survey program to distribute a Q-Probes-type questionnaire about hemolysis practices to Chemistry Survey participants. Of 3495 participants sent the questionnaire, 846 (24%) responded. In 71% of 772 laboratories, the hemolysis rate was less than 3.0%, whereas in 5%, it was 6.0% or greater. A visual scale, an instrument scale, and combination of visual and instrument scales were used to identify hemolysis in 48%, 11%, and 41% of laboratories, respectively. A picture of the hemolysis level was used as an aid to technologists' visual interpretation of hemolysis levels in 40% of laboratories. In 7.0% of laboratories, all hemolyzed specimens were rejected; in 4% of laboratories, no hemolyzed specimens were rejected; and in 88% of laboratories, some specimens were rejected depending on hemolysis levels. Participants used 69 different terms to describe hemolysis scales, with 21 terms used in more than 10 laboratories. Slight and moderate were the terms used most commonly. Of 16 different cutoffs used to reject hemolyzed specimens, moderate was the most common, occurring in 30% of laboratories. For whole blood electrolyte measurements performed in 86 laboratories, 57% did not evaluate the presence of hemolysis, but for those that did, the most common practice in 21 laboratories (24%) was centrifuging and visually determining the presence of hemolysis in all specimens. Hemolysis practices vary widely. Standard assessment and consistent reporting are the first steps in reducing interlaboratory variability among results.

  6. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan part 2 mappings for the ASC software quality engineering practices, version 2.0.

    Energy Technology Data Exchange (ETDEWEB)

    Heaphy, Robert; Sturtevant, Judith E.; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Minana, Molly A.; Hackney, Patricia; Forsythe, Christi A.; Schofield, Joseph Richard, Jr. (,; .); Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2006-09-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR001.3.2 and CPR001.3.6 and to a Department of Energy document, ''ASCI Software Quality Engineering: Goals, Principles, and Guidelines''. This document also identifies ASC management and software project teams' responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  7. Has compliance with CLIA requirements really improved quality in US clinical laboratories?

    Science.gov (United States)

    Ehrmeyer, Sharon S; Laessig, Ronald H

    2004-08-02

    The Clinical Laboratory Improvement Amendments of 1988 (CLIA'88) mandate universal requirements for all U.S. clinical laboratory-testing sites. The intent of CLIA'88 is to ensure quality testing through a combination of minimum quality practices that incorporate total quality management concepts. These regulations do not contain established, objective indicators or measures to assess quality. However, there is an implicit assumption that compliance with traditionally accepted good laboratory practices--following manufacturers' directions, routinely analysing quality control materials, applying quality assurance principles, employing and assessing competent testing personnel, and participating in external quality assessment or proficiency testing (PT)--will result in improved test quality. The CLIA'88 regulations do include PT performance standards, which intentionally or unintentionally, define intra-laboratory performance. Passing PT has become a prime motivation for improving laboratory performance; it can also be used as an objective indicator to assess whether compliance to CLIA has improved intra-laboratory quality. Data from 1994 through 2002 indicate that the percentage of laboratories passing PT has increased. In addition to PT performance, subjective indicators of improved quality--frequency of inspection deficiencies, the number of government sanctions for non-compliance, and customer satisfaction--were evaluated. The results from these subjective indicators are more difficult to interpret but also seem to show improved quality in US clinical laboratories eleven years post-CLIA'88.

  8. Environmental Quality Laboratory Research Report, 1985-1987

    OpenAIRE

    Brooks, Norman H.

    1988-01-01

    The Environmental Quality Laboratory at Caltech is a center for research on large-scale systems problems of natural resources and environmental quality. The principal areas of investigation at EQL are: 1. Air quality management. 2. Water resources and water quality management. 3. Control of hazardous substances in the environment. 4. Energy policy, including regulation, conservation and energy-environment tradeoffs. 5. Resources policy (other than energy); residuals m...

  9. 7 CFR 58.442 - Laboratory and quality control tests.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Laboratory and quality control tests. 58.442 Section... Service 1 Operations and Operating Procedures § 58.442 Laboratory and quality control tests. (a) Chemical... Methods or by other methods giving equivalent results. (b) Weight or volume control. Representative...

  10. Analytical laboratory quality assurance guidance in support of EM environmental sampling and analysis activities

    International Nuclear Information System (INIS)

    1994-05-01

    This document introduces QA guidance pertaining to design and implementation of laboratory procedures and processes for collecting DOE Environmental Restoration and Waste Management (EM) ESAA (environmental sampling and analysis activities) data. It addresses several goals: identifying key laboratory issues and program elements to EM HQ and field office managers; providing non-prescriptive guidance; and introducing environmental data collection program elements for EM-263 assessment documents and programs. The guidance describes the implementation of laboratory QA elements within a functional QA program (development of the QA program and data quality objectives are not covered here)

  11. Quality system implementation in the Radiotoxicology Laboratory of IPEN, Brazil

    International Nuclear Information System (INIS)

    Gaburo, J.C.; Caldeira Filho, J.S.; Todo, A.S.; Sanches, M.; Campos, L.L.

    2002-01-01

    The perception of assured quality is getting more transparence in the research and development areas. The Radiotoxicology Laboratory, LRT, of IPEN, operating since 1978, has as main attribution the development and implantation of analytical techniques for the measurements of different radionuclides in biological samples. Thus, the LRT considers being of extreme importance to have a management of the quality system to guarantee the reliability of the results and to obtain Accreditation Certificate of the National Institute of Metrology, INMETRO. With this objective the LRT has participated of projects of quality assurance for analytical laboratories since 1997, promoted by International Atomic Energy Agency, IAEA. Currently the quality system of the LRT is in implementation phase, operating in compliance with the quality system of IPEN (consistent pair ISO 9001-9004:2000) and with NBR ISO/IEC 17025. The quality system implemented in the LRT is described in its Quality Manual, MQ-LRT and in complementary procedures that are in their first revision. The participation of the laboratory in intercomparison programs among national as international laboratories and the analysis of the results of internal as well as external audits has demonstrated that the LRT laboratory presents good performance and with suitable methodology and accurate and precise results. With the implementation of the quality system it was possible to verify the effectiveness and efficiency of the tests carried out in the Radiotoxicology Laboratory. The project ARCAL XXVI was concluded in November 2001 and the LRT earned the Certificate of Recognition by IAEA. (author)

  12. Iowa Central Quality Fuel Testing Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Heach, Don; Bidieman, Julaine

    2013-09-30

    The objective of this project is to finalize the creation of an independent quality fuel testing laboratory on the campus of Iowa Central Community College in Fort Dodge, Iowa that shall provide the exploding biofuels industry a timely and cost-effective centrally located laboratory to complete all state and federal fuel and related tests that are required. The recipient shall work with various state regulatory agencies, biofuel companies and state and national industry associations to ensure that training and testing needs of their members and American consumers are met. The recipient shall work with the Iowa Department of Ag and Land Stewardship on the development of an Iowa Biofuel Quality Standard along with the Development of a standard that can be used throughout industry.

  13. Quality indicators in laboratory medicine: a fundamental tool for quality and patient safety.

    Science.gov (United States)

    Plebani, Mario; Sciacovelli, Laura; Marinova, Mariela; Marcuccitti, Jessica; Chiozza, Maria Laura

    2013-09-01

    The identification of reliable quality indicators (QIs) is a crucial step in enabling users to quantify the quality of laboratory services. The current lack of attention to extra-laboratory factors is in stark contrast with the body of evidence pointing to the multitude of errors that continue to occur in the pre- and post-analytical phases. Different QIs and terminologies are currently used and, therefore, there is the need to harmonize proposed QIs. A model of quality indicators (MQI) has been consensually developed by a group of clinical laboratories according to a project launched by a working group of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC). The model includes 57 QIs related to key processes (35 pre-, 7 intra- and 15 post-analytical phases) and 3 to support processes. The developed MQI and the data collected provide evidence of the feasibility of the project to harmonize currently available QIs, but further efforts should be done to involve more clinical laboratories and to collect a more consistent amount of data. Copyright © 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  14. Quality assurance in radionuclide laboratories

    International Nuclear Information System (INIS)

    Otto, R.; Voelkle, H.; Wershofen, H.; Wilhelm, C.

    2003-01-01

    The authors are members of an ad-hoc working group preparing a contribution to the procedures manual (''Loseblattsammlung'') dealing with quality assurance and quality control in radionuclide laboratories. The Loseblattsammlung is edited by the working group ''Environmental Monitoring'' of the German-Swiss Radiological Protection Association. The intention of the manual under preparation is not to give a procedure on how to establish a quality management system allowing for an accreditation in accordance with the international standard DIN EN ISO/IEC 17025:2000 04 (''ISO 17025'') [1] but to compile routine quality control procedures necessary for reliable measurements and to give tips to the practitioner on how to keep both the extent and the frequency of procedures on a reasonable level. A short version of the Loseblatt is presented here. (orig.)

  15. Quality assurance in medical laboratories

    International Nuclear Information System (INIS)

    Boroviczeny, K.G. von; Merten, R.; Merten, U.P.

    1987-01-01

    The book presents a comprehensive and specified survey of the quality assurance measures and methods applied in medical laboratories in the pre-analytical phase and in the analytical and post-analytical phases. It also gives information on computer-aided procedures, cost-benefit analyses in this field, and on official requirements and standards in the fields of clinical chemistry, hematology, immunology and microbiology, and equipment testing and inspection. One chapter of the book particularly deals with quality assurance for radioimmunological in-vitro analyses. With 112 figs., 337 tabs [de

  16. Approaches to quality management and accreditation in a genetic testing laboratory

    Science.gov (United States)

    Berwouts, Sarah; Morris, Michael A; Dequeker, Elisabeth

    2010-01-01

    Medical laboratories, and specifically genetic testing laboratories, provide vital medical services to different clients: clinicians requesting a test, patients from whom the sample was collected, public health and medical-legal instances, referral laboratories and authoritative bodies. All expect results that are accurate and obtained in an efficient and effective manner, within a suitable time frame and at acceptable cost. There are different ways of achieving the end results, but compliance with International Organization for Standardization (ISO) 15189, the international standard for the accreditation of medical laboratories, is becoming progressively accepted as the optimal approach to assuring quality in medical testing. We present recommendations and strategies designed to aid genetic testing laboratories with the implementation of a quality management system, including key aspects such as document control, external quality assessment, internal quality control, internal audit, management review, validation, as well as managing the human side of change. The focus is on pragmatic approaches to attain the levels of quality management and quality assurance required for accreditation according to ISO 15189, within the context of genetic testing. Attention is also given to implementing efficient and effective quality improvement. PMID:20720559

  17. Quality of Control of Clinical-Biochemical Laboratories – Serbian Case

    Directory of Open Access Journals (Sweden)

    Vinko Peric

    2014-06-01

    Full Text Available In the last 20 years in medical laboratories, numerous activities regarding quality and accreditation system were taken. Approach to this problem in European countries is different, so the task of the Accreditation Work Group of the Confederation of European societies for clinical chemistry (EC 4 to help the efforts to harmonize this issue. External quality control in clinical-chemical laboratories imposed the need for the implementation of quality management system. »Good laboratory practice« and its principles were adopted by nominated bodies, both international and national. In the beginning, the standard ISO 9001 was applied for certification and for accreditation EN 45001 and ISO Guide 25, which are prepared for testing and calibration laboratories. Standard ISO 17025 is the successor of the previous documents and for now it is a reference for mentioned laboratories. Accreditation Work Group of the Confederation of European societies for clinical chemistry (EC 4 made an amendment of the requirements for medical laboratories, which this standard describes. Standard draft ISO 15189 was adopted on February 2003 as a final version with requirements for medical laboratories.

  18. Analytical quality control concept in the Euratom on-site laboratories

    International Nuclear Information System (INIS)

    Mayer, K.; Duinslaeger, L.; Cromboom, O.; Ottmar, H.; Wojnowski, D.; Vegt, H. van der

    2001-01-01

    Full text: Two on-site laboratories have been developed, installed, commissioned and put into routine operation by the Euratom safeguards office (ESO), jointly with the Institute for Transuranium Elements (ITU). These laboratories are operated by ITU staff and provide verification measurement results on samples taken by Euratom inspectors. The analysts work in weekly changing shift teams, manage the laboratories and operate the various analytical techniques. Operating such a laboratory at a remote location, without a senior scientist immediately available in case of problems, The existing boundary conditions challenge the robustness of the entire laboratory, i.e. comprising staff and instrumentation. In order to continuously ensure a high degree of reliability of the measurement results, a stringent quality control system was implemented. The quality control concept for the two on-site laboratories was developed at a very early stage and implemented in the pre-OSL training facility at ITU. This enabled to thoroughly test and develop further the concept. At the same time the analysts get acquainted with the quality control procedures in place and they are instilled with the principles. The quality control concept makes use of a fully computerized data management and data acquisition system. All measurement devices, including balances, density meters, mass spectrometers, passive neutron counter, hybrid K-edge instrument, gamma spectrometers and alpha spectrometers are networked and data exchange is performed on electronic basis. A specifically developed laboratory information management system collects individual measurement data, calculates intermediate and final result and shares the information with a quality control module. In order to ensure the reliability of the results, which are reported to the ESO inspectorate, five levels of quality control were implemented. The present paper describes in detail the different levels of quality control, which check the

  19. ASVCP quality assurance guidelines: control of general analytical factors in veterinary laboratories.

    Science.gov (United States)

    Flatland, Bente; Freeman, Kathy P; Friedrichs, Kristen R; Vap, Linda M; Getzy, Karen M; Evans, Ellen W; Harr, Kendal E

    2010-09-01

    Owing to lack of governmental regulation of veterinary laboratory performance, veterinarians ideally should demonstrate a commitment to self-monitoring and regulation of laboratory performance from within the profession. In response to member concerns about quality management in veterinary laboratories, the American Society for Veterinary Clinical Pathology (ASVCP) formed a Quality Assurance and Laboratory Standards (QAS) committee in 1996. This committee recently published updated and peer-reviewed Quality Assurance Guidelines on the ASVCP website. The Quality Assurance Guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports on 1) general analytic factors for veterinary laboratory performance and comparisons, 2) hematology and hemostasis, and 3) clinical chemistry, endocrine assessment, and urinalysis. This report documents recommendations for control of general analytical factors within veterinary clinical laboratories and is based on section 2.1 (Analytical Factors Important In Veterinary Clinical Pathology, General) of the newly revised ASVCP QAS Guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimum guidelines for quality assurance and quality control for veterinary laboratory testing. It is hoped that these guidelines will provide a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts. ©2010 American Society for Veterinary Clinical Pathology.

  20. Quality assurance in the HIV/AIDS laboratory network of China.

    Science.gov (United States)

    Jiang, Yan; Qiu, Maofeng; Zhang, Guiyun; Xing, Wenge; Xiao, Yao; Pan, Pinliang; Yao, Jun; Ou, Chin-Yih; Su, Xueli

    2010-12-01

    In 2009, there were 8273 local screening laboratories, 254 confirmatory laboratories, 35 provincial confirmatory central laboratories and 1 National AIDS Reference Laboratory (NARL) in China. These laboratories were located in Center for Disease Control and Prevention (CDC) facilities, hospitals, blood donation clinics, maternal and child health (MCH) hospitals and border health quarantine health-care facilities. The NARL and provincial laboratories provide quality assurance through technical, bio-safety and managerial training; periodic proficiency testing; on-site supervisory inspections; and commercial serologic kit evaluations. From 2002 to 2009, more than 220 million HIV antibody tests were performed at screening laboratories, and all reactive and indeterminate samples were confirmed at confirmatory laboratories. The use of highly technically complex tests, including CD4 cell enumeration, viral load, dried blood spot (DBS)-based early infant diagnosis (EID), drug resistance (DR) genotyping, HIV-1 subtyping and incidence assays, have increased in recent years and their performance quality is closely monitored. China has made significant progress in establishing a well-coordinated HIV laboratory network and QA systems. However, the coverage and intensity of HIV testing and quality assurance programmes need to be strengthened so as to ensure that more infected persons are diagnosed and that they receive timely prevention and treatment services.

  1. Quality assurance of laboratory work and clinical use of laboratory tests in general practice in norway: a survey.

    Science.gov (United States)

    Thue, Geir; Jevnaker, Marianne; Gulstad, Guri Andersen; Sandberg, Sverre

    2011-09-01

    Virtually all the general practices in Norway participate in the Norwegian Quality Improvement of Laboratory Services in Primary Care, NOKLUS. In order to assess and develop NOKLUS's services, it was decided to carry out an investigation in the largest participating group, general practices. In autumn 2008 a questionnaire was sent to all Norwegian general practices asking for feedback on different aspects of NOKLUS's main services: contact with medical laboratory technologists, sending of control materials, use and maintenance of practice-specific laboratory binders, courses, and testing of laboratory equipment. In addition, attitudes were elicited towards possible new services directed at assessing other technical equipment and clinical use of tests. Responses were received from 1290 of 1552 practices (83%). The great majority thought that the frequency of sending out control material should continue as at present, and they were pleased with the feedback reports and follow-up by the laboratory technologists in the counties. Even after many years of practical experience, there is still a need to update laboratory knowledge through visits to practices, courses, and written information. Practices also wanted quality assurance of blood pressure meters and spirometers, and many doctors wanted feedback on their use of laboratory tests. Services regarding quality assurance of point-of-care tests, guidance, and courses should be continued. Quality assurance of other technical equipment and of the doctor's clinical use of laboratory tests should be established as part of comprehensive quality assurance.

  2. Performance Indicators For Quality In Surgical And Laboratory ...

    African Journals Online (AJOL)

    Methodology: Hospital records were reviewed and information recorded for planned and postponed operations, laboratory equipment, reagents, laboratory tests and quality assurance programmes. Results: In the year 2001 a total of 4332 non-emergency operations were planned, 3313 operations were performed and 1019 ...

  3. Evaluating laboratory key performance using quality indicators in Alexandria University Hospital Clinical Chemistry Laboratories.

    Science.gov (United States)

    Rizk, Mostafa M; Zaki, Adel; Hossam, Nermine; Aboul-Ela, Yasmin

    2014-12-01

    The performance of clinical laboratories plays a fundamental role in the quality and effectiveness of healthcare. To evaluate the laboratory performance in Alexandria University Hospital Clinical Laboratories using key quality indicators and to compare the performance before and after an improvement plan based on ISO 15189 standards. The study was carried out on inpatient samples for a period of 7 months that was divided into three phases: phase I included data collection for evaluation of the existing process before improvement (March-May 2012); an intermediate phase, which included corrective, preventive action, quality initiative and steps for improvement (June 2012); and phase II, which included data collection for evaluation of the process after improvement (July 2012-September 2012). In terms of the preanalytical indicators, incomplete request forms in phase I showed that the total number of received requests were 31 944, with a percentage of defected request of 33.66%; whereas in phase II, there was a significant reduction in all defected request items (Plaboratories.

  4. [Standardization in laboratory hematology by participating in external quality assurance programs].

    Science.gov (United States)

    Nazor, Aida; Siftar, Zoran; Flegar-Mestrić, Zlata

    2011-09-01

    Since 1985, Department of Clinical Chemistry and Laboratory Medicine, Merkur University Hospital, Zagreb, has been participating in the International External Quality Assessment Scheme for Hematology (IEQAS-H) organized by the World Health Organization (WHO). Owing to very good results, in 1987 the Department received a certificate of participation in this control scheme. Department has been cooperating in the external quality assessment program in laboratory hematology which has been continuously performed in Croatia since 1986 by the Committee for External Quality Assessment Schemes under the auspices of the Croatian Society of Medical Biochemists and School of Pharmacy and Biochemistry, University of Zagreb. Nowadays, 186 medical biochemical laboratories are included in the National External Quality Assessment program, which is performed three times per year. Our Department has participated in the international projects of the European Committee for External Quality Assurance Programs in Laboratory Medicine (EQALM).

  5. [External quality assessment in clinical biochemistry laboratories: pilot study in 11 laboratories of Lomé (Togo)].

    Science.gov (United States)

    Kouassi, Kafui; Fétéké, Lochina; Assignon, Selom; Dorkenoo, Ameyo; Napo-Koura, Gado

    2015-01-01

    This study aims to evaluate the performance of a few biochemistry analysis and make recommendations to the place of the stakeholders. It is a cross-sectional study conducted between the October 1(st), 2012 and the July 31, 2013 bearing on the results of 5 common examinations of clinical biochemistry, provided by 11 laboratories volunteers opening in the public and private sectors. These laboratories have analysed during the 3 cycles, 2 levels (medium and high) of serum concentration of urea, glucose, creatinine and serum aminotransferases. The performance of laboratories have been determined from the acceptable limits corresponding to the limits of total errors, defined by the French Society of Clinical Biology (SFBC). A system of internal quality control is implemented by all laboratories and 45% of them participated in international programs of external quality assessment (EQA). The rate of acceptable results for the entire study was of 69%. There was a significant difference (plaboratories engaged in a quality approach and the group with default implementation of the quality approach. Also a significant difference was observed between the laboratories of the central level and those of the peripheral level of our health system (plaboratories remains relatively unsatisfactory. It is important that the Ministry of Health put in place a national program of EQA with mandatory participation.

  6. Laboratory diagnosis of the rare anaemias: external quality assessment benefits patient care

    OpenAIRE

    Barbara De La Salle; Andrea Mosca; Renata Paleari; Vasileios Rapanakis; Keith Hyde

    2013-01-01

    Since its introduction in the 1960s, external quality assessment has developed to become an essential component of the quality management system of the diagnostic laboratory. External quality assessment provides a long term, retrospective view of laboratory performance, demonstrating the competence of the laboratory to others. The ENERCA project (the European Network for Rare and Congenital Anaemias) has established a list of core laboratory tests that are used in the diagnosis of rare and co...

  7. Sandia National Laboratories ASCI Applications Software Quality Engineering Practices; TOPICAL

    International Nuclear Information System (INIS)

    ZEPPER, JOHN D.; ARAGON, KATHRYN MARY; ELLIS, MOLLY A.; BYLE, KATHLEEN A.; EATON, DONNA SUE

    2002-01-01

    This document provides a guide to the deployment of the software verification activities, software engineering practices, and project management principles that guide the development of Accelerated Strategic Computing Initiative (ASCI) applications software at Sandia National Laboratories (Sandia). The goal of this document is to identify practices and activities that will foster the development of reliable and trusted products produced by the ASCI Applications program. Document contents include an explanation of the structure and purpose of the ASCI Quality Management Council, an overview of the software development lifecycle, an outline of the practices and activities that should be followed, and an assessment tool. These sections map practices and activities at Sandia to the ASCI Software Quality Engineering: Goals, Principles, and Guidelines, a Department of Energy document

  8. 222-S laboratory quality assurance plan

    International Nuclear Information System (INIS)

    Meznarich, H.K.

    1995-01-01

    This document provides quality assurance guidelines and quality control requirements for analytical services. This document is designed on the basis of Hanford Analytical Services Quality Assurance Plan (HASQAP) technical guidelines and is used for governing 222-S and 222-SA analytical and quality control activities. The 222-S Laboratory provides analytical services to various clients including, but not limited to, waste characterization for the Tank Waste Remediation Systems (TWRS), waste characterization for regulatory waste treatment, storage, and disposal (TSD), regulatory compliance samples, radiation screening, process samples, and TPA samples. A graded approach is applied on the level of sample custody, QC, data verification, and data reporting to meet the specific needs of the client

  9. Quality of HIV laboratory testing in Tanzania: a situation analysis ...

    African Journals Online (AJOL)

    December 2004 to February 2005 in 12 laboratories which were conveniently selected to represent all the zones of Tanzania. The questionnaires comprised of questions on laboratory particulars, internal and external quality control for HIV testing and quality control of reagents. Source and level of customer satisfaction of ...

  10. Los Alamos National Laboratory Yucca Mountain Site Characterization Project 1993 Quality Program status report

    International Nuclear Information System (INIS)

    Boliver, S.L.

    1995-05-01

    This status report is for calendar year 1993. It summarizes the annual activities and accomplishments of the Los Alamos National Laboratory (Los Alamos) Yucca Mountain Site Characterization Project (YMP or Project) quality assurance program. By identifying the accomplishments of the quality program, we establish a baseline that will assist in decision making, improve administrative controls and predictability, and allow us to annually identify long term trends and to evaluate improvements. This is the third annual status report (Bolivar, 1992; Bolivar, 1994). This report is divided into two primary sections: Program Activities and Trend Analysis. Under Program Activities, programmatic issues occurring in 1993 are discussed. The goals for 1993 are also listed, followed by a discussion of their status. Lastly, goals for 1994 are identified. The Trend Analysis section is a summary of 1993 quarterly trend reports and provides a good overview of the quality assurance issues of the Los Alamos YMP

  11. Los Alamos National Laboratory Yucca Mountain Site Characterization Project 1993 Quality Program status report

    Energy Technology Data Exchange (ETDEWEB)

    Bolivar, S.L.

    1995-05-01

    This status report is for calendar year 1993. It summarizes the annual activities and accomplishments of the Los Alamos National Laboratory (Los Alamos) Yucca Mountain Site Characterization Project (YMP or Project) quality assurance program. By identifying the accomplishments of the quality program, we establish a baseline that will assist in decision making, improve administrative controls and predictability, and allow us to annually identify long term trends and to evaluate improvements. This is the third annual status report (Bolivar, 1992; Bolivar, 1994). This report is divided into two primary sections: Program Activities and Trend Analysis. Under Program Activities, programmatic issues occurring in 1993 are discussed. The goals for 1993 are also listed, followed by a discussion of their status. Lastly, goals for 1994 are identified. The Trend Analysis section is a summary of 1993 quarterly trend reports and provides a good overview of the quality assurance issues of the Los Alamos YMP.

  12. Quality assurance practices in Europe: a survey of molecular genetic testing laboratories

    Science.gov (United States)

    Berwouts, Sarah; Fanning, Katrina; Morris, Michael A; Barton, David E; Dequeker, Elisabeth

    2012-01-01

    In the 2000s, a number of initiatives were taken internationally to improve quality in genetic testing services. To contribute to and update the limited literature available related to this topic, we surveyed 910 human molecular genetic testing laboratories, of which 291 (32%) from 29 European countries responded. The majority of laboratories were in the public sector (81%), affiliated with a university hospital (60%). Only a minority of laboratories was accredited (23%), and 26% was certified. A total of 22% of laboratories did not participate in external quality assessment (EQA) and 28% did not use reference materials (RMs). The main motivations given for accreditation were to improve laboratory profile (85%) and national recognition (84%). Nearly all respondents (95%) would prefer working in an accredited laboratory. In accredited laboratories, participation in EQA (Pquality assurance (Pquality implementation score (QIS), we showed that accredited laboratories (average score 92) comply better than certified laboratories (average score 69, Pquality indicators. We conclude that quality practices vary widely in European genetic testing laboratories. This leads to a potentially dangerous situation in which the quality of genetic testing is not consistently assured. PMID:22739339

  13. [CAP quality management system in clinical laboratory and its issue].

    Science.gov (United States)

    Tazawa, Hiromitsu

    2004-03-01

    The CAP (College of American Pathologists) was established in 1962 and, at present, CAP-accredited laboratories include about 6000 institutions all over the world, mainly in the U.S. The essential purpose of CAP accreditation is high quality reservation and improvement of clinical laboratory services for patient care, and is based on seven points, listed below. (1) Establishment of a laboratory management program and laboratory techniques to assure accuracy and improve overall quality of laboratory services. (2) Maintenance and improvement of accuracy objectively by centering on a CAP survey. (3) Thoroughness in safety and health administration. (4) Reservation of the performance of laboratory services by personnel and proficiency management. (5) Provision of appropriate information to physicians, and contribution to improved quality of patient care by close communication with physicians (improvement in patient care). (6) Reduction of running costs and personnel costs based on evidence by employing the above-mentioned criteria. (7) Reduction of laboratory error. In the future, accreditation and/or certification by organizations such as CAP, ISO, etc., may become a requirement for providing any clinical laboratory services in Japan. Taking the essence of the CAP and the characteristics of the new international standard, ISO151589, into consideration, it is important to choose the best suited accreditation and/or certification depending of the purpose of clinical laboratory.

  14. External quality assurance performance of clinical research laboratories in sub-saharan Africa.

    Science.gov (United States)

    Amukele, Timothy K; Michael, Kurt; Hanes, Mary; Miller, Robert E; Jackson, J Brooks

    2012-11-01

    Patient Safety Monitoring in International Laboratories (JHU-SMILE) is a resource at Johns Hopkins University that supports and monitors laboratories in National Institutes of Health-funded international clinical trials. To determine the impact of the JHU-SMILE quality assurance scheme in sub-Saharan African laboratories, we reviewed 40 to 60 months of external quality assurance (EQA) results of the College of American Pathologists (CAP) in these laboratories. We reviewed the performance of 8 analytes: albumin, alanine aminotransferase, creatinine, sodium, WBC, hemoglobin, hematocrit, and the human immunodeficiency virus antibody rapid test. Over the 40- to 60-month observation period, the sub-Saharan laboratories had a 1.63% failure rate, which was 40% lower than the 2011 CAP-wide rate of 2.8%. Seventy-six percent of the observed EQA failures occurred in 4 of the 21 laboratories. These results demonstrate that a system of remote monitoring, feedback, and audits can support quality in low-resource settings, even in places without strong regulatory support for laboratory quality.

  15. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1 : ASC software quality engineering practices version 1.0.

    Energy Technology Data Exchange (ETDEWEB)

    Minana, Molly A.; Sturtevant, Judith E.; Heaphy, Robert; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Forsythe, Christi A.; Schofield, Joseph Richard, Jr.; Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2005-01-01

    The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in DOE/AL Quality Criteria (QC-1) as conformance to customer requirements and expectations. This quality plan defines the ASC program software quality practices and provides mappings of these practices to the SNL Corporate Process Requirements (CPR 1.3.2 and CPR 1.3.6) and the Department of Energy (DOE) document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines (GP&G). This quality plan identifies ASC management and software project teams' responsibilities for cost-effective software engineering quality practices. The SNL ASC Software Quality Plan establishes the signatories commitment to improving software products by applying cost-effective software engineering quality practices. This document explains the project teams opportunities for tailoring and implementing the practices; enumerates the practices that compose the development of SNL ASC's software products; and includes a sample assessment checklist that was developed based upon the practices in this document.

  16. Implementation of Good Clinical Laboratory Practice (GCLP) guidelines within the External Quality Assurance Program Oversight Laboratory (EQAPOL).

    Science.gov (United States)

    Todd, Christopher A; Sanchez, Ana M; Garcia, Ambrosia; Denny, Thomas N; Sarzotti-Kelsoe, Marcella

    2014-07-01

    The EQAPOL contract was awarded to Duke University to develop and manage global proficiency testing programs for flow cytometry-, ELISpot-, and Luminex bead-based assays (cytokine analytes), as well as create a genetically diverse panel of HIV-1 viral cultures to be made available to National Institutes of Health (NIH) researchers. As a part of this contract, EQAPOL was required to operate under Good Clinical Laboratory Practices (GCLP) that are traditionally used for laboratories conducting endpoint assays for human clinical trials. EQAPOL adapted these guidelines to the management of proficiency testing programs while simultaneously incorporating aspects of ISO/IEC 17043 which are specifically designed for external proficiency management. Over the first two years of the contract, the EQAPOL Oversight Laboratories received training, developed standard operating procedures and quality management practices, implemented strict quality control procedures for equipment, reagents, and documentation, and received audits from the EQAPOL Central Quality Assurance Unit. GCLP programs, such as EQAPOL, strengthen a laboratory's ability to perform critical assays and provide quality assessments of future potential vaccines. © 2013.

  17. Role of a quality management system in improving patient safety - laboratory aspects.

    Science.gov (United States)

    Allen, Lynn C

    2013-09-01

    The aim of this study is to describe how implementation of a quality management system (QMS) based on ISO 15189 enhances patient safety. A literature review showed that several European hospitals implemented a QMS based on ISO 9001 and assessed the impact on patient safety. An Internet search showed that problems affecting patient safety have occurred in a number of laboratories across Canada. The requirements of a QMS based on ISO 15189 are outlined, and the impact of the implementation of each requirement on patient safety is summarized. The Quality Management Program - Laboratory Services in Ontario is briefly described, and the experience of Ontario laboratories with Ontario Laboratory Accreditation, based on ISO 15189, is outlined. Several hospitals that implemented ISO 9001 reported either a positive impact or no impact on patient safety. Patient safety problems in Canadian laboratories are described. Implementation of each requirement of the QMS can be seen to have a positive effect on patient safety. Average laboratory conformance on Ontario Laboratory Accreditation is very high, and laboratories must address and resolve any nonconformities. Other standards, practices, and quality requirements may also contribute to patient safety. Implementation of a QMS based on ISO 15189 provides a solid foundation for quality in the laboratory and enhances patient safety. It helps to prevent patient safety issues; when such issues do occur, effective processes are in place for investigation and resolution. Patient safety problems in Canadian laboratories might have been prevented had effective QMSs been in place. Ontario Laboratory Accreditation has had a positive impact on quality in Ontario laboratories. Copyright © 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  18. GESCAL: Quality management automated system for a calibration and test laboratory

    International Nuclear Information System (INIS)

    Manzano de Armas, J.; Valdes Ramos, M.; Morales Monzon, J.A.

    1998-01-01

    GESCAL is a software created to automate all elements composing the quality system in a calibration and test laboratory. It also evaluates quality according to its objectives and policies. This integrated data system decreases considerably the amount of time devoted to manage quality. It is speedier in searching and evaluating information registers thus notably in reducing the workload for laboratory staff

  19. The WHO AFRO external quality assessment programme (EQAP): Linking laboratory networks through EQA programmes.

    Science.gov (United States)

    Boeras, Debrah I; Peeling, Rosanna W; Onyebujoh, Philip; Yahaya, Ali A; Gumede-Moeletsi, Hieronyma N; Ndihokubwayo, Jean B

    2016-01-01

    External Quality Assessment (EQA) surveys performed by the World Health Organization Regional Office for Africa (WHO AFRO) revealed the need for the strengthening of public health microbiology laboratories, particularly for testing of epidemic-prone diseases in the African Region. These surveys revealed common issues such as supply chain management, skilled personnel, logistical support and overall lack of quality standards. For sustainable improvements to health systems as well as global health security, deficiencies identified need to be actively corrected through robust quality assurance programmes and implementation of laboratory quality management systems. Given all the pathogens of public health importance, an external quality assessment programme with a focus on vaccine-preventable diseases and emerging and re-emerging dangerous pathogens is important, and should not be stand-alone, but integrated within laboratory networks as seen in polio, measles, yellow fever and rubella. In 2015, WHO AFRO collaborated with the US Centers for Disease Control and Prevention, the London School of Hygiene & Tropical Medicine and partners in a series of consultations with countries and national and regional EQA providers for the development of quality assurance models to support HIV point-of-care testing and monitoring. These consultations revealed similar challenges as seen in the WHO AFRO surveys. WHO AFRO brought forth its experience in implementing quality standards for health programmes, and also opened discussions on how lessons learned through such established programmes can be utilised to supporting and strengthening the introduction of early infant diagnosis of HIV and viral load point-of-care testing. An optimised external quality assessment programme will impact the ability of countries to meet core capacities, providing improved quality management systems, improving the confidence of diagnostic network services in Africa, and including capacities to detect events

  20. Recommended procedures for performance testing of radiobioassay laboratories: Volume 1, Quality assurance

    International Nuclear Information System (INIS)

    Fenrick, H.W.; MacLellan, J.A.

    1988-11-01

    Draft American National Standards Institute (ANSI) Standard N13.30 (Performance Criteria for Radiobioassay) was developed in response to a concern expressed by the US Department of Energy and US Nuclear Regulatory Commission to help ensure that bioassay laboratories provide accurate and consistent results. The draft standard specifies the criteria for defining the procedures necessary to establish a bioassay performance-testing laboratory and program. The testing laboratory will conduct tests to evaluate the performance of service laboratories. Pacific Northwest Laboratory helped define responsibilities and develop procedures as part of an effort to evaluate the draft ANSI N13.30 performance criteria for quality assurance at bioassay laboratories. This report recommends elements of quality assurance and quality control responsibilities for the bioassay performance-testing laboratory program, including the qualification and performance of personnel and the calibration, certification, and performance of equipment. The data base and recommended records system for documenting radiobioassay performance at the service laboratories are also presented. 15 refs

  1. DNA decontamination methods for internal quality management in clinical PCR laboratories.

    Science.gov (United States)

    Wu, Yingping; Wu, Jianyong; Zhang, Zhihui; Cheng, Chen

    2018-03-01

    The polymerase chain reaction (PCR) technique, one of the most commonly applied methods in diagnostic and molecular biology, has a frustrating downside: the occurrence of false-positive signals due to contamination. In previous research, various DNA decontamination methods have been developed to overcome this limitation. Unfortunately, the use of random or poorly focused sampling methods for monitoring air and/or object surfaces leads to the incomplete elimination during decontamination procedures. We herein attempted to develop a novel DNA decontamination method (environmental surveillance, including surface and air sampling) and quality management program for clinical molecular diagnostic laboratories (or clinical PCR laboratories). Here, we performed a step-by-step evaluation of current DNA decontamination methods and developed an effective procedure for assessing the presence of decontaminating DNA via PCR analysis. Performing targeted environmental surveillance by sampling, which reached optimal performance over 2 weeks, and the decontamination process had been verified as reliable. Additionally, the process was validated to not affect PCR amplification efficiency based on a comparative study. In this study, effective guidelines for DNA decontamination were developed. The method employed ensured that surface DNA contamination could be effectively identified and eliminated. Furthermore, our study highlighted the importance of overall quality assurance and good clinical laboratory practices for preventing contamination, which are key factors for compliance with regulatory or accreditation requirements. Taken together, we provided the evidence that the presented scheme ranged from troubleshooting to the elimination of surface contamination, could serve as critical foundation for developing regular environmental surveillance guidelines for PCR laboratories. © 2017 Wiley Periodicals, Inc.

  2. Development of a quality assurance program for ionizing radiation secondary calibration laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Heaton, H.T. II; Taylor, A.R. Jr. [Center for Devices and Radiological Health, Rockville, MD (United States)

    1993-12-31

    For calibration laboratories, routine calibrations of instruments meeting stated accuracy goals are important. One method of achieving the accuracy goals is to establish and follow a quality assurance program designed to monitor all aspects of the calibration program and to provide the appropriate feedback mechanism if adjustments are needed. In the United States there are a number of organizations with laboratory accreditation programs. All existing accreditation programs require that the laboratory implement a quality assurance program with essentially the same elements in all of these programs. Collectively, these elements have been designated as a Measurement Quality Assurance (MQA) program. This paper will briefly discuss the interrelationship of the elements of an MQA program. Using the Center for Devices and Radiological Health (CDRH) X-ray Calibration Laboratory (XCL) as an example, it will focus on setting up a quality control program for the equipment in a Secondary Calibration Laboratory.

  3. The Individualized Quality Control Plan - Coming Soon to Clinical Microbiology Laboratories Everywhere!

    Science.gov (United States)

    Anderson, Nancy

    2015-11-15

    As of January 1, 2016, microbiology laboratories can choose to adopt a new quality control option, the Individualized Quality Control Plan (IQCP), under the Clinical Laboratory Improvement Amendments of 1988 (CLIA). This voluntary approach increases flexibility for meeting regulatory requirements and provides laboratories the opportunity to customize QC for their testing in their unique environments and by their testing personnel. IQCP is an all-inclusive approach to quality based on risk management to address potential errors in the total testing process. It includes three main steps, (1) performing a risk assessment, (2) developing a QC plan, and (3) monitoring the plan through quality assessment. Resources are available from the Centers for Medicare & Medicaid Services, Centers for Disease Control and Prevention, American Society for Microbiology, Clinical and Laboratory Standards Institute, and accrediting organizations, such as the College of American Pathologists and Joint Commission, to assist microbiology laboratories implementing IQCP.

  4. Development of a quality assurance program for ionizing radiation secondary calibration laboratories

    International Nuclear Information System (INIS)

    Heaton, H.T. II; Taylor, A.R. Jr.

    1993-01-01

    For calibration laboratories, routine calibrations of instruments meeting stated accuracy goals are important. One method of achieving the accuracy goals is to establish and follow a quality assurance program designed to monitor all aspects of the calibration program and to provide the appropriate feedback mechanism if adjustments are needed. In the United States there are a number of organizations with laboratory accreditation programs. All existing accreditation programs require that the laboratory implement a quality assurance program with essentially the same elements in all of these programs. Collectively, these elements have been designated as a Measurement Quality Assurance (MQA) program. This paper will briefly discuss the interrelationship of the elements of an MQA program. Using the Center for Devices and Radiological Health (CDRH) X-ray Calibration Laboratory (XCL) as an example, it will focus on setting up a quality control program for the equipment in a Secondary Calibration Laboratory

  5. Developing a customised approach for strengthening tuberculosis laboratory quality management systems toward accreditation

    Directory of Open Access Journals (Sweden)

    Heidi Albert

    2017-03-01

    Full Text Available Background: Quality-assured tuberculosis laboratory services are critical to achieve global and national goals for tuberculosis prevention and care. Implementation of a quality management system (QMS in laboratories leads to improved quality of diagnostic tests and better patient care. The Strengthening Laboratory Management Toward Accreditation (SLMTA programme has led to measurable improvements in the QMS of clinical laboratories. However, progress in tuberculosis laboratories has been slower, which may be attributed to the need for a structured tuberculosis-specific approach to implementing QMS. We describe the development and early implementation of the Strengthening Tuberculosis Laboratory Management Toward Accreditation (TB SLMTA programme. Development: The TB SLMTA curriculum was developed by customizing the SLMTA curriculum to include specific tools, job aids and supplementary materials specific to the tuberculosis laboratory. The TB SLMTA Harmonized Checklist was developed from the World Health Organisation Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation checklist, and incorporated tuberculosis-specific requirements from the Global Laboratory Initiative Stepwise Process Towards Tuberculosis Laboratory Accreditation online tool. Implementation: Four regional training-of-trainers workshops have been conducted since 2013. The TB SLMTA programme has been rolled out in 37 tuberculosis laboratories in 10 countries using the Workshop approach in 32 laboratories in five countries and the Facility based approach in five tuberculosis laboratories in five countries. Conclusion: Lessons learnt from early implementation of TB SLMTA suggest that a structured training and mentoring programme can build a foundation towards further quality improvement in tuberculosis laboratories. Structured mentoring, and institutionalisation of QMS into country programmes, is needed to support tuberculosis laboratories

  6. Improving of Quality Control and Quality Assurance in 14C and 3H Laboratory; Participation in the IAEA Model Project

    International Nuclear Information System (INIS)

    Obelic, B.

    2001-01-01

    Full text: Users of laboratory's analytical results are increasingly requiring demonstrable proofs of the reliability and credibility of the results using internationally accepted standards, because the economic, ecological, medical and legal decisions based on laboratory results need to be accepted nationally and internationally. Credibility, respect and opportunities of the laboratories are improved when objective evidence on the reliability and quality of the results can be given. This is achieved through inculcation of a quality culture through definition of well-defined procedures and controls and operational checks characteristic of quality assurance and quality control (Q A/QC). IAEA launched in 1999 a two-and-a-half year model project entitled Quality Control and Quality Assurance of Nuclear Analytical Techniques with participation of laboratories using alpha, beta and/or gamma spectrometry from CEE and NIS countries. The project started to introduce and implement QA principles in accordance with the ISO-17025 guide, leading eventually to a level at which the QA system is self-sustainable and might be appropriate for formal accreditation or certification by respective national authorities. Activities within the project consist of semi-annual reports, two training workshops, two inspection visits of the laboratories by IAEA experts and proficiency tests. The following topics were considered: organisation requirements, acceptance criteria and non-conformance management of QC, internal and external method validation, statistical analyses and uncertainty evaluation, standard operation procedures and quality manual documentation. 14 C and 3 H Laboratory of the Rudjer Boskovic Institute has been one of ten laboratories participating in the Project. In the Laboratory all the procedures required in the quality control were included implicitly, while during the Model Project much effort has been devoted to elaboration of explicit documentation. Since the beginning

  7. Piloting laboratory quality system management in six health facilities in Nigeria.

    Directory of Open Access Journals (Sweden)

    Henry Mbah

    Full Text Available Achieving accreditation in laboratories is a challenge in Nigeria like in most African countries. Nigeria adopted the World Health Organization Regional Office for Africa Stepwise Laboratory (Quality Improvement Process Towards Accreditation (WHO/AFRO- SLIPTA in 2010. We report on FHI360 effort and progress in piloting WHO-AFRO recognition and accreditation preparedness in six health facility laboratories in five different states of Nigeria.Laboratory assessments were conducted at baseline, follow up and exit using the WHO/AFRO- SLIPTA checklist. From the total percentage score obtained, the quality status of laboratories were classified using a zero to five star rating, based on the WHO/AFRO quality improvement stepwise approach. Major interventions include advocacy, capacity building, mentorship and quality improvement projects.At baseline audit, two of the laboratories attained 1- star while the remaining four were at 0- star. At follow up audit one lab was at 1- star, two at 3-star and three at 4-star. At exit audit, four labs were at 4- star, one at 3-star and one at 2-star rating. One laboratory dropped a 'star' at exit audit, while others consistently improved. The two weakest elements at baseline; internal audit (4% and occurrence/incidence management (15% improved significantly, with an exit score of 76% and 81% respectively. The elements facility and safety was the major strength across board throughout the audit exercise.This effort resulted in measurable and positive impact on the laboratories. We recommend further improvement towards a formal international accreditation status and scale up of WHO/AFRO- SLIPTA implementation in Nigeria.

  8. Evaluation of quality indicators in a laboratory supporting tertiary cancer care facilities in India.

    Science.gov (United States)

    Kumar, Savitha Anil; Jayanna, Prashanth; Prabhudesai, Shilpa; Kumar, Ajai

    2014-01-01

    To collect and tabulate errors and nonconformities in the preanalytical, analytical, and postanalytical process phases in a diagnostic clinical laboratory that supports a super-specialty cancer center in India, and identify areas of potential improvement in patient services. We collected data from our laboratory during a period of 24 months. Departments in the study included clinical biochemistry, hematology, clinical pathology, microbiology and serology, surgical pathology, and molecular pathology. We had initiated quality assessment based on international standards in our laboratory in 2010, with the aim of obtaining accreditation by national and international governing bodies. We followed the guidelines specified by International Organization for Standardization (ISO) 15189:2007 to identify noncompliant elements of our processes. Among a total of 144,030 specimens that our referral laboratory received during the 2-year period of our study, we uncovered an overall error rate for all 3 process phases of 1.23%; all of our error rates closely approximated the results from our peer institutions. Errors were most common in the preanalytical phase in both years of study; preanalytical- and postanalytical-phase errors constituted more than 90% of all errors. Further improvements are warranted in laboratory services and are contingent on adequate training and interdepartmental communication and cooperation. Copyright© by the American Society for Clinical Pathology (ASCP).

  9. [Importance of quality control of baciloscopy in laboratories that perform diagnosis of tuberculosis].

    Science.gov (United States)

    Sardiñas, Misleidis; García, Grechen; Rosarys Martínez, María; Díaz, Raúl; Mederos, Lilian M

    2016-06-01

    Baciloscopy is the primary tool for pulmonary tuberculosis diagnosis, being this technique the most used internationally in the search for infectious cases. Quality control is the process of the rechecking smears by a highly qualified observer. To evaluate and highlight the importance of quality control of smear microscopy in the Provincial Laboratories diagnosticians of Tuberculosis in Cuba. This study was conducted at the National Reference Laboratory and Research in Tuberculosis, Leprosy and Mycobacteria in the Institute of Tropical Medicine "Pedro Kouri", Havana, Cuba, Were evaluated 2676 smears received from January 2013 to December 2014, from Provincial Centers of Hygiene, Epidemiology and Microbiology of Cuba, including the special municipality Isla de la Juventud. 2,664 (99.5%) were concordant smears, the correlation obtained for the positive smears were 96.5% and 99.8% for negative. Were identified12 reading errors: 7 (3.5%) false positive and 5 (0.2%) false negatives. Slides were classified with adequate quality of smears in 2039 (76.2%), showed difficulties in realizing the extension in 1464 (54.7%) and staining were adequate in 2343 (87.6%). The kappa index was 0.9674. Although there was good agreement between observations it is recommended to improve the quality of extended, maintain staff training program that performs this activity, like regular supervision by specialists, to further improve the quality of diagnosis.

  10. Quality management system in hospital radiopharmacy laboratory

    International Nuclear Information System (INIS)

    Poch, Carolina; Rabiller, Graciela; Basualdo, Daniel A.; El Tamer, Elias A.

    2009-01-01

    Objective: 1) To determine the necessary conditions for increasing the complexity of the Radiopharmacy Laboratory and reach an operational level defined by the IAEA as 3a (Operational Guidance on Hospital Radiopharmacy). Our aim is that, within a framework of quality, last generation radiopharmaceuticals can be used, by sophisticated techniques such as labeling with bifunctional chelating agents, like HYNIC; 2) Consequently, we decided to implement a Quality Management System (QMS) in the field of Hospital Radiopharmacy in order to guarantee the safe and effective preparation and handling of radiopharmaceuticals for the diagnosis of patients, based on recommendations of the IAEA. Procedure For the implementation of the QMS, the sector of Radiopharmacy was capacitated in the application of ISO 9001. In a first stage it had begun with the formulation of the main documents and their enumeration. According to the recommendations of the IAEA Operational Guide, this year we proceeded to the optimization of the documents produced in the first stage and formulation of new documents essential to the improvement of work in the Radiopharmacy Laboratory. Results: Corrections were made to the performed procedures, and new ones were composed such as: Reception of raw materials, Control dose calibrator (Activity meter), General procedure of dosage, Procedure for decontamination, for Using the bio safety cabinet, for Cleaning the hot laboratory, etc. The Quality Controls were added to each of the Work Instructions of radiopharmaceuticals to be undertaken and how and when to carry out, with their respective references. Records were modified and new ones incorporated, in order to ensure traceability of the results before and after injection. Finally, the require documentation has been completed with the addition of the Staff Training Plan, and other records such as Nonconformance and Corrective and Preventive Actions. Conclusion: With the application of a QMS correctly implemented

  11. Harmonization activities of Noklus - a quality improvement organization for point-of-care laboratory examinations.

    Science.gov (United States)

    Stavelin, Anne; Sandberg, Sverre

    2018-05-16

    Noklus is a non-profit quality improvement organization that focuses to improve all elements in the total testing process. The aim is to ensure that all medical laboratory examinations are ordered, performed and interpreted correctly and in accordance with the patients' needs for investigation, treatment and follow-up. For 25 years, Noklus has focused on point-of-care (POC) testing in primary healthcare laboratories and has more than 3100 voluntary participants. The Noklus quality system uses different tools to obtain harmonization and improvement: (1) external quality assessment for the pre-examination, examination and postexamination phase to monitor the harmonization process and to identify areas that need improvement and harmonization, (2) manufacturer-independent evaluations of the analytical quality and user-friendliness of POC instruments and (3) close interactions and follow-up of the participants through site visits, courses, training and guidance. Noklus also recommends which tests that should be performed in the different facilities like general practitioner offices, nursing homes, home care, etc. About 400 courses with more than 6000 delegates are organized annually. In 2017, more than 21,000 e-learning programs were completed.

  12. Preliminary probe of quality indicators and quality specification in total testing process in 5753 laboratories in China.

    Science.gov (United States)

    Fei, Yang; Kang, Fengfeng; Wang, Wei; Zhao, Haijian; He, Falin; Zhong, Kun; Wang, Zhiguo; Chen, Wenxiang

    2016-08-01

    The aim of the study was to promote the establishment and implementation of quality indicators (QIs) in clinical laboratories, catch up with the state of art, and provide preliminary quality specifications for established QIs. Clinical laboratories from different provinces in China were included in this QIs survey in 2015. All participants were asked to collect data related to QIs and complete QIs questionnaires. Defect percentages and sigma values were calculated for each QI. The 25th percentile, median, and the 75th percentile of defect percentages and TATs were calculated as optimum, desirable and minimum quality specifications. While 25th, median, and 75th of sigma values were calculated as minimum, desirable and optimum quality specifications, respectively. Five thousand seven hundred and fifty-three clinical laboratories from 28 provinces in China participated in this survey. Median defect percentages of pre-examination QIs varied largely from 0.01% (incorrect sample container) to 0.57% (blood culture contamination) with sigma values varied from 4.0σ to 5.1σ. Median defect percentages of examination phase QIs were all really high. The most common problem in examination phase was test uncovered by inter-laboratory comparison (86.67%). Defect percentages of critical values notification and timely critical values notification were all 0.00% (6.0σ). While the median of defect percentages of incorrect laboratory reports was only 0.01% (5.4σ). Improvements are needed in all phases of total testing process (TTP) in laboratories in China, especially in examination phase. More attention should be paid when microbiology specimens are collected and results are reported. Quality specifications can provide directions for laboratories to make effort for.

  13. Importance of implementing an analytical quality control system in a core laboratory.

    Science.gov (United States)

    Marques-Garcia, F; Garcia-Codesal, M F; Caro-Narros, M R; Contreras-SanFeliciano, T

    2015-01-01

    The aim of the clinical laboratory is to provide useful information for screening, diagnosis and monitoring of disease. The laboratory should ensure the quality of extra-analytical and analytical process, based on set criteria. To do this, it develops and implements a system of internal quality control, designed to detect errors, and compare its data with other laboratories, through external quality control. In this way it has a tool to detect the fulfillment of the objectives set, and in case of errors, allowing corrective actions to be made, and ensure the reliability of the results. This article sets out to describe the design and implementation of an internal quality control protocol, as well as its periodical assessment intervals (6 months) to determine compliance with pre-determined specifications (Stockholm Consensus(1)). A total of 40 biochemical and 15 immunochemical methods were evaluated using three different control materials. Next, a standard operation procedure was planned to develop a system of internal quality control that included calculating the error of the analytical process, setting quality specifications, and verifying compliance. The quality control data were then statistically depicted as means, standard deviations, and coefficients of variation, as well as systematic, random, and total errors. The quality specifications were then fixed and the operational rules to apply in the analytical process were calculated. Finally, our data were compared with those of other laboratories through an external quality assurance program. The development of an analytical quality control system is a highly structured process. This should be designed to detect errors that compromise the stability of the analytical process. The laboratory should review its quality indicators, systematic, random and total error at regular intervals, in order to ensure that they are meeting pre-determined specifications, and if not, apply the appropriate corrective actions

  14. What's to Be Done About Laboratory Quality? Process Indicators, Laboratory Stewardship, the Outcomes Problem, Risk Assessment, and Economic Value: Responding to Contemporary Global Challenges.

    Science.gov (United States)

    Meier, Frederick A; Badrick, Tony C; Sikaris, Kenneth A

    2018-02-17

    For 50 years, structure, process, and outcomes measures have assessed health care quality. For clinical laboratories, structural quality has generally been assessed by inspection. For assessing process, quality indicators (QIs), statistical monitors of steps in the clinical laboratory total testing, have proliferated across the globe. Connections between structural and process laboratory measures and patient outcomes, however, have rarely been demonstrated. To inform further development of clinical laboratory quality systems, we conducted a selective but worldwide review of publications on clinical laboratory quality assessment. Some QIs, like seven generic College of American Pathologists Q-Tracks monitors, have demonstrated significant process improvement; other measures have uncovered critical opportunities to improve test selection and result management. The College of Pathologists of Australasia Key Indicator Monitoring and Management System has deployed risk calculations, introduced from failure mode effects analysis, as surrogate measures for outcomes. Showing economic value from clinical laboratory testing quality is a challenge. Clinical laboratories should converge on fewer (7-14) rather than more (21-35) process monitors; monitors should cover all steps of the testing process under laboratory control and include especially high-risk specimen-quality QIs. Clinical laboratory stewardship, the combination of education interventions among clinician test orderers and report consumers with revision of test order formats and result reporting schemes, improves test ordering, but improving result reception is more difficult. Risk calculation reorders the importance of quality monitors by balancing three probabilities: defect frequency, weight of potential harm, and detection difficulty. The triple approach of (1) a more focused suite of generic consensus quality indicators, (2) more active clinical laboratory testing stewardship, and (3) integration of formal

  15. Quality assurance programs at the PNL calibrations laboratory

    International Nuclear Information System (INIS)

    Piper, R.K.; McDonald, J.C.; Fox, R.A.; Eichner, F.N.

    1993-03-01

    The calibrations laboratory at Pacific Northwest Laboratory (PNL) serves as a radiological standardization facility for personnel and environmental dosimetry and radiological survey instruments. As part of this function, the calibrations laboratory must maintain radiological reference fields with calibrations traceable to the National Institute of Standards and Technology (NIST). This task is accomplished by a combination of (1) sources or reference instruments calibrated at or by NIST, (2) measurement quality assurance (MQA) interactions with NIST, and (3) rigorous internal annual and quarterly calibration verifications. This paper describes a representative sample of the facilities, sources, and actions used to maintain accurate and traceable fields

  16. The role of the EPA radiation quality assurance program in the measurement quality assurance accreditation program for radioassay laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Grady, T.M. [Environmental Monitoring Systems Laboratory, Las Vegas, NV (United States)

    1993-12-31

    As the nature and extent of radiological contamination becomes better documented and more public, radioanalytical laboratories are faced with a constantly expanding variety of new and difficult analytical requirements. Concurrent with those requirements is the responsibility to provide customers, regulatory officials, or the public with defensible data produced in an environment of verifiable, controlled quality. To meet that need, a quality assurance accreditation program for radioassay laboratories has been proposed by the American National Standards Institute (ANSI). The standard will provide the organizational framework and functional requirements needed to assure the quality of laboratory outputs. Under the proposed program, the U.S. Environmental Protection Agency`s (EPA`s) Laboratory Intercomparison Program plays a key role as a reference laboratory. The current and proposed roles of the EPA Intercomparison Program are discussed, as are the functional relationships between EPA, the accreditating organization, and the service and monitoring laboratories.

  17. System Quality Management in Software Testing Laboratory that Chooses Accreditation

    Directory of Open Access Journals (Sweden)

    Yanet Brito R.

    2013-12-01

    Full Text Available The evaluation of software products will reach full maturity when executed by the scheme and provides third party certification. For the validity of the certification, the independent laboratory must be accredited for that function, using internationally recognized standards. This brings with it a challenge for the Industrial Laboratory Testing Software (LIPS, responsible for testing the products developed in Cuban Software Industry, define strategies that will permit it to offer services with a high level of quality. Therefore it is necessary to establish a system of quality management according to NC-ISO/IEC 17025: 2006 to continuously improve the operational capacity and technical competence of the laboratory, with a view to future accreditation of tests performed. This article discusses the process defined in the LIPS for the implementation of a Management System of Quality, from the current standards and trends, as a necessary step to opt for the accreditation of the tests performed.

  18. SSCL magnet systems quality program implementation for laboratory and industry

    International Nuclear Information System (INIS)

    Warner, D.G.; Bever, D.L.

    1992-01-01

    The development and delivery of reliable and producible magnets for the Superconducting Super Collider Laboratory (SSCL) require the teamwork of a large and diverse workforce composed of personnel with backgrounds in laboratory research, defense, and energy. The SSCL Magnet Quality Program is being implemented with focus on three definitive objectives: (1) communication of requirements, (2) teamwork, and (3) verification. Examination of the SSCL Magnet Systems Division's (MSD) current and planned approach to implementation of the SSCL Magnet Quality Program utilizing these objectives is discussed

  19. [Software for illustrating a cost-quality balance carried out by clinical laboratory practice].

    Science.gov (United States)

    Nishibori, Masahiro; Asayama, Hitoshi; Kimura, Satoshi; Takagi, Yasushi; Hagihara, Michio; Fujiwara, Mutsunori; Yoneyama, Akiko; Watanabe, Takashi

    2010-09-01

    We have no proper reference indicating the quality of clinical laboratory practice, which should clearly illustrates that better medical tests require more expenses. Japanese Society of Laboratory Medicine was concerned about recent difficult medical economy and issued a committee report proposing a guideline to evaluate the good laboratory practice. According to the guideline, we developed software that illustrate a cost-quality balance carried out by clinical laboratory practice. We encountered a number of controversial problems, for example, how to measure and weight each quality-related factor, how to calculate costs of a laboratory test and how to consider characteristics of a clinical laboratory. Consequently we finished only prototype software within the given period and the budget. In this paper, software implementation of the guideline and the above-mentioned problems are summarized. Aiming to stimulate these discussions, the operative software will be put on the Society's homepage for trial

  20. Quality management systems for your in vitro fertilization clinic's laboratory: Why bother?

    Science.gov (United States)

    Olofsson, Jan I; Banker, Manish R; Sjoblom, Late Peter

    2013-01-01

    Several countries have in recent years introduced prescribed requirements for treatment and monitoring of outcomes, as well as a licensing or accreditation requirement for in vitro fertilization (IVF) clinics and their laboratories. It is commonplace for Assisted Reproductive Technology (ART) laboratories to be required to have a quality control system. However, more effective Total Quality Management systems are now being implemented by an increasing number of ART clinics. In India, it is now a requirement to have a quality management system in order to be accredited and to help meet customer demand for improved delivery of ART services. This review contains the proceedings a quality management session at the Indian Fertility Experts Meet (IFEM) 2010 and focuses on the creation of a patient-oriented best-in-class IVF laboratory.

  1. Implementation of quality assurance and quality control in the Nuclear Analytical Laboratory of the Estonian Radiation Protection Centre

    International Nuclear Information System (INIS)

    Koeoep, T.; Jakobson, E.

    2002-01-01

    The Analytical Laboratory of the Estonian Radiation Protection Centre is in the process of implementing the system of Quality Assurance (QA) and Quality Control (QC) in the framework of the IAEA TC Project RER/2/004/ 'QA/QC of Nuclear Analytical Techniques'. The draft Quality Manual with annexes has been prepared accordingly to the ISO 17025 Guide, documents and other printed material delivered on the seminars of the project. The laboratory supply has been supplemented with necessary equipment for guaranteeing of quality. Proficiency testing included in the project has been performed successfully. (author)

  2. Working toward a sustainable laboratory quality improvement programme through country ownership: Mozambique's SLMTA story.

    Science.gov (United States)

    Masamha, Jessina; Skaggs, Beth; Pinto, Isabel; Mandlaze, Ana Paula; Simbine, Carolina; Chongo, Patrina; de Sousa, Leonardo; Kidane, Solon; Yao, Katy; Luman, Elizabeth T; Samogudo, Eduardo

    2014-01-01

    Launched in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has emerged as an innovative approach for the improvement of laboratory quality. In order to ensure sustainability, Mozambique embedded the SLMTA programme within the existing Ministry of Health (MOH) laboratory structure. This article outlines the steps followed to establish a national framework for quality improvement and embedding the SLMTA programme within existing MOH laboratory systems. The MOH adopted SLMTA as the national laboratory quality improvement strategy, hired a dedicated coordinator and established a national laboratory quality technical working group comprising mostly personnel from key MOH departments. The working group developed an implementation framework for advocacy, training, mentorship, supervision and audits. Emphasis was placed on building local capacity for programme activities. After receiving training, a team of 25 implementers (18 from the MOH and seven from partner organisations) conducted baseline audits (using the Stepwise Laboratory Quality Improvement Process Towards Accreditation [SLIPTA] checklist), workshops and site visits in six reference and two central hospital laboratories. Exit audits were conducted in six of the eight laboratories and their results are presented. The six laboratories demonstrated substantial improvement in audit scores; median scores increased from 35% at baseline to 57% at exit. It has been recommended that the National Tuberculosis Reference Laboratory apply for international accreditation. Successful implementation of SLMTA requires partnership between programme implementers, whilst effectiveness and long-term viability depend on country leadership, ownership and commitment. Integration of SLMTA into the existing MOH laboratory system will ensure durability beyond initial investments. The Mozambican model holds great promise that country leadership, ownership and institutionalisation can set the stage for

  3. Quality control for diagnostic oral microbiology laboratories in European countries

    NARCIS (Netherlands)

    Rautemaa-Richardson, R.; van der Reijden, W.A.; Dahlen, G.; Smith, A.J.

    2011-01-01

    Participation in diagnostic microbiology internal and external quality control (QC) processes is good laboratory practice and an essential component of a quality management system. However, no QC scheme for diagnostic oral microbiology existed until 2009 when the Clinical Oral Microbiology (COMB)

  4. The impact of SLMTA in improving laboratory quality systems in the Caribbean Region.

    Science.gov (United States)

    Guevara, Giselle; Gordon, Floris; Irving, Yvette; Whyms, Ismae; Parris, Keith; Beckles, Songee; Maruta, Talkmore; Ndlovu, Nqobile; Albalak, Rachel; Alemnji, George

    Past efforts to improve laboratory quality systems and to achieve accreditation for better patient care in the Caribbean Region have been slow. To describe the impact of the Strengthening of Laboratory Management Toward Accreditation (SLMTA) training programme and mentorship amongst five clinical laboratories in the Caribbean after 18 months. Five national reference laboratories from four countries participated in the SLMTA programme that incorporated classroom teaching and implementation of improvement projects. Mentors were assigned to the laboratories to guide trainees on their improvement projects and to assist in the development of Quality Management Systems (QMS). Audits were conducted at baseline, six months, exit (at 12 months) and post-SLMTA (at 18 months) using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist to measure changes in implementation of the QMS during the period. At the end of each audit, a comprehensive implementation plan was developed in order to address gaps. Baseline audit scores ranged from 19% to 52%, corresponding to 0 stars on the SLIPTA five-star scale. After 18 months, one laboratory reached four stars, two reached three stars and two reached two stars. There was a corresponding decrease in nonconformities and development of over 100 management and technical standard operating procedures in each of the five laboratories. The tremendous improvement in these five Caribbean laboratories shows that SLMTA coupled with mentorship is an effective, user-friendly, flexible and customisable approach to the implementation of laboratory QMS. It is recommended that other laboratories in the region consider using the SLMTA training programme as they engage in quality systems improvement and preparation for accreditation.

  5. Electronic laboratory quality assurance program: A method of enhancing the prosthodontic curriculum and addressing accreditation standards.

    Science.gov (United States)

    Moghadam, Marjan; Jahangiri, Leila

    2015-08-01

    An electronic quality assurance (eQA) program was developed to replace a paper-based system and to address standards introduced by the Commission on Dental Accreditation (CODA) and to improve educational outcomes. This eQA program provides feedback to predoctoral dental students on prosthodontic laboratory steps at New York University College of Dentistry. The purpose of this study was to compare the eQA program of performing laboratory quality assurance with the former paper-based format. Fourth-year predoctoral dental students (n=334) who experienced both the paper-based and the electronic version of the quality assurance program were surveyed about their experiences. Additionally, data extracted from the eQA program were analyzed to identify areas of weakness in the curriculum. The study findings revealed that 73.8% of the students preferred the eQA program to the paper-based version. The average number of treatments that did not pass quality assurance standards was 119.5 per month. This indicated a 6.34% laboratory failure rate. Further analysis of these data revealed that 62.1% of the errors were related to fixed prosthodontic treatment, 27.9% to partial removable dental prostheses, and 10% to complete removable dental prostheses in the first 18 months of program implementation. The eQA program was favored by dental students who have experienced both electronic and paper-based versions of the system. Error type analysis can yield the ability to create customized faculty standardization sessions and refine the didactic and clinical teaching of the predoctoral students. This program was also able to link patient care activity with the student's laboratory activities, thus addressing the latest requirements of the CODA regarding the competence of graduates in evaluating laboratory work related to their patient care. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  6. Quality assurance in a large research and development laboratory

    International Nuclear Information System (INIS)

    Neill, F.H.

    1980-01-01

    Developing a quality assurance program for a large research and development laboratory provided a unique opportunity for innovative planning. The quality assurance program that emerged has been tailored to meet the requirements of several sponsoring organizations and contains the flexibility for experimental programs ranging from large engineering-scale development projects to bench-scale basic research programs

  7. Laboratory diagnosis of the rare anaemias: external quality assessment benefits patient care

    Directory of Open Access Journals (Sweden)

    Barbara De La Salle

    2013-03-01

    Full Text Available Since its introduction in the 1960s, external quality assessment has developed to become an essential component of the quality management system of the diagnostic laboratory. External quality assessment provides a long term, retrospective view of laboratory performance, demonstrating the competence of the laboratory to others. The ENERCA project (the European Network for Rare and Congenital Anaemias has established a list of core laboratory tests that are used in the diagnosis of rare and congenital anaemias, which has been used as the basis for questionnaires to laboratories, to establish the use and quality assurance of diagnostic testing in the congenital and rare anaemias, and to European EQA providers for services in this key area. In general, the provision of EQA for rare and congenital anaemias is widely variable with little provision for the very rare disorders. For the more common congenital anaemias, such as the haemoglobinopathies and thalassaemias, provision is better but there is variation in aspects of the scheme design, especially the frequency of distribution. Where laboratories did not take part in EQA for individual tests, or there was no EQA available, a desire to participate was expressed in 66% (102/154 of cases. The provision of external quality assessment (EQA services for rare disorders is a challenge. For many of these conditions, the number of patients in any one member state is very small with only a few laboratories providing diagnostic testing. In these cases, the development of pan-European or cross-border EQA may be the only means by which standardisation of methods and results can be achieved. An EQA survey of 243 laboratories for performance in Hb A2 quantification showed encouraging results in that there was a clear differentiation in the results from a beta Thalassaemia carrier and an individual with no evidence of Thalassaemia; however, a bias was observed between different methods of measurement.

  8. Improving quality in national reference laboratories: The role of SLMTA and mentorship

    Directory of Open Access Journals (Sweden)

    Rosemary A. Audu

    2014-09-01

    Full Text Available Background: The Nigerian Institute of Medical Research houses two reference laboratories: the virology and tuberculosis laboratories. Both were enrolled in the Strengthening Laboratory Management Toward Accreditation (SLMTA programme. Objective: To describe the impact of SLMTA and discuss factors affecting the results, with an emphasis on mentorship. Methods: The SLMTA programme was implemented from April 2010 through November 2012. Participants attended three workshops and executed quality improvement projects; laboratory auditors evaluated performance using a standard checklist. The virology laboratory did not receive mentorship; however, the tuberculosis laboratory had an international mentor who visited the laboratory four times during the programme, spending two to four weeks embedded within the laboratory during each visit. Results: There was an overall improvement in the performance of both laboratories, with the virology laboratory increasing 13% (from 80% at baseline to 93% at exit audit and the tuberculosis laboratory increasing 29% (from 66% to 95%. These scores were maintained nine months later at the surveillance audit. Conclusion: The SLMTA programme resulted in improved and sustained quality management performance for both laboratories. Mentoring was a possible factor in the substantial improvement made by the tuberculosis laboratory and should be considered in order to augment the training received from the SLMTA workshops.

  9. [The external evaluation of study quality: the role in maintaining the reliability of laboratory information].

    Science.gov (United States)

    Men'shikov, V V

    2013-08-01

    The external evaluation of quality of clinical laboratory examinations was gradually introduced in USSR medical laboratories since 1970s. In Russia, in the middle of 1990 a unified all-national system of external evaluation quality was organized known as the Federal center of external evaluation of quality at the basis of laboratory of the state research center of preventive medicine. The main positions of policy in this area were neatly formulated in the guidance documents of ministry of Health. Nowadays, the center of external evaluation of quality proposes 100 and more types of control studies and permanently extends their specter starting from interests of different disciplines of clinical medicine. The consistent participation of laboratories in the cycles of external evaluation of quality intrinsically promotes improvement of indicators of properness and precision of analysis results and increases reliability of laboratory information. However, a significant percentage of laboratories does not participate at all in external evaluation of quality or takes part in control process irregularly and in limited number of tests. The managers of a number of medical organizations disregard the application of the proposed possibilities to increase reliability of laboratory information and limit financing of studies in the field of quality control. The article proposes to adopt the national standard on the basis of ISO 17043 "Evaluation of compliance. The common requirements of professional competence testing".

  10. Quality management in European screening laboratories in blood establishments: A view of current approaches and trends.

    Science.gov (United States)

    Pereira, Paulo; Westgard, James O; Encarnação, Pedro; Seghatchian, Jerard; de Sousa, Gracinda

    2015-04-01

    The screening laboratory has a critical role in the post-transfusion safety. The success of its targets and efficiency depends on the management system used. Even though the European Union directive 2002/98/EC requires a quality management system in blood establishments, its requirements for screening laboratories are generic. Complementary approaches are needed to implement a quality management system focused on screening laboratories. This article briefly discusses the current good manufacturing practices and good laboratory practices, as well as the trends in quality management system standards. ISO 9001 is widely accepted in some European Union blood establishments as the quality management standard, however this is not synonymous of its successful application. The ISO "risk-based thinking" is interrelated with the quality risk-management process of the EuBIS "Standards and criteria for the inspection of blood establishments". ISO 15189 should be the next step on the quality assurance of a screening laboratory, since it is focused on medical laboratory. To standardize the quality management systems in blood establishments' screening laboratories, new national and European claims focused on technical requirements following ISO 15189 is needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. An overview of Quality Management System implementation in a research laboratory

    Science.gov (United States)

    Molinéro-Demilly, Valérie; Charki, Abdérafi; Jeoffrion, Christine; Lyonnet, Barbara; O'Brien, Steve; Martin, Luc

    2018-02-01

    The aim of this paper is to show the advantages of implementing a Quality Management System (QMS) in a research laboratory in order to improve the management of risks specific to research programmes and to increase the reliability of results. This paper also presents experience gained from feedback following the implementation of the Quality process in a research laboratory at INRA, the French National Institute for Agronomic Research and details the various challenges encountered and solutions proposed to help achieve smoother adoption of a QMS process. The 7Ms (Management, Measurement, Manpower, Methods, Materials, Machinery, Mother-nature) methodology based on the Ishikawa `Fishbone' diagram is used to show the effectiveness of the actions considered by a QMS, which involve both the organization and the activities of the laboratory. Practical examples illustrate the benefits and improvements observed in the laboratory.

  12. [Evaluation of clinical laboratories--assurance of their quality and competence].

    Science.gov (United States)

    Kawai, Tadashi

    2007-01-01

    Since ISO 15189:2003 was published, the accreditation program of clinical laboratories based on ISO 15189 has been introduced in many countries, except for those in USA where all clinical laboratories must be required to follow the federal law, CLIA'88. It will certainly help the accredited clinical laboratories improve their quality and competence. In relation to the activity of JCTLM, reference measurement laboratories will be accredited, based on ISO 15195 which is now under its review and amendment by ISO/TC212/WG2. In Japan, JCCLS (Japanese Committee for Clinical Laboratory Standards) and JAB (Japan Accreditation Board for Conformity Assessment) cojointly started the accreditation program for clinical laboratories, based on ISO 15189:2003, and a total of 15 laboratories including university hospitals, community hospitals and independent clinical laboratories have been accredited up until the end of 2006.

  13. Factors Affecting Quality of Laboratory Services in Public and Private Health Facilities in Addis Ababa, Ethiopia.

    Science.gov (United States)

    Mesfin, Eyob Abera; Taye, Binyam; Belay, Getachew; Ashenafi, Aytenew; Girma, Veronica

    2017-10-01

    Quality laboratory service is an essential component of health care system but in Sub-Saharan Africa such as Ethiopia, laboratories quality system remains weak due to several factors and it needs more attention to strengthen its capacity and quality system. A cross sectional study was conducted using a questionnaire to assess factors affecting the quality of laboratory service at private and public health institutions in Addis Ababa. A total of 213 laboratory professionals participated in the study and 131 (61.5%) participants had bachelor degree. Majority, 133 (62.4%), of the professionals did not attend any work related training. Seventy five (35.2%) respondents believed that their laboratories did not provide quality laboratory services and the major reported factors affecting provision of quality services were shortage of resources (64.3%), poor management support (57.3%), poor equipment quality (53.4%), high workload (41.1%), lack of equipment calibration (38.3%) and lack of knowledge (23.3%). Moreover logistic regression analysis showed that provision of quality laboratory service was significantly associated with result verification (AOR=9.21, 95% CI=2.26, 37.48), internal quality control (AOR= 6.11, 95% CI=2.11, 17.70), turnaround time (AOR=5.11, 95% CI=1.94, 13.46), shortage of equipment (AOR=7.76, 95% CI=2.55, 23.66), communication with clinicians (AOR=3.24, 95% CI=1.25, 8.41) and lack of job description (AOR=3.67, 95% CI=1.319, 10.22). In conclusion, the major factors that affecting the quality of laboratory service were associated with poor human resource management, poor resources provision, poor management commitment, ineffective communication system and lack of well-established quality management system.

  14. Methodological and reporting quality in laboratory studies of human eating behavior

    NARCIS (Netherlands)

    Robinson, E.; Bevelander, K.E.; Field, M.; Jones, A.

    2018-01-01

    The methodological quality and reporting practices of laboratory studies of human eating behavior determine the validity and replicability of nutrition science. The aim of this research was to examine basic methodology and reporting practices in recent representative laboratory studies of human

  15. Correction of stream quality trends for the effects of laboratory measurement bias

    Science.gov (United States)

    Alexander, Richard B.; Smith, Richard A.; Schwarz, Gregory E.

    1993-01-01

    We present a statistical model relating measurements of water quality to associated errors in laboratory methods. Estimation of the model allows us to correct trends in water quality for long-term and short-term variations in laboratory measurement errors. An illustration of the bias correction method for a large national set of stream water quality and quality assurance data shows that reductions in the bias of estimates of water quality trend slopes are achieved at the expense of increases in the variance of these estimates. Slight improvements occur in the precision of estimates of trend in bias by using correlative information on bias and water quality to estimate random variations in measurement bias. The results of this investigation stress the need for reliable, long-term quality assurance data and efficient statistical methods to assess the effects of measurement errors on the detection of water quality trends.

  16. Radiation safety and quality control in the cyclotron laboratory

    International Nuclear Information System (INIS)

    Sharma, S.; Krause, G.; Ebadi, M.

    2006-01-01

    Radiation safety was determined to maintain quality control in the cyclotron laboratory. Based on the results of 438 runs in the Faraday cup (20 μA for 10 min), 20 runs on 18 O-water target (40 μA for 2 h) and 10 runs on 18 O-gas targets (30 μA for 45 min), we have established that occupationally exposed workers remain 10 ± 5 times below federal regulatory limits (FRLs) in the cyclotron vault, 30 ± 8 times below FRL in the radiochemistry laboratory and 200 ± 10 times below the FRL outside the cyclotron laboratory during beam operation. (The FRL for unrestricted area are <20 μSv in 1 h.) The non-occupationally exposed workers serving in offices in the vicinity of the cyclotron vault within 100 m distance remained 200 times below the FRL irrespective of beam being on or off, suggesting that routine beam operation of 40 μA for 2 h once a day during office hours is safe provided quality control and system performance measures as discussed in this report are strictly maintained. (authors)

  17. Quality management systems for your in vitro fertilization clinic′s laboratory: Why bother?

    Directory of Open Access Journals (Sweden)

    Jan I Olofsson

    2013-01-01

    Full Text Available Several countries have in recent years introduced prescribed requirements for treatment and monitoring of outcomes, as well as a licensing or accreditation requirement for in vitro fertilization (IVF clinics and their laboratories. It is commonplace for Assisted Reproductive Technology (ART laboratories to be required to have a quality control system. However, more effective Total Quality Management systems are now being implemented by an increasing number of ART clinics. In India, it is now a requirement to have a quality management system in order to be accredited and to help meet customer demand for improved delivery of ART services. This review contains the proceedings a quality management session at the Indian Fertility Experts Meet (IFEM 2010 and focuses on the creation of a patient-oriented best-in-class IVF laboratory.

  18. Working toward a sustainable laboratory quality improvement programme through country ownership: Mozambique’s SLMTA story

    Directory of Open Access Journals (Sweden)

    Jessina Masamha

    2014-11-01

    Full Text Available Background: Launched in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA programme has emerged as an innovative approach for the improvement of laboratory quality. In order to ensure sustainability, Mozambique embedded the SLMTA programme within the existing Ministry of Health (MOH laboratory structure. Objective: This article outlines the steps followed to establish a national framework for quality improvement and embed the SLMTA programme within existing MOH laboratory systems. Methods: The MOH adopted SLMTA as the national laboratory quality improvement strategy, hired a dedicated coordinator and established a national laboratory quality technical working group comprising mostly personnel from key MOH departments. The working group developed an implementation framework for advocacy, training, mentorship, supervision and audits. Emphasis was placed on building local capacity for programme activities. After receiving training, a team of 25 implementers (18 from the MOH and sevenfrom partner organisations conducted baseline audits (using the Stepwise Laboratory Quality Improvement Process Towards Accreditation [SLIPTA] checklist, workshops and site visits in six reference and two central hospital laboratories. Exit audits were conducted in six of the eight laboratories and their results are presented. Results: The six laboratories demonstrated substantial improvement in SLIPTA checklistscores; median scores increased from 35% at baseline to 57% at exit. It has been recommended that the National Tuberculosis Reference Laboratory apply for international accreditation. Conclusion: Successful implementation of SLMTA requires partnership between programme implementers, whilst effectiveness and long-term viability depend on country leadership, ownership and commitment. Integration of SLMTA into the existing MOH laboratory system will ensure durability beyond initial investments. The Mozambican model holds great promise that

  19. The impact of SLMTA in improving laboratory quality systems in the Caribbean Region

    Directory of Open Access Journals (Sweden)

    Giselle Guevara

    2014-11-01

    Objective: To describe the impact of the Strengthening of Laboratory Management Toward Accreditation (SLMTA training programme and mentorship amongst five clinical laboratories in the Caribbean after 18 months. Method: Five national reference laboratories from four countries participated in the SLMTA programme that incorporated classroom teaching and implementation of improvement projects. Mentors were assigned to the laboratories to guide trainees on their improvement projects and to assist in the development of Quality Management Systems (QMS. Audits were conducted at baseline, six months, exit (at 12 months and post-SLMTA (at 18 months using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA checklist to measure changes in implementation of the QMS during the period. At the end of each audit, a comprehensive implementation plan was developed in order to address gaps. Results: Baseline audit scores ranged from 19% to 52%, corresponding to 0 stars on the SLIPTA five-star scale. After 18 months, one laboratory reached four stars, two reached three stars and two reached two stars. There was a corresponding decrease in nonconformities and development of over 100 management and technical standard operating procedures in each of the five laboratories. Conclusion: The tremendous improvement in these five Caribbean laboratories shows that SLMTA coupled with mentorship is an effective, user-friendly, flexible and customisable approach to the implementation of laboratory QMS. It is recommended that other laboratories in the region consider using the SLMTA training programme as they engage in quality systems improvement and preparation for accreditation.

  20. [Study of continuous quality improvement for clinical laboratory processes via the platform of Hospital Group].

    Science.gov (United States)

    Song, Wenqi; Shen, Ying; Peng, Xiaoxia; Tian, Jian; Wang, Hui; Xu, Lili; Nie, Xiaolu; Ni, Xin

    2015-05-26

    The program of continuous quality improvement in clinical laboratory processes for complete blood count (CBC) was launched via the platform of Beijing Children's Hospital Group in order to improve the quality of pediatric clinical laboratories. Fifteen children's hospitals of Beijing Children's Hospital group were investigated using the method of Chinese adapted continuous quality improvement with PDCA (Plan-Do-Check-Action). The questionnaire survey and inter-laboratory comparison was conducted to find the existing problems, to analyze reasons, to set forth quality targets and to put them into practice. Then, targeted training was conducted to 15 children's hospitals and the second questionnaire survey, self examinations by the clinical laboratories was performed. At the same time, the Group's online internal quality control platform was established. Overall effects of the program were evaluated so that lay a foundation for the next stage of PDCA. Both quality of control system documents and CBC internal quality control scheme for all of clinical laboratories were improved through this program. In addition, standardization of performance verification was also improved, especially with the comparable verification rate of precision and internal laboratory results up to 100%. In terms of instrument calibration and mandatory diagnostic rates, only three out of the 15 hospitals (20%) failed to pass muster in 2014 from 46.67% (seven out of the 15 hospitals) in 2013. The abnormal data of intraday precision variance coefficients of the five CBC indicator parameters (WBC, RBC, Hb, Plt and Hct) of all the 15 laboratories accounted for 1.2% (2/165) in 2014, a marked decrease from 9.6% (14/145) in 2013. While the number of the hospitals using only one horizontal quality control object for daily quality control has dropped to three from five. The 15 hospitals organized a total of 263 times of training in 2014 from 101 times in 2013, up 160%. The quality improvement program for

  1. Quality management and accreditation in a mixed research and clinical hair testing analytical laboratory setting-a review.

    Science.gov (United States)

    Fulga, Netta

    2013-06-01

    Quality management and accreditation in the analytical laboratory setting are developing rapidly and becoming the standard worldwide. Quality management refers to all the activities used by organizations to ensure product or service consistency. Accreditation is a formal recognition by an authoritative regulatory body that a laboratory is competent to perform examinations and report results. The Motherisk Drug Testing Laboratory is licensed to operate at the Hospital for Sick Children in Toronto, Ontario. The laboratory performs toxicology tests of hair and meconium samples for research and clinical purposes. Most of the samples are involved in a chain of custody cases. Establishing a quality management system and achieving accreditation became mandatory by legislation for all Ontario clinical laboratories since 2003. The Ontario Laboratory Accreditation program is based on International Organization for Standardization 15189-Medical laboratories-Particular requirements for quality and competence, an international standard that has been adopted as a national standard in Canada. The implementation of a quality management system involves management commitment, planning and staff education, documentation of the system, validation of processes, and assessment against the requirements. The maintenance of a quality management system requires control and monitoring of the entire laboratory path of workflow. The process of transformation of a research/clinical laboratory into an accredited laboratory, and the benefits of maintaining an effective quality management system, are presented in this article.

  2. Internal quality control of neutron activation analysis laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Kim, S. H.; Mun, J. H.; BaeK, S. Y.; Jung, Y. S.; Kim, Y. J. [KAERI, Taejon (Korea, Republic of)

    2004-07-01

    The importance for quality assurance and control in analytical laboratories has been emphasized, day by day. Internal quality control using certified reference materials(CRMs) can be one of effective methods for this purpose. In this study, 10 kinds of CRMs consisting of soil, sediment and biological matrix were analyzed. To evaluate the confidence of analytical results and the validation of testing method and procedure, the accuracy and the precision of the measured elements were treated statistically and the reproducibility was compared with those values produced before 2003.

  3. Tuberculosis Laboratory Diagnosis Quality Assurance among Public Health Facilities in West Amhara Region, Ethiopia.

    Science.gov (United States)

    Shiferaw, Melashu Balew; Hailu, Hiwot Amare; Fola, Abebe Alemu; Derebe, Mulatu Melese; Kebede, Aimro Tadese; Kebede, Abayneh Admas; Emiru, Manamnot Agegne; Gelaw, Zelalem Dessie

    2015-01-01

    Reliable smear microscopy is an important component of Directly Observed Treatment Scheme (DOTS) strategy for TB control program in countries with limited resources. Despite external quality assessment is established in Ethiopia, there is lower TB detection rate (48%) in Amhara region compared to the World Health Organization (WHO) estimate (70%). This highlights the quality of smear microscopy needs to be evaluated. Therefore, the aim of this study was to assess the quality of sputum smear microscopy performance among health center laboratories in West Amhara region, Ethiopia. A cross sectional study was conducted from July 08, 2013 to July 07, 2014. Data were collected from 201 public health center laboratories using a structured questionnaire. Slides were collected based on Lot Quality Assurance Sampling (LQAS) method and rechecked blindly by trained laboratory technologists. The data were entered into EPI info V.7 and smear quality indicators and AFB results were analyzed by SPSS version 20. Among 201 laboratories enrolled in this study, 47 (23.4%) laboratories had major errors. Forty one (20.4%) laboratories had a total of 67 false negative and 29 (14.4%) laboratories had a total of 68 false positive results. Specimen quality, smear thickness and evenness were found poor in 134 (66.7%), 133 (66.2%) and 126 (62.7%) laboratories, respectively. Unavailability of microscope lens cleaning solution (AOR: 2.90; 95% CI: 1.25-6.75; P: 0.013) and dirty smears (AOR: 2.65; 95% CI: 1.14-6.18; P: 0.024) were correlated with false negative results whereas no previous EQA participation (AOR: 3.43; 95% CI: 1. 39-8.45; P: 0.007) was associated with false positive results. The performance of health facilities for sputum smear microscopy was relatively poor in West Amhara region. Hence, strengthening the EQA program and technical support on sputum smear microscopy are recommended to ensure quality tuberculosis diagnostic service.

  4. Tuberculosis Laboratory Diagnosis Quality Assurance among Public Health Facilities in West Amhara Region, Ethiopia.

    Directory of Open Access Journals (Sweden)

    Melashu Balew Shiferaw

    Full Text Available Reliable smear microscopy is an important component of Directly Observed Treatment Scheme (DOTS strategy for TB control program in countries with limited resources. Despite external quality assessment is established in Ethiopia, there is lower TB detection rate (48% in Amhara region compared to the World Health Organization (WHO estimate (70%. This highlights the quality of smear microscopy needs to be evaluated. Therefore, the aim of this study was to assess the quality of sputum smear microscopy performance among health center laboratories in West Amhara region, Ethiopia.A cross sectional study was conducted from July 08, 2013 to July 07, 2014. Data were collected from 201 public health center laboratories using a structured questionnaire. Slides were collected based on Lot Quality Assurance Sampling (LQAS method and rechecked blindly by trained laboratory technologists. The data were entered into EPI info V.7 and smear quality indicators and AFB results were analyzed by SPSS version 20.Among 201 laboratories enrolled in this study, 47 (23.4% laboratories had major errors. Forty one (20.4% laboratories had a total of 67 false negative and 29 (14.4% laboratories had a total of 68 false positive results. Specimen quality, smear thickness and evenness were found poor in 134 (66.7%, 133 (66.2% and 126 (62.7% laboratories, respectively. Unavailability of microscope lens cleaning solution (AOR: 2.90; 95% CI: 1.25-6.75; P: 0.013 and dirty smears (AOR: 2.65; 95% CI: 1.14-6.18; P: 0.024 were correlated with false negative results whereas no previous EQA participation (AOR: 3.43; 95% CI: 1. 39-8.45; P: 0.007 was associated with false positive results.The performance of health facilities for sputum smear microscopy was relatively poor in West Amhara region. Hence, strengthening the EQA program and technical support on sputum smear microscopy are recommended to ensure quality tuberculosis diagnostic service.

  5. Water Quality & Pollutant Source Monitoring: Field and Laboratory Procedures. Training Manual.

    Science.gov (United States)

    Office of Water Program Operations (EPA), Cincinnati, OH. National Training and Operational Technology Center.

    This training manual presents material on techniques and instrumentation used to develop data in field monitoring programs and related laboratory operations concerned with water quality and pollution monitoring. Topics include: collection and handling of samples; bacteriological, biological, and chemical field and laboratory methods; field…

  6. QUALITY ASSURANCE GUIDELINES FOR LABORATORIES PERFORMING FORENSIC ANALYSIS OF CHEMICAL TERRORISM

    Science.gov (United States)

    The Scientific Working Group on Forensic Analysis of Chemical Terrorism (SWGFACT) has developed the following quality assurance guidelines to provide laboratories engaged in forensic analysis of chemical evidence associated with terrorism a framework to implement a quality assura...

  7. The external quality assessment scheme: Five years experience as a participating laboratory

    Directory of Open Access Journals (Sweden)

    Chaudhary Rajendra

    2010-01-01

    Full Text Available Background and Aim : Quality assurance in blood banking includes active participation in the external quality program. Such a program offers valuable benefits to patient care, their safety, and an overall quality of laboratory practices. In the year 2002, we participated in the External Quality Assessment Scheme (EQAS under the World Health Organization (WHO, Bureau of Laboratory Quality Standards, Thailand. Materials and Methods: In the current study we evaluated our EQAS test result of the past five years, from 2003 to 2007. Test results of all blood samples such as ABO grouping, D typing, antibody screening, antibody identification, and transfusion transmitted infection (TTI testing were analyzed and documented. Results: Discordant results in one or more instances were observed with antibody identification, weak D testing, and tests for anti-HIV1/2 and HBsAg. Twice we failed to detect the ′anti-Mia′ antibody in the issued sample and that could be attributed to the absence of the corresponding antigen in the used cell panel. HBsAg was missed due to its critically low titer in the serum and the comparatively low sensitivity of our Enzyme-Linked Immunosorbent Assay (ELISA test kit. Conclusion: All these failures in the last five years have helped us to significantly improve our transfusion service in terms of performance evaluation, patient care and safety issues, and the overall quality of laboratory practices. We therefore recommend all laboratories and hospitals to participate in the EQAS program, which will definitely help them to improve from what they learn.

  8. Cost effectiveness of adopted quality requirements in hospital laboratories.

    Science.gov (United States)

    Hamza, Alneil; Ahmed-Abakur, Eltayib; Abugroun, Elsir; Bakhit, Siham; Holi, Mohamed

    2013-01-01

    The present study was designed in quasi-experiment to assess adoption of the essential clauses of particular clinical laboratory quality management requirements based on international organization for standardization (ISO 15189) in hospital laboratories and to evaluate the cost effectiveness of compliance to ISO 15189. The quality management intervention based on ISO 15189 was conceded through three phases; pre - intervention phase, Intervention phase and Post-intervention phase. In pre-intervention phase the compliance to ISO 15189 was 49% for study group vs. 47% for control group with P value 0.48, while the post intervention results displayed 54% vs. 79% for study group and control group respectively in compliance to ISO 15189 and statistically significant difference (P value 0.00) with effect size (Cohen's d) of (0.00) in pre-intervention phase and (0.99) in post - intervention phase. The annual average cost per-test for the study group and control group was 1.80 ± 0.25 vs. 1.97 ± 0.39, respectively with P value 0.39 whereas the post-intervention results showed that the annual average total costs per-test for study group and control group was 1.57 ± 0.23 vs 2.08 ± 0.38, P value 0.019 respectively, with cost-effectiveness ratio of (0.88) in pre -intervention phase and (0.52) in post-intervention phase. The planned adoption of quality management requirements (QMS) in clinical laboratories had great effect to increase the compliance percent with quality management system requirement, raise the average total cost effectiveness, and improve the analytical process capability of the testing procedure.

  9. Quality assurance plan for the Close Support Laboratory for the remedial investigation at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1993-08-01

    The primary purpose of the Close Support Laboratory (CSL) is to provide rapid radiological screening of investigation-derived samples before they are shipped to off-site laboratories for more detailed analyses. Analyses for volatile organic compounds and miscellaneous water quality parameters are also performed at the CSL. CSL data are also used to select samples for off-site laboratory analysis, for rapid qualitative and quantitative determinations, and for other processes when off-site analysis is not needed and/or is impractical. This plan specifies methods of implementing analytical and radiological protocols and procedures for the documentation, handling, control, and analysis of samples and describes the levels of authority and responsibility for laboratory operation. Specific quality control methods used by the CSL for individual analyses are described in project procedures

  10. National survey on internal quality control for tumour markers in clinical laboratories in China.

    Science.gov (United States)

    Wang, Wei; Zhong, Kun; Yuan, Shuai; He, Falin; Du, Yuxuan; Hu, Zhehui; Wang, Zhiguo

    2018-06-15

    This survey was initiated to obtain knowledge on the current situation of internal quality control (IQC) practice for tumour markers (TMs) in China. Additionally, we tried to acquire the most appropriate quality specifications. This survey was a current status survey. The IQC information had been collected via online questionnaires. All of 1821 clinical laboratories which participated in the 2016 TMs external quality assessment (EQA) programme had been enrolled. The imprecision evaluation criteria were the minimal, desirable, and optimal allowable imprecisions based on biological variations, and 1/3 total allowable error (TEa) and 1/4 TEa. A total of 1628 laboratories answered the questionnaires (89%). The coefficients of variation (CVs) of the IQC of participant laboratories varied greatly from 1% (5 th percentile) to 13% (95 th percentile). More than 82% (82 - 91%) of participant laboratories two types of CVs met 1/3 TEa except for CA 19-9. The percentiles of current CVs were smaller than cumulative CVs. A number of 1240 laboratories (76%) reported their principles and systems used. The electrochemiluminescence was the most used principle (45%) and had the smallest CVs. The performance of laboratories for TMs IQC has yet to be improved. On the basis of the obtained results, 1/3 TEa would be realistic and attainable quality specification for TMs IQC for clinical laboratories in China.

  11. Quality Indicators in Laboratory Medicine: the status of the progress of IFCC Working Group "Laboratory Errors and Patient Safety" project.

    Science.gov (United States)

    Sciacovelli, Laura; Lippi, Giuseppe; Sumarac, Zorica; West, Jamie; Garcia Del Pino Castro, Isabel; Furtado Vieira, Keila; Ivanov, Agnes; Plebani, Mario

    2017-03-01

    The knowledge of error rates is essential in all clinical laboratories as it enables them to accurately identify their risk level, and compare it with those of other laboratories in order to evaluate their performance in relation to the State-of-the-Art (i.e. benchmarking) and define priorities for improvement actions. Although no activity is risk free, it is widely accepted that the risk of error is minimized by the use of Quality Indicators (QIs) managed as a part of laboratory improvement strategy and proven to be suitable monitoring and improvement tools. The purpose of QIs is to keep the error risk at a level that minimizes the likelihood of patients. However, identifying a suitable State-of-the-Art is challenging, because it calls for the knowledge of error rates measured in a variety of laboratories throughout world that differ in their organization and management, context, and the population they serve. Moreover, it also depends on the choice of the events to keep under control and the individual procedure for measurement. Although many laboratory professionals believe that the systemic use of QIs in Laboratory Medicine may be effective in decreasing errors occurring throughout the total testing process (TTP), to improve patient safety as well as to satisfy the requirements of International Standard ISO 15189, they find it difficult to maintain standardized and systematic data collection, and to promote continued high level of interest, commitment and dedication in the entire staff. Although many laboratories worldwide express a willingness to participate to the Model of QIs (MQI) project of IFCC Working Group "Laboratory Errors and Patient Safety", few systematically enter/record their own results and/or use a number of QIs designed to cover all phases of the TTP. Many laboratories justify their inadequate participation in data collection of QIs by claiming that the number of QIs included in the MQI is excessive. However, an analysis of results suggests

  12. Quality-assurance results for routine water analysis in US Geological Survey laboratories, water year 1991

    Science.gov (United States)

    Maloney, T.J.; Ludtke, A.S.; Krizman, T.L.

    1994-01-01

    The US. Geological Survey operates a quality- assurance program based on the analyses of reference samples for the National Water Quality Laboratory in Arvada, Colorado, and the Quality of Water Service Unit in Ocala, Florida. Reference samples containing selected inorganic, nutrient, and low ionic-strength constituents are prepared and disguised as routine samples. The program goal is to determine precision and bias for as many analytical methods offered by the participating laboratories as possible. The samples typically are submitted at a rate of approximately 5 percent of the annual environmental sample load for each constituent. The samples are distributed to the laboratories throughout the year. Analytical data for these reference samples reflect the quality of environmental sample data produced by the laboratories because the samples are processed in the same manner for all steps from sample login through data release. The results are stored permanently in the National Water Data Storage and Retrieval System. During water year 1991, 86 analytical procedures were evaluated at the National Water Quality Laboratory and 37 analytical procedures were evaluated at the Quality of Water Service Unit. An overall evaluation of the inorganic (major ion and trace metal) constituent data for water year 1991 indicated analytical imprecision in the National Water Quality Laboratory for 5 of 67 analytical procedures: aluminum (whole-water recoverable, atomic emission spectrometric, direct-current plasma); calcium (atomic emission spectrometric, direct); fluoride (ion-exchange chromatographic); iron (whole-water recoverable, atomic absorption spectrometric, direct); and sulfate (ion-exchange chromatographic). The results for 11 of 67 analytical procedures had positive or negative bias during water year 1991. Analytical imprecision was indicated in the determination of two of the five National Water Quality Laboratory nutrient constituents: orthophosphate as phosphorus and

  13. Quality assurance plan for the molten salt reactor experiment Remediation Project at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1998-02-01

    This Quality Assurance Plan (QAP) identifies and describes the systems utilized by Molten Salt Reactor Experiment (MSRE) Remediation Project personnel to implement the requirements and associated applicable guidance contained in the Quality Program Description, Y/QD-15 Rev. 2 (Martin Marietta Energy Systems, Inc., 1995) and Environmental Management and Enrichment Facilities Work Smart Standards. This QAP defines the quality assurance (QA) requirements applicable to all activities and operations in and directly pertinent to the MSRE Remediation Project. This QAP will be periodically reviewed, revised, and approved as necessary. This QAP identifies and describes the QA activities and procedures implemented by the various Oak Ridge National Laboratory support organizations and personnel to provide confidence that these activities meet the requirements of this project. Specific support organization (Division) quality requirements, including the degree of implementation of each, are contained in the appendixes of this plan

  14. Improved Specimen-Referral System and Increased Access to Quality Laboratory Services in Ethiopia: The Role of the Public-Private Partnership.

    Science.gov (United States)

    Kebede, Yenew; Fonjungo, Peter N; Tibesso, Gudeta; Shrivastava, Ritu; Nkengasong, John N; Kenyon, Thomas; Kebede, Amha; Gadde, Renuka; Ayana, Gonfa

    2016-04-15

    Nonstandardized specimen-transport logistics, lack of laboratory personnel to transport specimens, lack of standard specimen containers, and long turnaround time (TAT) hindered access to quality laboratory services. The objective of the Becton, Dickinson, and Company (BD)-US President's Emergency Plan for AIDS Relief (PEPFAR) Public-Private Partnership (PPP) was to support country-specific programs to develop integrated laboratory systems, services, and quality improvement strategies, with an emphasis on strengthening the specimen-referral system (SRS). In 2007, through the Centers for Disease Control and Prevention (CDC), the Ethiopian Public Health Institute (EPHI) joined with the BD-PEPFAR PPP to strengthen laboratory systems. A joint planning and assessment committee identified gaps in the SRS for prioritization and intervention and piloted the system in Addis Ababa and Amhara Region. The PPP established standardized, streamlined specimen logistics, using the Ethiopian Postal Service Enterprise to support a laboratory network in which 554 facilities referred specimens to 160 laboratories. The PPP supported procuring 400 standard specimen containers and the training of 586 laboratory personnel and 81 postal workers. The average TAT was reduced from 7 days (range, 2-14 days) to 2 days (range, 1-3 days) in Addis Ababa and from 10 days (range, 6-21 days) to 5 days (range, 2-6 days) in Amhara Region. This study highlights the feasibility and untapped potential of PPPs to strengthen laboratory systems. This planned and structured approach to improving specimen referral enhanced access to quality laboratory services. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  15. Association Between Echocardiography Laboratory Accreditation and the Quality of Imaging and Reporting for Valvular Heart Disease.

    Science.gov (United States)

    Thaden, Jeremy J; Tsang, Michael Y; Ayoub, Chadi; Padang, Ratnasari; Nkomo, Vuyisile T; Tucker, Stephen F; Cassidy, Cynthia S; Bremer, Merri; Kane, Garvan C; Pellikka, Patricia A

    2017-08-01

    It is presumed that echocardiographic laboratory accreditation leads to improved quality, but there are few data. We sought to compare the quality of echocardiographic examinations performed at accredited versus nonaccredited laboratories for the evaluation of valvular heart disease. We enrolled 335 consecutive valvular heart disease subjects who underwent echocardiography at our institution and an external accredited or nonaccredited institution within 6 months. Completeness and quality of echocardiographic reports and images were assessed by investigators blinded to the external laboratory accreditation status and echocardiographic results. Compared with nonaccredited laboratories, accredited sites more frequently reported patient sex (94% versus 78%; P heart disease. Future quality improvement initiatives should highlight the importance of high-quality color Doppler imaging and echocardiographic quantification to improve the accuracy, reproducibility, and quality of echocardiographic studies for valvular heart disease. © 2017 American Heart Association, Inc.

  16. Development and Implementation of a Quality Improvement Process for Echocardiographic Laboratory Accreditation.

    Science.gov (United States)

    Gilliland, Yvonne E; Lavie, Carl J; Ahmad, Homaa; Bernal, Jose A; Cash, Michael E; Dinshaw, Homeyar; Milani, Richard V; Shah, Sangeeta; Bienvenu, Lisa; White, Christopher J

    2016-03-01

    We describe our process for quality improvement (QI) for a 3-year accreditation cycle in echocardiography by the Intersocietal Accreditation Commission (IAC) for a large group practice. Echocardiographic laboratory accreditation by the IAC was introduced in 1996, which is not required but could impact reimbursement. To ensure high-quality patient care and community recognition as a facility committed to providing high-quality echocardiographic services, we applied for IAC accreditation in 2010. Currently, there is little published data regarding the IAC process to meet echocardiography standards. We describe our approach for developing a multicampus QI process for echocardiographic laboratory accreditation during the 3-year cycle of accreditation by the IAC. We developed a quarterly review assessing (1) the variability of the interpretations, (2) the quality of the examinations, (3) a correlation of echocardiographic studies with other imaging modalities, (4) the timely completion of reports, (5) procedure volume, (6) maintenance of Continuing Medical Education credits by faculty, and (7) meeting Appropriate Use Criteria. We developed and implemented a multicampus process for QI during the 3-year accreditation cycle by the IAC for Echocardiography. We documented both the process and the achievement of those metrics by the Echocardiography Laboratories at the Ochsner Medical Institutions. We found the QI process using IAC standards to be a continuous educational experience for our Echocardiography Laboratory physicians and staff. We offer our process as an example and guide for other echocardiography laboratories who wish to apply for such accreditation or reaccreditation. © 2016, Wiley Periodicals, Inc.

  17. AUDILAB: a knowledge-based quality audit simulator for testing laboratories.

    Science.gov (United States)

    Brai, A; Garnerin, P

    1997-05-01

    In order to obtain an accreditation, a laboratory must be prepared to provide a point-by-point check of various activities against the chosen reference standard, both from a general point of view and in relation to details of application. This paper describes AUDILAB, a computerized simulator accessible by network, able to provide testing laboratories with realistic quality audits performed in a customized way. AUDILAB establishes a detailed list of strengths (compliance with corresponding requirements of established standards) and weaknesses (improvements needed for laboratory's accreditation). The standard used by AUDILAB is the EN 45001 "General criteria for the operation of testing laboratories". A preliminary validation has already been completed. AUDILAB became operational in September 1993.

  18. Student laboratory reports: an approach to improving feedback and quality

    Science.gov (United States)

    Ellingsen, Pål Gunnar; Støvneng, Jon Andreas

    2018-05-01

    We present an ongoing effort in improving the quality of laboratory reports written by first and second year physics students. The effort involves a new approach where students are given the opportunity to submit reports at intermediate deadlines, receive feedback, and then resubmit for the final deadline. In combination with a differential grading system, instead of pass/fail, the improved feedback results in higher quality reports. Improvement in the quality of the reports is visible through the grade statistics.

  19. Managing quality in laboratory analysis

    International Nuclear Information System (INIS)

    Piciorea, Iuliana

    2007-01-01

    For the results of analyses to be reliable, the laboratories has to be authorized or to prove that they follows ISO/CEI standard no. 17025:2005 'General requirements for the competence of testing and calibration laboratories'. Analytic measurements are the results of analytic methods and procedures. It is considered that the chosen analytic method or procedure is appropriated for the desired purpose. From the legal point of view 'matching for a purpose' means that all methods and procedures are valid and this validation is made using qualified and verified equipment. Using state of art equipment in a laboratory, it is not enough to obtain correct results. The type, the extension and management of a validation action permit to obtain conclusions regarding the existence of adequate equipment, showing at the same time that the lab has an adequate management and competent personnel. To give results of required quality ensuring the conformity with national and international regulations, hence to prove its qualifications and competence some of measures are required as follows: - the usage of validated testing methods; - the usage of their quality control procedures; - participating to capability testing of the lab; -accreditation according to the requirements of an international standard as ISO/CEI 17025:2005. This accreditation is a set of technical and organization requirements about equipment checking, the way of choosing test methods, personal competence, determination of measurement uncertainty, etc. According to ISO, the validation represents the confirmation throughout examination and supplying of realistic proofs showing that the necessary requirements needed for utilization are fulfilled. The object of validation is checking the fact that the measurement conditions and the equation used to get the final result include all influences that could affect it. For validation studies, a series of checks is made: - linearity check - it is checked if the method is

  20. Quality assurance consideration for cement-based grout technology programs at Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

    McDaniel, E.W.; Tallent, O.K.; Sams, T.L.; Delzer, D.B.

    1987-01-01

    Oak Ridge National Laboratory has developed and is continuing to refine a method of immobilizing low-level radioactive liquid wastes by mixing them with cementitious dry-solid blends. A quality assurance program is vital to the project because Nuclear Regulatory Commission (NRC), Environmental Protection Agency (EPA) and state environmental regulations must be demonstrably met (the work must be defensible in a court of law). The end result of quality assurance (QA) is, by definition, a product of demonstrable quality. In the laboratory, this entails traceability, repeatability, and credibility. This paper describes the application of QA in grout technology development at Oak Ridge National Laboratory

  1. Quality management at Argonne National Laboratory: Status, accomplishments, and lessons learned

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-06-01

    In April 1992, Argonne National Laboratory (ANL) launched the implementation of quality management (QM) as an initiative of the Laboratory Director. The goal of the program is to seek ways of improving Laboratory performance and effectiveness by drawing from the realm of experiences in the global total quality management movement. The Argonne QM initiative began with fact finding and formulating a strategy for implementation; the emphasis is that the underlying principles of QM should be an integral part of how the Laboratory is managed and operated. A primary theme that has guided the Argonne QM initiative is to consider only those practices that offer the potential for real improvement, make sense, fit the culture, and would be credible to the broad population. In October 1993, the Laboratory began to pilot a targeted set of QM activities selected to produce outcomes important to the Laboratory--strengthening the customer focus, improving work processes, enhancing employee involvement and satisfaction, and institutionalizing QM. This report describes the results of the just-concluded QM development and demonstration phase in terms of detailed strategies, accomplishments, and lessons learned. These results are offered as evidence to support the conclusion that the Argonne QM initiative has achieved value-added results and credibility and is well positioned to support future deployment across the entire Laboratory as an integrated management initiative. Recommendations for follow-on actions to implement future deployment are provided separately.

  2. Laboratory automation of high-quality and efficient ligand-binding assays for biotherapeutic drug development.

    Science.gov (United States)

    Wang, Jin; Patel, Vimal; Burns, Daniel; Laycock, John; Pandya, Kinnari; Tsoi, Jennifer; DeSilva, Binodh; Ma, Mark; Lee, Jean

    2013-07-01

    Regulated bioanalytical laboratories that run ligand-binding assays in support of biotherapeutics development face ever-increasing demand to support more projects with increased efficiency. Laboratory automation is a tool that has the potential to improve both quality and efficiency in a bioanalytical laboratory. The success of laboratory automation requires thoughtful evaluation of program needs and fit-for-purpose strategies, followed by pragmatic implementation plans and continuous user support. In this article, we present the development of fit-for-purpose automation of total walk-away and flexible modular modes. We shared the sustaining experience of vendor collaboration and team work to educate, promote and track the use of automation. The implementation of laboratory automation improves assay performance, data quality, process efficiency and method transfer to CRO in a regulated bioanalytical laboratory environment.

  3. Quality Assurance and Control in Laboratory using Neutron Activation Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Y. S.; Moon, J. H.; Sun, G. M.; Kim, S. H.; Baek, S. Y.; Lim, J. M.; Kim, H. R

    2007-01-15

    In accordance with the increment of international trade associated with the worldwide globalization, the importance of quality assurance and control for the commodity produced from one's own country has been stressed. ISO (International Organization for Standards) defines quality control as 'the operational techniques and activities that are used to fulfill the requirements for quality'. Since 1996, the HANARO research reactor in the Korea Atomic Energy Research Institute has been operated thereafter initial critical operation on April 1995. Neutron activation analysis system and applied techniques which is one of a nuclear analytical technologies using reactor neutrons has been developed for user's supporting and the establishment of the quality system for a measurement and analysis, testing and inspection was implemented successfully. On the basis of the qualified NAA system, the test and measurement of more than 1500 samples which is requested from 30 organizations including industrial companies, universities and institutes carried out in NAA laboratory annually. Moreover, as the goal of mutual recognition agreement (MRA) which can be removed a technical barrier in international trade, the objectivity and the confidence of analytical quality in NAA laboratory became established through the installation of international accreditation system by implementing analytical quality system in accordance with international standards in 2001. The aim of the report was to summarize the technical management of introduction, methods and the results for a quality control and assurance which should be performed in NAA technique using the HANARO research reactor. The report will help building up effective quality control strategy in the future.

  4. Quality Assurance and Control in Laboratory using Neutron Activation Analysis

    International Nuclear Information System (INIS)

    Chung, Y. S.; Moon, J. H.; Sun, G. M.; Kim, S. H.; Baek, S. Y.; Lim, J. M.; Kim, H. R.

    2007-01-01

    In accordance with the increment of international trade associated with the worldwide globalization, the importance of quality assurance and control for the commodity produced from one's own country has been stressed. ISO (International Organization for Standards) defines quality control as 'the operational techniques and activities that are used to fulfill the requirements for quality'. Since 1996, the HANARO research reactor in the Korea Atomic Energy Research Institute has been operated thereafter initial critical operation on April 1995. Neutron activation analysis system and applied techniques which is one of a nuclear analytical technologies using reactor neutrons has been developed for user's supporting and the establishment of the quality system for a measurement and analysis, testing and inspection was implemented successfully. On the basis of the qualified NAA system, the test and measurement of more than 1500 samples which is requested from 30 organizations including industrial companies, universities and institutes carried out in NAA laboratory annually. Moreover, as the goal of mutual recognition agreement (MRA) which can be removed a technical barrier in international trade, the objectivity and the confidence of analytical quality in NAA laboratory became established through the installation of international accreditation system by implementing analytical quality system in accordance with international standards in 2001. The aim of the report was to summarize the technical management of introduction, methods and the results for a quality control and assurance which should be performed in NAA technique using the HANARO research reactor. The report will help building up effective quality control strategy in the future

  5. ASVCP quality assurance guidelines: external quality assessment and comparative testing for reference and in-clinic laboratories.

    Science.gov (United States)

    Camus, Melinda S; Flatland, Bente; Freeman, Kathleen P; Cruz Cardona, Janice A

    2015-12-01

    The purpose of this document is to educate providers of veterinary laboratory diagnostic testing in any setting about comparative testing. These guidelines will define, explain, and illustrate the importance of a multi-faceted laboratory quality management program which includes comparative testing. The guidelines will provide suggestions for implementation of such testing, including which samples should be tested, frequency of testing, and recommendations for result interpretation. Examples and a list of vendors and manufacturers supplying control materials and services to veterinary laboratories are also included. © 2015 American Society for Veterinary Clinical Pathology.

  6. Application of Sigma Metrics Analysis for the Assessment and Modification of Quality Control Program in the Clinical Chemistry Laboratory of a Tertiary Care Hospital.

    Science.gov (United States)

    Iqbal, Sahar; Mustansar, Tazeen

    2017-03-01

    Sigma is a metric that quantifies the performance of a process as a rate of Defects-Per-Million opportunities. In clinical laboratories, sigma metric analysis is used to assess the performance of laboratory process system. Sigma metric is also used as a quality management strategy for a laboratory process to improve the quality by addressing the errors after identification. The aim of this study is to evaluate the errors in quality control of analytical phase of laboratory system by sigma metric. For this purpose sigma metric analysis was done for analytes using the internal and external quality control as quality indicators. Results of sigma metric analysis were used to identify the gaps and need for modification in the strategy of laboratory quality control procedure. Sigma metric was calculated for quality control program of ten clinical chemistry analytes including glucose, chloride, cholesterol, triglyceride, HDL, albumin, direct bilirubin, total bilirubin, protein and creatinine, at two control levels. To calculate the sigma metric imprecision and bias was calculated with internal and external quality control data, respectively. The minimum acceptable performance was considered as 3 sigma. Westgard sigma rules were applied to customize the quality control procedure. Sigma level was found acceptable (≥3) for glucose (L2), cholesterol, triglyceride, HDL, direct bilirubin and creatinine at both levels of control. For rest of the analytes sigma metric was found control levels (8.8 and 8.0 at L2 and L3, respectively). We conclude that analytes with the sigma value quality control procedure. In this study application of sigma rules provided us the practical solution for improved and focused design of QC procedure.

  7. Standard guide for establishing a quality assurance program for analytical chemistry laboratories within the nuclear industry

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2006-01-01

    1.1 This guide covers the establishment of a quality assurance (QA) program for analytical chemistry laboratories within the nuclear industry. Reference to key elements of ANSI/ISO/ASQC Q9001, Quality Systems, provides guidance to the functional aspects of analytical laboratory operation. When implemented as recommended, the practices presented in this guide will provide a comprehensive QA program for the laboratory. The practices are grouped by functions, which constitute the basic elements of a laboratory QA program. 1.2 The essential, basic elements of a laboratory QA program appear in the following order: Section Organization 5 Quality Assurance Program 6 Training and Qualification 7 Procedures 8 Laboratory Records 9 Control of Records 10 Control of Procurement 11 Control of Measuring Equipment and Materials 12 Control of Measurements 13 Deficiencies and Corrective Actions 14

  8. Sunway Medical Laboratory Quality Control Plans Based on Six Sigma, Risk Management and Uncertainty.

    Science.gov (United States)

    Jairaman, Jamuna; Sakiman, Zarinah; Li, Lee Suan

    2017-03-01

    Sunway Medical Centre (SunMed) implemented Six Sigma, measurement uncertainty, and risk management after the CLSI EP23 Individualized Quality Control Plan approach. Despite the differences in all three approaches, each implementation was beneficial to the laboratory, and none was in conflict with another approach. A synthesis of these approaches, built on a solid foundation of quality control planning, can help build a strong quality management system for the entire laboratory. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Los Alamos National Laboratory transuranic waste quality assurance project plan. Revision 1

    International Nuclear Information System (INIS)

    1997-01-01

    This Transuranic (TRU) Waste Quality Assurance Project Plan (QAPjP) serves as the quality management plan for the characterization of transuranic waste in preparation for certification and transportation. The Transuranic Waste Characterization/Certification Program (TWCP) consists of personnel who sample and analyze waste, validate and report data; and provide project management, quality assurance, audit and assessment, and records management support, all in accordance with established requirements for disposal of TRU waste at the Waste Isolation Pilot Plant (WIPP) facility. This QAPjP addresses how the TWCP meets the quality requirements of the Carlsbad Area Office (CAO) Quality Assurance Program Description (QAPD) and the technical requirements of the Transuranic Waste Characterization Quality Assurance Program Plan (QAPP). The TWCP characterizes and certifies retrievably stored and newly generated TRU waste using the waste selection, testing, sampling, and analytical techniques and data quality objectives (DQOs) described in the QAPP, the Los Alamos National Laboratory Transuranic Waste Certification Plan (Certification Plan), and the CST Waste Management Facilities Waste Acceptance Criteria and Certification [Los Alamos National Laboratory (LANL) Waste Acceptance Criteria (WAC)]. At the present, the TWCP does not address remote-handled (RH) waste

  10. Application of indices Cp and Cpk to improve quality control capability in clinical biochemistry laboratories.

    Science.gov (United States)

    Chen, Ming-Shu; Wu, Ming-Hsun; Lin, Chih-Ming

    2014-04-30

    The traditional criteria for acceptability of analytic quality may not be objective in clinical laboratories. To establish quality control procedures intended to enhance Westgard multi-rules for improving the quality of clinical biochemistry tests, we applied the Cp and Cpk quality-control indices to monitor tolerance fitting and systematic variation of clinical biochemistry test results. Daily quality-control data of a large Taiwanese hospital in 2009 were analyzed. The test items were selected based on an Olympus biochemistry machine and included serum albumin, aspartate aminotransferase, cholesterol, glucose and potassium levels. Cp and Cpk values were calculated for normal and abnormal levels, respectively. The tolerance range was estimated with data from 50 laboratories using the same instruments and reagents. The results showed a monthly trend of variation for the five items under investigation. The index values of glucose were lower than those of the other items, and their values were usually quality control, but also for revealing inter-laboratory qualitycontrol capability differences.

  11. Development and implementation of the Caribbean Laboratory Quality Management Systems Stepwise Improvement Process (LQMS-SIP) Towards Accreditation.

    Science.gov (United States)

    Alemnji, George; Edghill, Lisa; Guevara, Giselle; Wallace-Sankarsingh, Sacha; Albalak, Rachel; Cognat, Sebastien; Nkengasong, John; Gabastou, Jean-Marc

    2017-01-01

    Implementing quality management systems and accrediting laboratories in the Caribbean has been a challenge. We report the development of a stepwise process for quality systems improvement in the Caribbean Region. The Caribbean Laboratory Stakeholders met under a joint Pan American Health Organization/US Centers for Disease Control and Prevention initiative and developed a user-friendly framework called 'Laboratory Quality Management System - Stepwise Improvement Process (LQMS-SIP) Towards Accreditation' to support countries in strengthening laboratory services through a stepwise approach toward fulfilling the ISO 15189: 2012 requirements. This approach consists of a three-tiered framework. Tier 1 represents the minimum requirements corresponding to the mandatory criteria for obtaining a licence from the Ministry of Health of the participating country. The next two tiers are quality improvement milestones that are achieved through the implementation of specific quality management system requirements. Laboratories that meet the requirements of the three tiers will be encouraged to apply for accreditation. The Caribbean Regional Organisation for Standards and Quality hosts the LQMS-SIP Secretariat and will work with countries, including the Ministry of Health and stakeholders, including laboratory staff, to coordinate and implement LQMS-SIP activities. The Caribbean Public Health Agency will coordinate and advocate for the LQMS-SIP implementation. This article presents the Caribbean LQMS-SIP framework and describes how it will be implemented among various countries in the region to achieve quality improvement.

  12. Quality assurance program plan for low-level waste at the WSCF Laboratory

    International Nuclear Information System (INIS)

    Morrison, J.A.

    1994-01-01

    The purpose of this document is to provide guidance for the implementation of the Quality Assurance Program Plan (QAPP) for the management of low-level waste at the Waste Sampling and Characterization Facility (WSCF) Laboratory Complex as required by WHC-CM-4-2, Quality Assurance Manual, which is based on Quality Assurance Program Requirements for Nuclear Facilities, NQA-1 (ASME)

  13. Assuring the Quality of Next-Generation Sequencing in Clinical Microbiology and Public Health Laboratories.

    Science.gov (United States)

    Gargis, Amy S; Kalman, Lisa; Lubin, Ira M

    2016-12-01

    Clinical microbiology and public health laboratories are beginning to utilize next-generation sequencing (NGS) for a range of applications. This technology has the potential to transform the field by providing approaches that will complement, or even replace, many conventional laboratory tests. While the benefits of NGS are significant, the complexities of these assays require an evolving set of standards to ensure testing quality. Regulatory and accreditation requirements, professional guidelines, and best practices that help ensure the quality of NGS-based tests are emerging. This review highlights currently available standards and guidelines for the implementation of NGS in the clinical and public health laboratory setting, and it includes considerations for NGS test validation, quality control procedures, proficiency testing, and reference materials. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  14. ABACC laboratories quality assurance through Secondary Standards Exchange Program

    International Nuclear Information System (INIS)

    Guidicini, Olga Mafra; Thompson, Jay; Soriano, Michael

    2003-01-01

    In September 1999, the Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials (ABACC), with assistance from the New Brunswick Laboratory (NBL) of the U.S. Department of Energy, started a new cooperative activity with, among other objectives, the production and characterization of a traceable uranium secondary standard and the performance of the Third Round Robin for ABACC's laboratory network. Brazil and Argentina have fabricated UO 2 pellets for use as a secondary standard. Samples from the two batches were sent to NBL for the determination of the reference values for both uranium concentration (%U) and isotopic composition for each batch. ABACC and NBL then organized the Third ABACC Round Robin for Brazilian and Argentine laboratories that are part of the ABACC network. The laboratories comprising the network can be used to analyze real samples collected during the ABACC inspections. The Brazilian and Argentine pellets were distributed to all the laboratories together with the protocol to be followed for the uranium concentration analysis, the forms for reporting the measurement results, and natural UO 2 pellets (CETAMA OU1) to be used as reference material. For the laboratories with capability of measuring isotopics, NBL reference material CRM 125-A was provided. Several laboratories from each country provided results. As soon as the measurement results were sent to the organizers, they were statistically evaluated by NBL. During a meeting held at ABACC headquarters with the participation of NBL representatives, the ABACC technical support officer, and representatives of all the participant laboratories, the results were discussed and compared with the reference values. All the laboratories had the occasion, in an open discussion, to explain and show the difficulties and problems they faced during the exercise. ABACC had the opportunity not only to judge the quality of the measurements these laboratories performed, but also to determine

  15. [The practice of development and implementation of quality management systems in medical laboratories. The GOST R ISO 15189-2009 "medical laboratories. The detailed requirements to quality and competence". Particular difficulties of global nature].

    Science.gov (United States)

    Emanuel', A V; Ivanov, G A; Fleganova, I N; Emanuel', V L

    2012-12-01

    The article discusses the methodological issues related to the implementation of international principles of standardization in the format of GOST R ISO 9001-2008 "Quality management systems. Requirements", GOST R ISO 15189-2009 "Medical laboratories. The detailed requirements to quality and competence" and GOST R ISO 18113.1-5 "Medical items for diagnostics in vitro. Information provided by manufacturer (marking)". This approach legibly assigns the responsibility concerning the support of metrological correctness of laboratory measurements. The lacking of both full-value public and sectorial normative documentation and coordinated positions of Rosstandard and Minzdrav of Russia on functioning of medical laboratories is noted.

  16. Comparison of Laboratory and Field Remote Sensing Methods to Measure Forage Quality

    OpenAIRE

    Guo, Xulin; Wilmshurst, John F.; Li, Zhaoqin

    2010-01-01

    Recent research in range ecology has emphasized the importance of forage quality as a key indicator of rangeland condition. However, we lack tools to evaluate forage quality at scales appropriate for management. Using canopy reflectance data to measure forage quality has been conducted at both laboratory and field levels separately, but little work has been conducted to evaluate these methods simultaneously. The objective of this study is to find a reliable way of assessing grassland quality ...

  17. QUALITY MANAGEMENT SYSTEM IN CLINICAL LABORATORIES ACCORDING TO THE ISO 15189:2007 STANDARD - EVALUATION OF THE BENEFITS OF IMPLEMENTATION IN AN ASSISTED REPRODUCTION LABORATORY

    Directory of Open Access Journals (Sweden)

    A.D. Sialakouma

    2011-03-01

    Full Text Available Biomedical science is a sensitive discipline and presents unique challenges due to its social character, continuous development and competitiveness. The issue of quality management systems and accreditation is gaining increasing interest in this sector. All over Europe, Health Services Units have started to introduce quality management systems and harmonization of criteria for accreditation is of increasing importance. Moreover, clinical laboratories, like the Assisted Reproduction laboratories and biochemical laboratories are required to apply a Quality Management System in order to ensure their correct, scientific and effective operation. Ultimately, it is a moral obligation for every health care organisation to supply the best possible care for the patient. The specific features and the diversity of clinical laboratories led to the introduction (2003 and, recently to the revision (2007 of the international standard ISO 15189, which is the first international standard developed specifically to address the requirements for accreditation of this type of laboratory. The basic principles for the quality assurance in the clinical laboratories are: x Complete and unambiguous standardized operating procedures. x Complete and unambiguous directives of operation. x Obligatory detailed written documentation, i.e., how each action is done, who will do it, where will this action take place and when. x Suitable scheduling of calibration/control/preventive maintenance of laboratory equipment and recording of each activity. x Distribution of responsibilities among the staff and continuous education and briefing according to current scientific data. x Complete and informed record file keeping. x Continuous improvement which is monitored with the adoption of quantified indicators. x Internal and external audit of all activities. x Troubleshooting. All these principles should be supported by the Management in order that the necessary adaptations should be made

  18. External quality assessment on detection of hepatitis C virus RNA in clinical laboratories of China.

    Science.gov (United States)

    Wang, Lu-nan; Zhang, Rui; Shen, Zi-yu; Chen, Wen-xiang; Li, Jin-ming

    2008-06-05

    As with many studies carried out in European countries, a quality assurance program has been established by the National Center for Clinical Laboratories in China (NCCL). The results showed that the external quality assessment significantly improves laboratory performance for quantitative evaluation of hepatitis C virus (HCV) RNA. Serum panels were delivered twice annually to the clinical laboratories which performed HCV RNA detection in China. Each panel made up of 5 coded samples. All laboratories were requested to carry out the detection within the required time period and report on testing results which contained qualitative and/or quantitative test findings, reagents used and relevant information about apparatus. All the positive samples were calibrated against the first International Standard for HCV RNA in a collaborative study and the range of comparison target value (TG) designated as +/- 0.5 log. The numbers of laboratories reporting on qualitative testing results for the first and second time external quality assessment were 168 and 167 in the year of 2003 and increased to 209 and 233 in 2007; the numbers of laboratories reporting on quantitative testing results were 134 and 147 in 2003 and rose to 340 and 339 in 2007. Deviation between the mean value for quantitative results at home in 2003 and the target value was above 0.5 log, which was comparatively high. By 2007, the target value was close to the national average except for the low concentrated specimens (10(3) IU/ml). The percentage of results within the range of GM +/- 0.5 log(10) varied from 8.2% to 93.5%. Some laboratories had some difficulties in the exact quantification of the lowest (3.00 log IU/ml) as well as of the highest viral levels (6.37 log IU/ml) values, very near to the limits of the dynamic range of the assays. The comparison of these results with the previous study confirms that a regular participation in external quality assessment (EQA) assures the achievement of a high

  19. Implementation of quality management systems and progress towards accreditation of National Tuberculosis Reference Laboratories in Africa

    Directory of Open Access Journals (Sweden)

    Heidi Albert

    2017-03-01

    Full Text Available Background: Laboratory services are essential at all stages of the tuberculosis care cascade, from diagnosis and drug resistance testing to monitoring response to treatment. Enabling access to quality services is a challenge in low-resource settings. Implementation of a strong quality management system (QMS and laboratory accreditation are key to improving patient care. Objectives: The study objective was to determine the status of QMS implementation and progress towards accreditation of National Tuberculosis Reference Laboratories (NTRLs in the African Region. Method: An online questionnaire was administered to NTRL managers in 47 World Health Organization Regional Office for Africa member states in the region, between February and April 2015, regarding the knowledge of QMS tools and progress toward implementation to inform strategies for tuberculosis diagnostic services strengthening in the region. Results: A total of 21 laboratories (43.0% had received SLMTA/TB-SLMTA training, of which 10 had also used the Global Laboratory Initiative accreditation tool. However, only 36.7% of NTRLs had received a laboratory audit, a first step in quality improvement. Most NTRLs participated in acid-fast bacilli microscopy external quality assurance (95.8%, although external quality assurance for other techniques was lower (60.4% for first-line drug susceptibility testing, 25.0% for second-line drug susceptibility testing, and 22.9% for molecular testing. Barriers to accreditation included lack of training and accreditation programmes. Only 28.6%of NTRLs had developed strategic plans and budgets which included accreditation. Conclusion: Good foundations are in place on the continent from which to scale up accreditation efforts. Laboratory audits should be conducted as a first step in developing quality improvement action plans. Political commitment and strong leadership are needed to drive accreditation efforts; advocacy will require clear evidence of patient

  20. Service Quality and Patient Satisfaction: An Exploratory Study of Pathology Laboratories in Jaipur.

    Science.gov (United States)

    Agarwal, Anuradha; Singh, Maithili R P

    2016-01-01

    One of the most important parts of healthcare system is diagnostics. Nowadays, Indians have become more aware of their health, due to improved and better availability of health related information, increase in medical tourism, and expanding health insurance. The demand for better diagnostic facilities have increased with the increase in lifestyle related diseases, excesses use of chemicals in agriculture practices and change in food habits. It is expected that the Indian diagnostic market will grow from USD $5 billion in the year 2012 to USD $32 billion by the year 2020 with 20% CAGR (India Brand Equity Foundation 2015 ). Today patients have easy access of information regarding the health services and they have become more concerned about it as they look forward to receiving the maximum value for their money. To win the confidence of the patients and to maintain that trust, it is required to deliver the right services to the right person at the right time. The purpose of this study was to develop a scale to measure the service quality at pathology laboratory. A thorough review of literature revealed that there are studies related to healthcare service quality but there is no such established scale to measure service quality of pathology laboratory. Thus, the authors strived to develop a reliable and valid instrument to measure the patients' perception toward pathology laboratory service quality. For this exploratory study was conducted on the sample of 80 patients of the laboratories in Jaipur city. The reliability and factor structures were tested to purify the scale. The findings revealed 13 items, comprising of three dimensions of service quality: responsiveness, tangibility, and reliability.

  1. Identifying Contractors’ Planned Quality Costs in Indonesian Construction Projects

    Directory of Open Access Journals (Sweden)

    Puti F. Marzuki

    2014-12-01

    Full Text Available In a very competitive construction industry, quality costs have to be measured to be able to identify potential quality problem areas and to focus attention on work output improvement opportunities. The awareness of contractors on the importance of quality costs could be reflected in the extent of their quality costs planning. This paper presents an identification of planned quality costs in three construction projects executed by two large Indonesian contractors, a state-owned company and a private company in Jakarta. The objective is to enable the contractors to elaborate their quality costs planning and thereby improve their work output based on the findi ngs. Quality costs are first grouped into three categories: prevention, appraisal, and failure costs. Based on the works of previous researchers, a list of quality management activities that should be covered in each quality costs category is then created. The contractors’ planned quality costs data for each category are identified and collected through interviews and questionnaire surveys that refer to the list. Quality costs are expressed as a percentage of contract value. It is revealed that although large contractors already have certain knowledge on quality costs in construction projects, these costs are not planned in a structured way through an analysis of systematic quality costs records. Through cost categorization it is also shown that higher prevention and appraisal costs lead to lower failure costs. It is then concluded that a lot of work is still to be done by the contractors to set up a quality costs recording system which can serve as a basis for their quality improvement planning.

  2. Measurement of radionuclides in contaminated environmental matrices: participation in quality assessment programme of U.S. Department of energy's environmental monitoring laboratory

    International Nuclear Information System (INIS)

    SIDDIQUE, N.; Rahman, A.; Waheed, S.; Wasim, M.; Daud, M.; Ahmad, S.

    2006-03-01

    A Quality Assessment Programme (QAP) was initiated by the US, Department of Energy (DOE) in 1998 to establish credibility of radionuclide measurements in contaminated environmental samples, i.e. soil, vegetation and air filters. In this context best-known and pertinent laboratories around the world were identified and invited to participate in this programme. To evaluate the performance of these prestigious laboratories, the Miniature Neutron Source Reactor (MNSR) Neutron Activation Analysis (NAA) Laboratory at NCD, PINSTECH, which is an IAEA declared Regional Resource Unit (IAEA-RRU), along with 76 other laboratories were asked to take part in a regular proficiency exercise. In this report, the performance of the NAA Laboratory throughout the QAP programme (1998-2004) is presented is detail, describing the procedures employed, the problems encountered and the improvement and expertise gained from participating in this assessment programme. (author)

  3. Assessment of three medical and research laboratories using WHO AFRO_SLIPTA Quality Standards in Southwestern Uganda: a long way to go.

    Science.gov (United States)

    Taremwa, Ivan Mugisha; Ampaire, Lucas; Iramiot, Jacob; Muhwezi, Obed; Matte, Aloysius; Itabangi, Herbert; Mbabazi, Hope; Atwebembeire, Jeninah; Kamwine, Monicah; Katawera, Victoria; Mbalibulha, Yona; Orikiriza, Patrick; Boum, Yap

    2017-01-01

    While the laboratory represents more than 70% of clinical diagnosis and patient management, access to reliable and quality laboratory diagnostics in sub-Saharan Africa remains a challenge. To gain knowledge and suggest evidence based interventions towards laboratory improvement in Southwestern Uganda, we assessed the baseline laboratory quality standards in three medical and research laboratories in Southwestern Uganda. We conducted a cross sectional survey from October, 2013 to April, 2014. Selected laboratories, including one private research, one private for profit and one public laboratory, were assessed using the WHO AFRO_SLIPTA checklist and baseline scores were determined. The three laboratories assessed met basic facility requirements, had trained personnel, and safety measures in place. Sample reception was properly designed and executed with a well designated chain of custody. All laboratories had sufficient equipment for the nature of work they were involved in. However, we found that standard operating procedures were incomplete in all three laboratories, lack of quality audit schemes by two laboratories and only one laboratory enrolled into external quality assurance schemes. The SLIPTA scores were one star for the research laboratory and no star for both the public and private-for-profit laboratories. While most of the laboratory systems were in place, the low scores obtained by the assessed laboratories reflect the need for improvement to reach standards of quality assured diagnostics in the region. Therefore, routine mentorship and regional supportive supervision are necessary to increase the quality of laboratory services.

  4. Impact of Nuclear Laboratory Personnel Credentials & Continuing Education on Nuclear Cardiology Laboratory Quality Operations.

    Science.gov (United States)

    Malhotra, Saurabh; Sobieraj, Diana M; Mann, April; Parker, Matthew W

    2017-12-22

    Background/Objectives: The specific credentials and continuing education (CME/CE) of nuclear cardiology laboratory medical and technical staff are important factors in the delivery of quality imaging services that have not been systematically evaluated. Methods: Nuclear cardiology accreditation application data from the Intersocietal Accreditation Commission (IAC) was used to characterize facilities performing myocardial perfusion imaging by setting, size, previous accreditation and credentials of the medical and technical staff. Credentials and CME/CE were compared against initial accreditation decisions (grant or delay) using multivariable logistic regression. Results: Complete data were available for 1913 nuclear cardiology laboratories from 2011-2014. Laboratories with initial positive accreditation decisions had a greater prevalence of Certification Board in Nuclear Cardiology (CBNC) certified medical directors and specialty credentialed technical directors. Certification and credentials of the medical and technical directors, respectively, staff CME/CE compliance, and assistance of a consultant with the application were positively associated with accreditation decisions. Conclusion: Nuclear cardiology laboratories directed by CBNC-certified physicians and NCT- or PET-credentialed technologists were less likely to receive delay decisions for MPI. CME/CE compliance of both the medical and technical directors was associated with accreditation decision. Medical and technical directors' years of experience were not associated with accreditation decision. Copyright © 2017 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  5. 21 CFR 111.110 - What quality control operations are required for laboratory operations associated with the...

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false What quality control operations are required for laboratory operations associated with the production and process control system? 111.110 Section 111.110 Food... § 111.110 What quality control operations are required for laboratory operations associated with the...

  6. International External Quality Assurance for Laboratory Diagnosis of Diphtheria ▿

    Science.gov (United States)

    Neal, S. E.; Efstratiou, A.

    2009-01-01

    The diphtheria surveillance network (DIPNET) encompassing National Diphtheria Reference Centers from 25 European countries is a Dedicated Surveillance Network recognized by the European Commission. A key DIPNET objective is the quality assessment of microbiological procedures for diphtheria across the European Union and beyond. A detailed questionnaire on the level of reference laboratory services and an external quality assessment (EQA) panel comprising six simulated throat specimens were sent to 34 centers. Twenty-three centers are designated National Diphtheria Reference Centers, with the laboratory in the United Kingdom being the only WHO Collaborating Centre. A variety of screening and identification tests were used, including the cysteinase test (20/34 centers), pyrazinamidase test (17/34 centers), and commercial kits (25/34 centers). The classic Elek test for toxigenicity testing is mostly used (28/34 centers), with variations in serum sources and antitoxin concentrations. Many laboratories reported problems obtaining Elek reagents or media. Only six centers produced acceptable results for all six specimens. Overall, 21% of identification and 13% of toxigenicity reports were unacceptable. Many centers could not isolate the target organism, and most found difficulties with the specimens that contained Corynebacterium striatum as a commensal contaminant. Nineteen centers generated either false-positive or negative toxigenic results, which may have caused inappropriate medical management. The discrepancies in this diphtheria diagnostics EQA alarmingly reflect the urgent need to improve laboratory performance in diphtheria diagnostics in Europe, standardize feasible and robust microbiological methods, and build awareness among public health authorities. Therefore, DIPNET recommends that regular workshops and EQA distributions for diphtheria diagnostics should be supported and maintained. PMID:19828749

  7. Assessing the outcome of Strengthening Laboratory Management Towards Accreditation (SLMTA) on laboratory quality management system in city government of Addis Ababa, Ethiopia.

    Science.gov (United States)

    Sisay, Abay; Mindaye, Tedla; Tesfaye, Abrham; Abera, Eyob; Desale, Adino

    2015-01-01

    Strengthening Laboratory Management Toward Accreditation (SLMTA) is a competency-based management training programme designed to bring about immediate and measurable laboratory improvement. The aim of this study is to assess the outcome of SLMTA on laboratory quality management system in Addis Ababa, Ethiopia. The study used an Institutional based cross sectional study design that employed a secondary and primary data collection approach on the participated institution of medical laboratory in SLMTA. The study was conducted in Addis Ababa city government and the data was collected from February 'April 2014 and data was entered in to EPI-data version 3.1 and was analyzed by SPSS version 20. The assessment finding indicate that there was a significant improvement in average scores (141.4; range of 65-196, 95%CI=86.275-115.5, p=0.000) at final with 3 laboratories become 3 star, 6 laboratories were at 2 star, 11 were 1 star. Laboratory facilities respondents which thought getting adequate and timely manner mentorship were found 2.5 times more likely to get good success in the final score(AOR=2.501, 95% CI=1.109-4.602) than which did not get it. At the end of SLMTA implementation,3 laboratories score 3 star, 6 laboratories were at 2 star, 11 were at 1 star. The most important contributing factor for not scoring star in the final outcome of SLMTA were not conducting their customer satisfaction survey, poor staff motivation, and lack of regular equipment service maintenance. Mentorship, onsite and offsite coaching and training activities had shown a great improvement on laboratory quality management system in most laboratories.

  8. A Decade of Experience in Implementing Quality Management System at Radiochemistry and Environmental Laboratory (RAS)

    International Nuclear Information System (INIS)

    Norfaizal Mohamed; Nita Salina Abu Bakar; Zal U'yun Wan Mahmood; Wo, Y.M.; Abdul Kadir Ishak; Nurrul Assyikeen Md Jaffary; Noor Fadzilah Yusof

    2016-01-01

    Quality management system has been introduced to a few laboratories in the Malaysian Nuclear Agency (Nuclear Malaysia) for the purpose to enhance the delivery of quality services to customers. Radiochemistry and Environmental Laboratory (RAS) is a service center in Nuclear Malaysia has implemented a quality management system in procedures carried out and has obtained accreditation for MS ISO/ IEC 17025 since 8 December 2005. This paper is intended to share experiences RAS in implementing a quality management system in accordance with standard MS ISO/ IEC 17025 accreditation and managed to keep it to this day. In addition, the RAS achievements including issues and challenges in implementing the quality management system in the past 10 years will also be discussed. (author)

  9. [Quality assessment of microscopic examination in tuberculosis diagnostic laboratories: a preliminary study].

    Science.gov (United States)

    Simşek, Hülya; Ceyhan, Ismail; Tarhan, Gülnur; Güner, Uğur

    2010-10-01

    Recently, the diagnosis of pulmonary tuberculosis (TB) has based on smear microscopy in the Direct Observed Treatment Strategy (DOTS) programme which provides the basis of treatment worldwide. Microscopic detection of AFB (Acid-Fast Bacilli) is one of the main components in the National TB Control Programmes (NTCP). Precision level in microscopy procedures and evaluations are the most important steps for accurate diagnosis of the disease and to initiate proper treatment. Therefore, the external quality assessment (EQA) is the most important implement to provide the reliability and validity of tests. In countries where NTCP are performed, this task is fulfilled by the National Reference Laboratories (NRL) according to the guidelines of the World Health Organization (WHO). For this purpose a pilot study was initiated by the central NRL of Turkey for EQA of AFB smear microscopy as part of the NTCP on January 1, 2005. A total of 5 laboratories of which 2 were district TB laboratories (A, B), 2 were tuberculosis control dispensaries (C, D), 1 was a national reference laboratory (E), participated in this study. Blind re-checking method (re-examination of randomly selected slides) was used for the evaluation, and the slides were sent to the central NRL with 3 months interval, four times a year, selected according to LQAS (Lot Quality Assurance Sampling) guides. In the re-evaluation of the slides, false positivity (FP), false negativity (FN) and quantification errors (QE) were noted. Laboratory A, sent totally 525 slides between January 1, 2005 and April 1, 2008. In the result of re-checking, 514 (97.9%) slides were found concordant, and 11 (2.1%) were discordant (10 FP, 1 FN). Laboratory B, participated in the study between October 1, 2005 and July 1, 2006 and of the 67 re-examined slides, 60 (89.5%) were concordant and 7 (10.5%) were discordant (2 FP, 0 FN, 5 QE). Laboratory C, sent 235 slides between January 1, 2005 and April 1, 2006; of them 218 (92.8%) were detected

  10. Quality management manual. National EU air quality reference laboratory of the Federal Environmental Agency; Qualitaetsmanagementhandbuch. Nationales EU-Luftqualitaets-Referenzlabor im Umweltbundesamt

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-02-01

    The 'Air' Department of the Federal Environmental Agency initiated a quality management system according to DIN EN ISO/IEC 17025 in order to carry out its tasks as a EU reference laboratory for air pollution monitoring. Harmonisation of measurements is attempted not only in the Federal Republic of Germany but world-wide. This is to be achieved by standardising the activities of reference laboratories on the basis of the DIN EN standards. The quality management system comprises complex organisational, technical and staff-oriented measures to ensure quality-relevant procedures and to control the interdependences between the individual processes. The specifications contained in this report are to ensure that quality requirements are met, and that the QM system will be updated continuously in order to ensure constant improvement.

  11. Laboratory quality assurance and its role in nuclear fuel reprocessing and refabrication

    International Nuclear Information System (INIS)

    Delvin, W.L.

    1977-09-01

    For the overall quality assurance (QA) program to be fully effective, the principles of QA must be applied to the operation of the analytical chemistry laboratory itself. This paper shows how QA is used at HEDL to produce confidence in each analytical result. Use of QA has resulted in the following benefits: poor laboratory practices have been found and eliminated, and an already adequate record system was improved even further

  12. Impact of quality improvement in tuberculosis laboratories in low- and lower-middle-income countries: a systematic review.

    Science.gov (United States)

    Olaru, I D; Albert, H; Zallet, J; Werner, U-E; Ahmed, N; Rieder, H L; Salfinger, M; Kranzer, K

    2018-03-01

    The effect of quality improvement measures on the performance of diagnostic tuberculosis (TB) laboratories in low- and lower-middle-income countries is not known, and is the subject of this review. Three databases were searched for quality improvement studies presenting data on performance parameters before and after the implementation of quality improvement interventions. Twenty-one studies were included in this review. Quality improvement measures were most frequently implemented by an external organization; settings targeted ranged from microscopy centers, hospitals, districts, regional and national reference laboratories. Quality improvement interventions and outcome measurements were highly heterogeneous. Most studies investigated interventions aimed at improving smear microscopy (n = 17). Two studies evaluated comprehensive quality improvement measures (n = 2) and another three studies focused on mycobacterial culture and drug susceptibility testing. Most studies showed an improvement in outcomes measured on before-after or time trend analysis. Quality improvement measures implemented in TB laboratories showed a positive impact on various outcomes. Due to the high heterogeneity of outcome reporting and interventions and the low quality of the studies, the effect size was not clear. Identification of standardized quality indicators and their link to the quality of patient care would improve knowledge in this field.

  13. Quality-assurance plan and field methods for quality-of-water activities, U.S. Geological Survey, Idaho National Engineering Laboratory, Idaho

    International Nuclear Information System (INIS)

    Mann, L.J.

    1996-10-01

    Water-quality activities at the Idaho National Engineering Laboratory (INEL) Project Office are part of the US Geological Survey's (USGS) Water Resources Division (WRD) mission of appraising the quantity and quality of the Nation's water resources. The purpose of the Quality Assurance Plan (QAP) for water-quality activities performed by the INEL Project Office is to maintain and improve the quality of technical products, and to provide a formal standardization, documentation, and review of the activities that lead to these products. The principles of this plan are as follows: (1) water-quality programs will be planned in a competent manner and activities will be monitored for compliance with stated objectives and approaches; (2) field, laboratory, and office activities will be performed in a conscientious and professional manner in accordance with specified WRD practices and procedures by qualified and experienced employees who are well trained and supervised, if or when, WRD practices and procedures are inadequate, data will be collected in a manner that its quality will be documented; (3) all water-quality activities will be reviewed for completeness, reliability, credibility, and conformance to specified standards and guidelines; (4) a record of actions will be kept to document the activity and the assigned responsibility; (5) remedial action will be taken to correct activities that are deficient

  14. Fuel quality control: Five years of activity in laboratories

    International Nuclear Information System (INIS)

    Bettinelli, M.; Cimini, G.; Durello, G.; Lucchesi, P.L.

    1991-01-01

    A description of how ENEL (Italian National Electricity Board) carries out the activity of fuel quality control is given, and the results of the Round Robin circuit which has been operating for five years in laboratories regulary performing the control analyses of these products are reported. The laboratories taking part in the Round Robin circuit are 41 (out of which 35 are ENEL laboratories and 6 are owned by external companies) and they are situated throughout Italy; the controlled parameters are the following: heat of combustion (PCS), sulphur (S), vanadium (V) and asphaltenes (ASF); the adopted methods are the official ASTM or IP ones. The statistical analysis of the results has permitted, for every parameter, the calculation of the repeatability and the reproducibility which, in most cases, have turned out to be in keeping with the values provided for in the regulations. Among the collateral initiatives promoted in the framework of this Round Robin, the following are reported: preparation of standards of fuel oil with a known content of a sulphur and vanadium; expediting visits to all the ENEL laboratories participating in the RRT; publication of a handbook of the adopted analysis methods (in Italian); definition of guide-lines on the right selection of new automatic equipment

  15. Comparison of laboratory and field remote sensing methods to measure forage quality.

    Science.gov (United States)

    Guo, Xulin; Wilmshurst, John F; Li, Zhaoqin

    2010-09-01

    Recent research in range ecology has emphasized the importance of forage quality as a key indicator of rangeland condition. However, we lack tools to evaluate forage quality at scales appropriate for management. Using canopy reflectance data to measure forage quality has been conducted at both laboratory and field levels separately, but little work has been conducted to evaluate these methods simultaneously. The objective of this study is to find a reliable way of assessing grassland quality through measuring forage chemistry with reflectance. We studied a mixed grass ecosystem in Grasslands National Park of Canada and surrounding pastures, located in southern Saskatchewan. Spectral reflectance was collected at both in-situ field level and in the laboratory. Vegetation samples were collected at each site, sorted into the green grass portion, and then sent to a chemical company for measuring forage quality variables, including protein, lignin, ash, moisture at 135 °C, Neutral Detergent Fiber (NDF), Acid Detergent Fiber (ADF), Total Digestible, Digestible Energy, Net Energy for Lactation, Net Energy for Maintenance, and Net Energy for Gain. Reflectance data were processed with the first derivative transformation and continuum removal method. Correlation analysis was conducted on spectral and forage quality variables. A regression model was further built to investigate the possibility of using canopy spectral measurements to predict the grassland quality. Results indicated that field level prediction of protein of mixed grass species was possible (r² = 0.63). However, the relationship between canopy reflectance and the other forage quality variables was not strong.

  16. Comparison of Laboratory and Field Remote Sensing Methods to Measure Forage Quality

    Directory of Open Access Journals (Sweden)

    Zhaoqin Li

    2010-09-01

    Full Text Available Recent research in range ecology has emphasized the importance of forage quality as a key indicator of rangeland condition. However, we lack tools to evaluate forage quality at scales appropriate for management. Using canopy reflectance data to measure forage quality has been conducted at both laboratory and field levels separately, but little work has been conducted to evaluate these methods simultaneously. The objective of this study is to find a reliable way of assessing grassland quality through measuring forage chemistry with reflectance. We studied a mixed grass ecosystem in Grasslands National Park of Canada and surrounding pastures, located in southern Saskatchewan. Spectral reflectance was collected at both in-situ field level and in the laboratory. Vegetation samples were collected at each site, sorted into the green grass portion, and then sent to a chemical company for measuring forage quality variables, including protein, lignin, ash, moisture at 135 ºC, Neutral Detergent Fiber (NDF, Acid Detergent Fiber (ADF, Total Digestible, Digestible Energy, Net Energy for Lactation, Net Energy for Maintenance, and Net Energy for Gain. Reflectance data were processed with the first derivative transformation and continuum removal method. Correlation analysis was conducted on spectral and forage quality variables. A regression model was further built to investigate the possibility of using canopy spectral measurements to predict the grassland quality. Results indicated that field level prediction of protein of mixed grass species was possible (r2 = 0.63. However, the relationship between canopy reflectance and the other forage quality variables was not strong.

  17. [Implementation of the technical requirements of the UNE-EN-ISO 15189 quality standard in a mycobacterial laboratory].

    Science.gov (United States)

    Guna Serrano, M del Remedio; Ocete Mochón, M Dolores; Lahiguera, M José; Bresó, M Carmen; Gimeno Cardona, Concepción

    2013-02-01

    The UNE-EN-ISO 15189:2007 standard defines the requirements for quality and competence that must be met by medical laboratories. These laboratories should use this international standard to develop their own quality management systems and to evaluate their own competencies; in turn, this standard will be used by accreditation bodies to confirm or recognize the laboratories' competence. In clinical microbiology laboratories, application of the standard implies the implementation of the technical and specific management requirements that must be met to achieve optimal quality when carrying out microbiological tests. In Spain, accreditation is granted by the Spanish Accreditation Body (Entidad Nacional de Acreditación). This review aims to discuss the practical application of the standard's technical requirements in mycobacterial laboratory. Firstly, we define the scope of accreditation. Secondly, we specify how the items of the standard on personnel management, control of equipment, environmental facilities, method validation, internal controls and customer satisfaction surveys were developed and implemented in our laboratory. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  18. Measurement control is one component of laboratory quality assurance: What are the others

    International Nuclear Information System (INIS)

    Delvin, W.L.

    1986-01-01

    The value of a quality assurance program is that the overlooking, ignoring, or downgrading of useful functions and practices will be minimized. The principles of quality assurance make a great tool for minimizing problems and for helping to find and correct deficiencies and problems when they occur. Finding and correcting deficiencies and problems while they are still small - before they become monsters - will certainly make life easier in the operation of a laboratory. This takes diligence in being aware of what is going on in the laboratory and firm resolve by management to take effective corrective actions when necessary. It takes more than applying band aids to problems. 4 refs

  19. Exploring the links between quality assurance and laboratory resources. An audit-based study.

    Science.gov (United States)

    Singh, Navjeevan; Panwar, Aru; Masih, Vipin Fazal; Arora, Vinod K; Bhatia, Arati

    2003-01-01

    To investigate and rectify the problems related to Ziehl-Neelsen (Z-N) staining in a cytology laboratory in the context of quality assurance. An audit based quality assurance study of 1,421 patients with clinical diagnoses of tubercular lymphadenopathy who underwent fine needle aspiration cytology. Data from 8 months were audited (group 1). Laboratory practices related to selection of smears for Z-N staining were studied. A 2-step corrective measure based on results of the audit was introduced for 2 months (group 2). Results were subjected to statistical analysis using the chi 2 test. Of 1,172 patients in group 1,368 had diagnoses other than tuberculosis. Overall acid-fast bacillus (AFB) positivity was 42%. AFB positivity in 249 patients in group 2 was 89% (P assurance. Solving everyday problems can have far-reaching benefits for the performance of laboratory personnel, resources and work flow.

  20. National Survey on Internal Quality Control Practice for Lipid Parameters in Laboratories of China from 2014 to 2016.

    Science.gov (United States)

    Ye, Yuanyuan; Wang, Wei; Zhao, Haijian; He, Falin; Zhong, Kun; Yuan, Shuai; Wang, Zhiguo

    2017-09-01

    To investigate the situation of Internal Quality Control (IQC) practice for total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol from 2014 to 2016 in laboratories in China and provide improvement measurements. A web-based External Quality Assessment (EQA) system was used to collect IQC data of lipid parameters in laboratories which continuously participated in the national EQA programs in China from 2014 to 2016. Pass rate of the coefficients of variation (CVs) of two level quality controls in four lipid parameters were calculated according to six quality specifications for precision to evaluate the current status of precision level of the four lipid parameters and their change over time in China. 533, 512, 504, and 466 laboratories continuously reported the data of level one for total cholesterol, triglyceride, HDL-cholesterol and LDL-cholesterol, and 212, 210, 208 and 198 laboratories reported the level two, respectively. The percentage of laboratories meeting the quality specification varied based on different criteria. Non-significant change can be found in the pass rate of CVs over time. The number of laboratories using a closed system increased over time, but still only accounted for a small proportion. There is no significant difference in the pass rate of CVs between closed and open systems. Triglycerides currently have a fairly good performance in China. While the performance of laboratories on total cholesterol, HDL-cholesterol and LDL-cholesterol has yet to be improved.

  1. Quality assurance plan for Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1994-01-01

    This Quality Assurance Plan (QAP) is concerned with design and construction (Sect. 2) and characterization and monitoring (Sect. 3). The basis for Sect. 2 is the Quality Assurance Plan for the Design and Construction of Waste Area Grouping 6 Closure at Oak Ridge National Laboratory, Oak Ridge, Tennessee, and the basis for Sect. 3 is the Environmental Restoration Quality Program Plan. Combining the two areas into one plan gives a single, overall document that explains the requirements and from which the individual QAPs and quality assurance project plans can be written. The Waste Area Grouping (WAG) 6 QAP establishes the procedures and requirements to be implemented for control of quality-related activities for the WAG 6 project. Quality Assurance (QA) activities are subject to requirements detailed in the Martin Marietta Energy Systems, Inc. (Energy Systems), QA Program and the Environmental Restoration (ER) QA Program, as well as to other quality requirements. These activities may be performed by Energy Systems organizations, subcontractors to Energy Systems, and architect-engineer (A-E) under prime contract to the US Department of Energy (DOE), or a construction manager under prime contract to DOE. This plan specifies the overall Energy Systems quality requirements for the project. The WAG 6 QAP will be supplemented by subproject QAPs that will identify additional requirements pertaining to each subproject

  2. The spectra of the standard x-ray qualities used in STUK's Radiation Metrology Laboratory

    International Nuclear Information System (INIS)

    Tapiovaara, T.; Tapiovaara, M.; Siiskonen, T.; Hakanen, A.

    2008-02-01

    This report presents the fluence spectra of the standard x-radiation qualities used in the Radiation Dosimetry Laboratory of Radiation and Nuclear Safety Authority (STUK). The spectra were measured in August 2007. The radiation qualities characterised in the report are the ISO Narrow spectrum series (ISO N10-N200, ISO 4037-1:1996) and both of the RQR-spectrum series specified by the IEC (IEC 1267:1994 and IEC 61267:2005). The measurements were made using a high purity Ge-detector and the measured pulse height spectra were corrected to fluence spectra. Spectral characteristics were computed from the spectral data and compared to the requirements in the standards and to the values given in the quality manual of the laboratory. (orig.)

  3. Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England.

    Science.gov (United States)

    Osaro, Erhabor; Chima, Njemanze

    2014-06-01

    The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the "engine room" of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges; staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5's, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

  4. Launching a Laboratory Testing Process Quality Improvement Toolkit: From the Shared Networks of Colorado Ambulatory Practices and Partners (SNOCAP).

    Science.gov (United States)

    Fernald, Douglas; Hamer, Mika; James, Kathy; Tutt, Brandon; West, David

    2015-01-01

    Family medicine and internal medicine physicians order diagnostic laboratory tests for nearly one-third of patient encounters in an average week, yet among medical errors in primary care, an estimated 15% to 54% are attributed to laboratory testing processes. From a practice improvement perspective, we (1) describe the need for laboratory testing process quality improvements from the perspective of primary care practices, and (2) describe the approaches and resources needed to implement laboratory testing process quality improvements in practice. We applied practice observations, process mapping, and interviews with primary care practices in the Shared Networks of Colorado Ambulatory Practices and Partners (SNOCAP)-affiliated practice-based research networks that field-tested in 2013 a laboratory testing process improvement toolkit. From the data collected in each of the 22 participating practices, common testing quality issues included, but were not limited to, 3 main testing process steps: laboratory test preparation, test tracking, and patient notification. Three overarching qualitative themes emerged: practices readily acknowledge multiple laboratory testing process problems; practices know that they need help addressing the issues; and practices face challenges with finding patient-centered solutions compatible with practice priorities and available resources. While practices were able to get started with guidance and a toolkit to improve laboratory testing processes, most did not seem able to achieve their quality improvement aims unassisted. Providing specific guidance tools with practice facilitation or other rapid-cycle quality improvement support may be an effective approach to improve common laboratory testing issues in primary care. © Copyright 2015 by the American Board of Family Medicine.

  5. Reduced Clostridium difficile Tests and Laboratory-Identified Events With a Computerized Clinical Decision Support Tool and Financial Incentive.

    Science.gov (United States)

    Madden, Gregory R; German Mesner, Ian; Cox, Heather L; Mathers, Amy J; Lyman, Jason A; Sifri, Costi D; Enfield, Kyle B

    2018-06-01

    We hypothesized that a computerized clinical decision support tool for Clostridium difficile testing would reduce unnecessary inpatient tests, resulting in fewer laboratory-identified events. Census-adjusted interrupted time-series analyses demonstrated significant reductions of 41% fewer tests and 31% fewer hospital-onset C. difficile infection laboratory-identified events following this intervention.Infect Control Hosp Epidemiol 2018;39:737-740.

  6. Evaluation of the implementation of a quality system in a basic research laboratory: viability and impacts.

    Science.gov (United States)

    Fraga, Hilda Carolina de Jesus Rios; Fukutani, Kiyoshi Ferreira; Celes, Fabiana Santana; Barral, Aldina Maria Prado; Oliveira, Camila Indiani de

    2012-01-01

    To evaluate the process of implementing a quality management system in a basic research laboratory of a public institution, particularly considering the feasibility and impacts of this improvement. This was a prospective and qualitative study. We employed the norm "NIT DICLA 035--Princípios das Boas Práticas de Laboratório (BPL)" and auxiliary documents of Organisation for Economic Co-operation and Development to complement the planning and implementation of a Quality System, in a basic research laboratory. In parallel, we used the PDCA tool to define the goals of each phase of the implementation process. This study enabled the laboratory to comply with the NIT DICLA 035 norm and to implement this norm during execution of a research study. Accordingly, documents were prepared and routines were established such as the registration of non-conformities, traceability of research data and equipment calibration. The implementation of a quality system, the setting of a laboratory focused on basic research is feasible once certain structural changes are made. Importantly, impacts were noticed during the process, which could be related to several improvements in the laboratory routine.

  7. The WHO AFRO external quality assessment programme (EQAP: Linking laboratory networks through EQA programmes

    Directory of Open Access Journals (Sweden)

    Debrah I. Boeras

    2016-10-01

    Full Text Available External Quality Assessment (EQA surveys performed by the World Health Organization Regional Office for Africa (WHO AFRO revealed the need for the strengthening of publichealth microbiology laboratories, particularly for testing of epidemic-prone diseases in theAfrican Region. These surveys revealed common issues such as supply chain managementskilled personnel, logistical support and overall lack of quality standards. For sustainableimprovements to health systems as well as global health security, deficiencies identified needto be actively corrected through robust quality assurance programmes and implementation oflaboratory quality management systems. Given all the pathogens of public health importance, an external quality assessment programmewith a focus on vaccine-preventable diseases and emerging and re-emerging dangerouspathogens is important, and should not be stand-alone, but integrated within laboratorynetworks as seen in polio, measles, yellow fever and rubella. In 2015, WHO AFRO collaborated with the US Centers for Disease Control and Preventionthe London School of Hygiene & Tropical Medicine and partners in a series of consultationswith countries and national and regional EQA providers for the development of qualityassurance models to support HIV point-of-care testing and monitoring. These consultationsrevealed similar challenges as seen in the WHO AFRO surveys. WHO AFRO brought forthits experience in implementing quality standards for health programmes, and also openeddiscussions on how lessons learned through such established programmes can be utilised tosupporting and strengthening the introduction of early infant diagnosis of HIV and viralload point-of-care testing. An optimised external quality assessment programme will impact the ability of countries tomeet core capacities, providing improved quality management systems, improving theconfidence of diagnostic network services in Africa, and including capacities to detect eventsof

  8. Comparison of semen quality between university-based and private assisted reproductive technology laboratories

    DEFF Research Database (Denmark)

    Jensen, Christian Fuglesang S; Khan, Omar; Sønksen, Jens

    2018-01-01

    laboratory, the first at each laboratory was selected for analysis. Comparison of major semen parameters was performed using descriptive statistics and Bland-Altman plots, with differences tested using Wilcoxon-signed rank test. RESULTS: Twenty-eight men aged 33 ± 5 (mean ± SD) years were included......OBJECTIVE: Obtaining a semen analysis (SA) is an essential step in evaluating infertile men. Despite using standardized procedures for analysis semen quality in the same individual often varies on repeated tests. The objective of this study was to investigate inter-laboratory variation in semen...

  9. Country-wide quality control of equipment in Norwegian laboratories performing in vivo nuclear medicine examinations

    International Nuclear Information System (INIS)

    Skretting, A.; Rootwelt, K.; Berthelsen, T.

    1984-01-01

    The report presents the methods used and the results obtained in quality control tests performd in all Norwegian hospital laboratories performing in vivo nuclear medicine examinations. The tests included activity meters and scintillation cameras. The activity meters were tested by means of calibrated, long-lived radioactive sources. The quality of these instruments were judged to be satisfactory for moderate and high activities, non of them showing a deviation of more than 10% from the calibration value. Deviations were larger at low activities and were for some laboratories unacceptable. The scintillation cameras test included studies of flood field (homogeneity), geometrical resolution and energy resolution, as well as measurements of count rate characteristics and sensitivity. 40% of the cameras were judged to have flood field responses with satisfactory homogeneity, whereas 32% of the cameras had a satisfactory resolution ability. A liver/abdomen phantom test was carried out by the staff of the actual laboratory. This test proved that only 20% of the laboratories had a satisfactory total performance, managing to detect and describe satisfactorily 4 out of 5 simulated defects in the liver phantom. Lack of information density and insufficient number of projections was the main reason for unsatisfactory results with good cameras. It is recommended that quality control equipment as used in the described tests should be made available to Norwegian hospitals for self assessment. Regular quality assurance tests as recommended by the Norwegian Association for Radiation Physics and Norwegian Society of Nuclear Medicine should be implemented in all hospitals. Moreover, a practical training course in quality assurance should be arranged. (RF)

  10. Contaminant monitoring programmes using marine organisms: Quality assurance and good laboratory practice

    International Nuclear Information System (INIS)

    1990-01-01

    This publication provides guidelines for obtaining reliable and relevant data during monitoring programmes in which contaminants are measured in marine organisms. It describes the precautions to be taken in each of the procedural steps from planning and sampling to the publication of data reports. The purpose of this document is to provide general guidance on quality assurance and to outline the approach that could be taken by laboratories to achieve the specific aims(s) for each marine pollution monitoring programme. Since most laboratories are currently focussing on programmes involving marine organisms, this document will be confined to this aspect. Four main aims can be identified for programmes involving the collection and analysis of marine organisms for the three main groups of contaminants (metals, organochlorine compounds and petroleum hydrocarbons), these are: (i) The measurement of contaminant levels in edible marine organisms in relation to public health; (ii) The identification of heavily contaminated areas of the sea (''hot spots'') where levels of contaminants are at least an order of magnitude higher than levels in clean or uncontaminated areas; (iii) The establishment of present levels of contaminants in marine organisms (i.e., a ''baseline''); (iv) The assessment of changes in concentrations of contaminants in organisms over a period of time (trends). The selection of organisms will be dictated by the eating patterns of the population. These can be identified by a survey of the species sold at the market, by obtaining information from colleagues in government departments who deal with such matters or in the absence of such information, by distributing a questionnaire to a representative section of the general public. 9 refs, 4 figs

  11. College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference on good laboratory practices in gynecologic cytology: background, rationale, and organization.

    Science.gov (United States)

    Tworek, Joseph A; Henry, Michael R; Blond, Barbara; Jones, Bruce Allen

    2013-02-01

    Gynecologic cytopathology is a heavily regulated field, with Clinical Laboratory Improvement Amendments of 1988 mandating the collection of many quality metrics. There is a lack of consensus regarding methods to collect, monitor, and benchmark these data and how these data should be used in a quality assurance program. Furthermore, the introduction of human papilloma virus testing and proficiency testing has provided more data to monitor. To determine good laboratory practices in quality assurance of gynecologic cytopathology. Data were collected through a written survey consisting of 98 questions submitted to 1245 Clinical Laboratory Improvement Amendments-licensed or Department of Defense laboratories. There were 541 usable responses. Additional input was sought through a Web posting of results and questions on the College of American Pathologists Web site. Four senior authors who authored the survey and 28 cytopathologists and cytotechnologists were assigned to 5 working groups to analyze data and present statements on good laboratory practices in gynecologic cytopathology at the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference. Ninety-eight attendees at the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference discussed and voted on good laboratory practice statements to obtain consensus. This paper describes the rationale, background, process, and strengths and limitations of a series of papers that summarize good laboratory practice statements in quality assurance in gynecologic cytopathology.

  12. Implementation of quality control systems in laboratories in Paraguay by the participants of ARCAL LXXVI project

    International Nuclear Information System (INIS)

    Villanueva, Z.

    2004-12-01

    In the Project ARCAL LXXVII, was realized the National Course of Control of Quality of Analytic Laboratories, from 12 to 16 of April in the CNEA, Paraguay, as a result of the one mentioned course was elaborated this project whose purpose is to elaborate the necessary documentation to fulfill the requirements of administration in the Analytic Laboratories to be adapted to the system of quality according to the ISO 17025 [es

  13. European specialist porphyria laboratories: diagnostic strategies, analytical quality, clinical interpretation, and reporting as assessed by an external quality assurance program.

    Science.gov (United States)

    Aarsand, Aasne K; Villanger, Jørild H; Støle, Egil; Deybach, Jean-Charles; Marsden, Joanne; To-Figueras, Jordi; Badminton, Mike; Elder, George H; Sandberg, Sverre

    2011-11-01

    The porphyrias are a group of rare metabolic disorders whose diagnosis depends on identification of specific patterns of porphyrin precursor and porphyrin accumulation in urine, blood, and feces. Diagnostic tests for porphyria are performed by specialized laboratories in many countries. Data regarding the analytical and diagnostic performance of these laboratories are scarce. We distributed 5 sets of multispecimen samples from different porphyria patients accompanied by clinical case histories to 18-21 European specialist porphyria laboratories/centers as part of a European Porphyria Network organized external analytical and postanalytical quality assessment (EQA) program. The laboratories stated which analyses they would normally have performed given the case histories and reported results of all porphyria-related analyses available, interpretative comments, and diagnoses. Reported diagnostic strategies initially showed considerable diversity, but the number of laboratories applying adequate diagnostic strategies increased during the study period. We found an average interlaboratory CV of 50% (range 12%-152%) for analytes in absolute concentrations. Result normalization by forming ratios to the upper reference limits did not reduce this variation. Sixty-five percent of reported results were within biological variation-based analytical quality specifications. Clinical interpretation of the obtained analytical results was accurate, and most laboratories established the correct diagnosis in all distributions. Based on a case-based EQA scheme, variations were apparent in analytical and diagnostic performance between European specialist porphyria laboratories. Our findings reinforce the use of EQA schemes as an essential tool to assess both analytical and diagnostic processes and thereby to improve patient care in rare diseases.

  14. HPV testing for primary cervical screening: Laboratory issues and evolving requirements for robust quality assurance.

    Science.gov (United States)

    Carozzi, Francesca Maria; Del Mistro, Annarosa; Cuschieri, Kate; Frayle, Helena; Sani, Cristina; Burroni, Elena

    2016-03-01

    This review aims to highlight the importance of Quality Assurance for Laboratories performing HPV test for Cervical Cancer Screening. An HPV test, to be used as primary screening test, must be validated according to international criteria, based on comparison of its clinical accuracy to HC2 or GP5+/6+ PCR-EIA tests. The number of validated platforms is increasing and appropriate Quality Assurance Programs (QAPs) which can interrogate longitudinal robustness and quality are paramount. This document describes the following topics: (1) the characteristics of an HPV laboratory and the personnel training needs, to ensure an elevated quality of the entire process and the optimal use of the resources; (2) the Quality Assurance, as both internal (IQA) and external quality assessment (EQA) systems, to be implemented and performed, and the description of the existing EQAs, including limitations; (3) general considerations for an optimal EQA program for hrHPV primary screening Due to the importance of Quality Assurance for this field, international efforts are necessary to improve QA International Collaboration. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Performance indicators for quality in surgical and laboratory services at Muhimbili National Hospital (MNH) in Tanzania.

    Science.gov (United States)

    Mbembati, Naboth A; Mwangu, Mugwira; Muhondwa, Eustace P Y; Leshabari, Melkizedek M

    2008-04-01

    Muhimbili National Hospital (MNH), a teaching and national referral hospital, is undergoing major reforms to improve the quality of health care. We performed a retrospective descriptive study using a set of performance indicators for the surgical and laboratory services of MNH in years 2001 and 2002, to help monitor and evaluate the impact of reforms on the quality of health care during and after the reform process. Hospital records were reviewed and information recorded for planned and postponed operations, laboratory equipment, reagents, laboratory tests and quality assurance programmes. In the year 2001 a total of 4332 non-emergency operations were planned, 3313 operations were performed and 1019 (23.5%) operations were postponed. In the year 2002, 4301 non-emergency operations were planned, 3046 were performed and 1255 (29%) were postponed. The most common reasons for operation postponement were "time-barred", interference by emergency operations, no show of patients and inoperable anaesthetic machines. Equipment problems and supply and staff shortages together accounted for one quarter of postponements. In the laboratory, a lack of equipment prevented some tests, but quality assurance was performed for most tests. Current surgical services at MNH are inadequate; operating theatres require modern, functioning equipment and adequate supplies of consumables to provide satisfactory care.

  16. Perceptions of a medical microbiology service: a survey of laboratory users.

    Science.gov (United States)

    Morgan, M S

    1995-10-01

    To ascertain the perception of laboratory users regarding the quality of the medical microbiology services in a district general hospital. Detailed questionnaires were circulated to all clinicians in the locality, with headings covering the quality of medical advice provided, the availability of information on specimen collection, format of request forms, specimen transport arrangements, turnaround times, the quality and need for interpretative advice, and the overall impression of the quality of the services provided. Two hundred and thirty five replies were received, giving a response rate of 69%. Transportation of specimens and communication of reports were identified as priority areas for improvement. The overall quality of the service was perceived as satisfactory, although areas were identified where substantial improvements could be made, some at little or no cost to the laboratory. The survey focused clinicians' attention on the service, raised the profile of the laboratory, and resulted in improved communications and a better understanding of customer needs. Overall, the exercise was felt to be extremely useful, and worthwhile repeating to gauge the effect of the changes instituted as a result.

  17. Total error components - isolation of laboratory variation from method performance

    International Nuclear Information System (INIS)

    Bottrell, D.; Bleyler, R.; Fisk, J.; Hiatt, M.

    1992-01-01

    The consideration of total error across sampling and analytical components of environmental measurements is relatively recent. The U.S. Environmental Protection Agency (EPA), through the Contract Laboratory Program (CLP), provides complete analyses and documented reports on approximately 70,000 samples per year. The quality assurance (QA) functions of the CLP procedures provide an ideal data base-CLP Automated Results Data Base (CARD)-to evaluate program performance relative to quality control (QC) criteria and to evaluate the analysis of blind samples. Repetitive analyses of blind samples within each participating laboratory provide a mechanism to separate laboratory and method performance. Isolation of error sources is necessary to identify effective options to establish performance expectations, and to improve procedures. In addition, optimized method performance is necessary to identify significant effects that result from the selection among alternative procedures in the data collection process (e.g., sampling device, storage container, mode of sample transit, etc.). This information is necessary to evaluate data quality; to understand overall quality; and to provide appropriate, cost-effective information required to support a specific decision

  18. Implementation of the World Health Organization Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation.

    Science.gov (United States)

    Ndihokubwayo, Jean-Bosco; Maruta, Talkmore; Ndlovu, Nqobile; Moyo, Sikhulile; Yahaya, Ali Ahmed; Coulibaly, Sheick Oumar; Kasolo, Francis; Turgeon, David; Abrol, Angelii P

    2016-01-01

    The increase in disease burden has continued to weigh upon health systems in Africa. The role of the laboratory has become increasingly critical in the improvement of health for diagnosis, management and treatment of diseases. In response, the World Health Organization Regional Office for Africa (WHO AFRO) and its partners created the WHO AFRO Stepwise Laboratory (Quality) Improvement Process Towards Accreditation (SLIPTA) program. WHO AFRO defined a governance structure with roles and responsibilities for six main stakeholders. Laboratories were evaluated by auditors trained and certified by the African Society for Laboratory Medicine. Laboratory performance was measured using the WHO AFRO SLIPTA scoring checklist and recognition certificates rated with 1-5 stars were issued. By March 2015, 27 of the 47 (57%) WHO AFRO member states had appointed a SLIPTA focal point and 14 Ministers of Health had endorsed SLIPTA as the desired programme for continuous quality improvement. Ninety-eight auditors from 17 African countries, competent in the Portuguese (3), French (12) and English (83) languages, were trained and certified. The mean score for the 159 laboratories audited between May 2013 and March 2015 was 69% (median 70%; SD 11.5; interquartile range 62-77). Of these audited laboratories, 70% achieved 55% compliance or higher (2 or more stars) and 1% scored at least 95% (5 stars). The lowest scoring sections of the WHO AFRO SLIPTA checklist were sections 6 (Internal Audit) and 10 (Corrective Action), which both had mean scores below 50%. The WHO AFRO SLIPTA is a process that countries with limited resources can adopt for effective implementation of quality management systems. Political commitment, ownership and investment in continuous quality improvement are integral components of the process.

  19. The Albuquerque Seismological Laboratory Data Quality Analyzer

    Science.gov (United States)

    Ringler, A. T.; Hagerty, M.; Holland, J.; Gee, L. S.; Wilson, D.

    2013-12-01

    The U.S. Geological Survey's Albuquerque Seismological Laboratory (ASL) has several efforts underway to improve data quality at its stations. The Data Quality Analyzer (DQA) is one such development. The DQA is designed to characterize station data quality in a quantitative and automated manner. Station quality is based on the evaluation of various metrics, such as timing quality, noise levels, sensor coherence, and so on. These metrics are aggregated into a measurable grade for each station. The DQA consists of a website, a metric calculator (Seedscan), and a PostgreSQL database. The website allows the user to make requests for various time periods, review specific networks and stations, adjust weighting of the station's grade, and plot metrics as a function of time. The website dynamically loads all station data from a PostgreSQL database. The database is central to the application; it acts as a hub where metric values and limited station descriptions are stored. Data is stored at the level of one sensor's channel per day. The database is populated by Seedscan. Seedscan reads and processes miniSEED data, to generate metric values. Seedscan, written in Java, compares hashes of metadata and data to detect changes and perform subsequent recalculations. This ensures that the metric values are up to date and accurate. Seedscan can be run in a scheduled task or on demand by way of a config file. It will compute metrics specified in its configuration file. While many metrics are currently in development, some are completed and being actively used. These include: availability, timing quality, gap count, deviation from the New Low Noise Model, deviation from a station's noise baseline, inter-sensor coherence, and data-synthetic fits. In all, 20 metrics are planned, but any number could be added. ASL is actively using the DQA on a daily basis for station diagnostics and evaluation. As Seedscan is scheduled to run every night, data quality analysts are able to then use the

  20. Using performance tasks employing IOM patient safety competencies to introduce quality improvement processes in medical laboratory science education.

    Science.gov (United States)

    Golemboski, Karen; Otto, Catherine N; Morris, Susan

    2013-01-01

    In order to contribute to improved healthcare quality through patient-centered care, laboratory professionals at all levels of practice must be able to recognize the connection between non-analytical factors and laboratory analysis, in the context of patient outcomes and quality improvement. These practices require qualities such as critical thinking (CT), teamwork skills, and familiarity with the quality improvement process, which will be essential for the development of evidence-based laboratory science practice. Performance tasks (PT) are an educational strategy which can be used to teach and assess CT and teamwork, while introducing Medical Laboratory Science (MLS) students at both baccalaureate and advanced-practice levels to the concepts of quality improvement processes and patient outcomes research. PT presents students with complex, realistic scenarios which require the incorporation of subject-specific knowledge with competencies such as effective team communication, patient-centered care, and successful use of information technology. A PT with assessment rubric was designed for use in a baccalaureate-level MLS program to teach and assess CT and teamwork competency. The results indicated that, even when students were able to integrate subject-specific knowledge in creative ways, their understanding of teamwork and quality improvement was limited. This indicates the need to intentionally teach skills such as collaboration and quality system design. PT represent one of many strategies that may be used in MLS education to develop essential professional competencies, encourage expert practice, and facilitate quality improvement.

  1. Quality control for radionuclide determinations in the Saxon state laboratories for environmental radioactivity by intercomparison and comparative measurements

    International Nuclear Information System (INIS)

    Knobus, B.

    2001-01-01

    Quality control for radionuclide analysis is necessary and essential for the quality assurance of the measuring results executing the measuring programmes of surveillance of the radioactivity in the environment and from installations. Acts, ordinances and guidelines require the participation in intercomparisons for authorized institutions detecting the demanded quality of measurements (e.g. trueness, reproducibility) for Federal Authorities. These are mainly those intercomparisons which are prepared, practised and evaluated by the federal laboratories. Comparative measurements are generally organized and executed by the state laboratory itself with a few participants for special measuring tasks. In this paper are described and discussed extend and special results of those intercomparisons and comparative measurements of the Saxon state laboratories for environmental radioactivity from 1992 until 2000. If necessary, there are following improvements for quality assurance. (orig.) [de

  2. Quality assurance and quality control at the joint IAEA NMCC On-Site Laboratory at RRP as a contribution to the inspectorate's review of near real time accountancy of nuclear material

    International Nuclear Information System (INIS)

    Ludwig, R.; Duhamel, G.; Raptis, K.; Mayorov, V.; Sato, Y.; Hara, S.; Itoh, Y.; Hayakawa, T.

    2011-01-01

    This paper provides updates on the elements of the quality management system (QMS) of the On-Site Laboratory for nuclear safeguards at the Rokkasho Reprocessing Plant. Representative examples of the OSL's quality control levels are discussed, such as analytical method performance review, method inter-comparison and participation in Laboratory inter-comparison exercises. It also highlights quality assurance measures to continuously improve the data quality within the boundary conditions of a high throughput industrial laboratory operating according to the guidelines of ISO 17025 and to meet the requirements of the ITV's on method uncertainties. (author)

  3. Laboratory interface in support of Environmental Restoration Programs

    International Nuclear Information System (INIS)

    Pardue, G.J. Jr.

    1994-01-01

    A vital part of quality environmental data resides in the communication between the project and the analytical laboratory. It is essential that the project clearly identify its objectives to the laboratory and that the laboratory understands the scope and limitations of the analytical process. Successful completion of an environmental project must include an aggressive program between project managers and subcontracted Lyrical laboratories. All to often, individuals and organizations tend to deflect errors and failures observed in environmental toward open-quotes the other guyclose quotes. The engineering firm will blame the laboratory, the laboratory will blame the field operation, the field operation will blame the engineering, and everyone will blame the customer for not understanding the true variables in the environmental arena. It is the contention of the authors, that the majority of failures derive from a lack of communication and misunderstanding. Several initiatives can be taken to improve communication and understanding between the various pieces of the environmental data quality puzzle. This presentation attempts to outline mechanisms to improve communication between the environmental project and the analytical laboratory with the intent of continuous quality improvement. Concepts include: project specific laboratory statements of work which focus on project and program requirements; project specific analytical laboratory readiness reviews (project kick-off meetings); laboratory team workshops; project/program performance tracking and self assessment and promotion of team success

  4. Proficiency testing schemes as a quality rating in industrial hygiene laboratories

    Directory of Open Access Journals (Sweden)

    Marek Dobecki

    2016-04-01

    Full Text Available This publication presents the principles of organization, implementation, assessment and exploitation of proficiency testing results in the work environmental laboratory based on basic requirements included in standard PN-EN ISO/IEC 17043 and ISO 13528. The basis for the proper functioning of the laboratory is to use and observe the basic requirements for the competence to carry out the tests and the guidelines on ensuring reliable and accurate results, specified e.g., according to the guidelines described in the standard PN-EN ISO/IEC 17043. The confirmation of the laboratory competence is the obtained accreditation. To obtain this certificate several conditions, including proficiency testing (PT should be met. The main aspects of this paper is to show the role of proficiency testing in the process of assuring a properly functioning quality system in the laboratory. The accreditation requirements, the types of proficiency testing schemes, methods of statistical analysis and interpretation of results are also discussed by the authors. Med Pr 2016;67(2:267–283

  5. Quality of the clinical laboratory department in a specialized hospital in Alexandria, Egypt.

    Science.gov (United States)

    Elhoseeny, T A; Mohammad, E K

    2013-01-01

    Assessment and improvement of turnaround times (TAT) as well as customer satisfaction is essential for laboratory quality management. This study in a specialized hospital in Alexandria, Egypt measured the current TAT for outpatient department bilirubin samples and evaluated the satisfaction of physicians with aspects of clinical laboratory services. While the mean TAT for 110 bilirubin tests [58.1 (SD 31.8) min] was within the College of American Pathologists' benchmark, the 90th percentile was long (96.7 min); 62.7% of tests were reported within 60 min. The mean overall satisfaction score of physicians (range 1-5) was 3.46 (SD 0.49). The highest satisfaction rating was for staff courtesy while the lowest ratings were for laboratory management responsiveness, outpatient stat TAT and critical value notification. Quality or reliability of results was judged by physicians as the most important factor (32.3%), followed by routine test TAT (18.5%). Further analysis of the different steps of the TAT would be helpful and follow-up through examining outliers is recommended

  6. Automation of the National Water Quality Laboratories, U. S. Geological Survey. I. Description of laboratory functions and definition of the automation project

    Energy Technology Data Exchange (ETDEWEB)

    Morris, W.F.; Ames, H.S.

    1977-07-01

    In January 1976, the Water Resources Division of the U.S. Geological Survey asked Lawrence Livermore Laboratory to conduct a feasibility study for automation of the National Water Quality (NWQ) Laboratory in Denver, Colorado (formerly Denver Central Laboratory). Results of the study were published in the Feasibility Study for Automation of the Central Laboratories, Lawrence Livermore Laboratory, Rept. UCRL-52001 (1976). Because the present system for processing water samples was found inadequate to meet the demands of a steadily increasing workload, new automation was recommended. In this document we present details necessary for future implementation of the new system, as well as descriptions of current laboratory automatic data processing and analytical facilities to better define the scope of the project and illustrate what the new system will accomplish. All pertinent inputs, outputs, and other operations that define the project are shown in functional designs.

  7. Automation of the National Water Quality Laboratories, U.S. Geological Survey. I. Description of laboratory functions and definition of the automation project

    International Nuclear Information System (INIS)

    Morris, W.F.; Ames, H.S.

    1977-01-01

    In January 1976, the Water Resources Division of the U.S. Geological Survey asked Lawrence Livermore Laboratory to conduct a feasibility study for automation of the National Water Quality (NWQ) Laboratory in Denver, Colorado (formerly Denver Central Laboratory). Results of the study were published in the Feasibility Study for Automation of the Central Laboratories, Lawrence Livermore Laboratory, Rept. UCRL-52001 (1976). Because the present system for processing water samples was found inadequate to meet the demands of a steadily increasing workload, new automation was recommended. In this document we present details necessary for future implementation of the new system, as well as descriptions of current laboratory automatic data processing and analytical facilities to better define the scope of the project and illustrate what the new system will accomplish. All pertinent inputs, outputs, and other operations that define the project are shown in functional designs

  8. The need for a quality standard for assurance in medical research laboratories

    Directory of Open Access Journals (Sweden)

    S Cohen

    2014-01-01

    Full Text Available The objective of this article is to show the results of a research study conducted to evaluate the need for a quality standard specific for medical research laboratories based on the shortfalls of ISO 15189 when used for this purpose. A qualitative research methodology was used, which comprised of collecting data from 20 well-qualified and experienced medical laboratory personnel by means of interviews based on a framework developed from a literature review. The data were analysed by means of a thematic technique and the results were verified by a team of medical researchers. The seven themes arising from the analyses were inflexibility; ambiguity; unfair requirements; inappropriate focus; inadequacy for research; renewal; and acceptance for accreditation. The results indicated that the ISO 15189 standard in its present content does not totally suit medical research laboratories and shows support for the development of a standard specific for research laboratories.

  9. Quality assurance program in the External dosimetry laboratory of the CPHR

    International Nuclear Information System (INIS)

    Molina P, D.; Pernas S, R.; Martinez H, E.; Cardenas H, J.

    2006-01-01

    From 1999 the Laboratory of External Dosimetry of the Radiation Protection and Hygiene Center comes applying in its service of personal dosimetry a Program of Quality Assurance. This program was designed according to the recommendations of national and international organizations as the National Assuring Office of the Republic of Cuba (ONARC), the International Standards Organization (ISO), the International Electro technique Commission (IEC) and the International Atomic Energy Agency (IAEA). In this work it is presented in a summarized way the operation of this Program of Quality Assurance which includes the administration and conservation of the results and the documentation of the service, the controls that are carried out to the equipment, the acceptance tests that are applied to the equipment and new dosemeters, the shipment and prosecution of the dosemeters, the evaluation, storage and conservation of the doses, the report of the results, the traceability and reproducibility of the measurements, the attention to the reclamations and the clients complaints and the internal and external audits to those that it undergoes periodically the laboratory. (Author)

  10. Identifying approaches for assessing methodological and reporting quality of systematic reviews

    DEFF Research Database (Denmark)

    Pussegoda, Kusala; Turner, Lucy; Garritty, Chantelle

    2017-01-01

    there are potential gaps in research best-practice guidance materials. The aims of this study are to identify reports assessing the methodological quality (MQ) and/or reporting quality (RQ) of a cohort of SRs and to assess their number, general characteristics, and approaches to 'quality' assessment over time......BACKGROUND: The methodological quality and completeness of reporting of the systematic reviews (SRs) is fundamental to optimal implementation of evidence-based health care and the reduction of research waste. Methods exist to appraise SRs yet little is known about how they are used in SRs or where...... or reporting guidelines used as proxy to assess RQ were used in 80% (61/76) of identified reports. These included two reporting guidelines (PRISMA and QUOROM) and five quality assessment tools (AMSTAR, R-AMSTAR, OQAQ, Mulrow, Sacks) and GRADE criteria. The remaining 24% (18/76) of reports developed their own...

  11. Quality control and assurance of Tc-99m generators and kits applied in SAEC laboratories

    International Nuclear Information System (INIS)

    Yassine, T.

    1998-01-01

    A brief description of quality assurance and quality control system applied in SAEC laboratories for production of 99m Tc-radiopharmaceuticals, is provided. The system includes documentation, procedures, releasing of the products and responsibilities. The system described here undergoes a continues development. (author)

  12. [Establishment of Quality Control System of Nucleic Acid Detection for Ebola Virus in Sierra Leone-China Friendship Biological Safety Laboratory].

    Science.gov (United States)

    Wang, Qin; Zhang, Yong; Nie, Kai; Wang, Huanyu; Du, Haijun; Song, Jingdong; Xiao, Kang; Lei, Wenwen; Guo, Jianqiang; Wei, Hejiang; Cai, Kun; Wang, Yanhai; Wu, Jiang; Gerald, Bangura; Kamara, Idrissa Laybohr; Liang, Mifang; Wu, Guizhen; Dong, Xiaoping

    2016-03-01

    The quality control process throughout the Ebola virus nucleic acid detection in Sierra Leone-China Friendship Biological Safety Laboratory (SLE-CHN Biosafety Lab) was described in detail, in order to comprehensively display the scientific, rigorous, accurate and efficient practice in detection of Ebola virus of first batch detection team in SLE-CHN Biosafety Lab. Firstly, the key points of laboratory quality control system was described, including the managements and organizing, quality control documents and information management, instrument, reagents and supplies, assessment, facilities design and space allocation, laboratory maintenance and biosecurity. Secondly, the application of quality control methods in the whole process of the Ebola virus detection, including before the test, during the test and after the test, was analyzed. The excellent and professional laboratory staffs, the implementation of humanized management are the cornerstone of the success; High-level biological safety protection is the premise for effective quality control and completion of Ebola virus detection tasks. And professional logistics is prerequisite for launching the laboratory diagnosis of Ebola virus. The establishment and running of SLE-CHN Biosafety Lab has landmark significance for the friendship between Sierra Leone and China, and the lab becomes the most important base for Ebola virus laboratory testing in Sierra Leone.

  13. The Quality Assurance_Quality Control of the Monitored Drift Tubes at the HEP Laboratory of the National Technical University of Athens

    CERN Document Server

    Alexopoulos, T; Dris, M; Filippas, A V; Fokitis, E; Gazis, E N; Katsoufis, E C; Maltezos, A; Maltezos, S; Papadopoulos, E; Papadopoulou, T D; Savva, Panagiota S; Stavropoulos, G D; Tsipolitis, G; Tzamariudaki, E

    2001-01-01

    The description of the Quality Assurance and Quality Control (QA_QC) procedures for the Monitored Drift Tubes (MDT's) followed at the HEP Laboratory of NTUA are presented and results of the tested tubes are given. The MDT's are the elements from which muon chambers for the ATLAS/LHC Muon Spectrometer are built..

  14. Development and operation of a quality assurance system for deviations from standard operating procedures in a clinical cell therapy laboratory.

    Science.gov (United States)

    McKenna, D; Kadidlo, D; Sumstad, D; McCullough, J

    2003-01-01

    Errors and accidents, or deviations from standard operating procedures, other policy, or regulations must be documented and reviewed, with corrective actions taken to assure quality performance in a cellular therapy laboratory. Though expectations and guidance for deviation management exist, a description of the framework for the development of such a program is lacking in the literature. Here we describe our deviation management program, which uses a Microsoft Access database and Microsoft Excel to analyze deviations and notable events, facilitating quality assurance (QA) functions and ongoing process improvement. Data is stored in a Microsoft Access database with an assignment to one of six deviation type categories. Deviation events are evaluated for potential impact on patient and product, and impact scores for each are determined using a 0- 4 grading scale. An immediate investigation occurs, and corrective actions are taken to prevent future similar events from taking place. Additionally, deviation data is collectively analyzed on a quarterly basis using Microsoft Excel, to identify recurring events or developing trends. Between January 1, 2001 and December 31, 2001 over 2500 products were processed at our laboratory. During this time period, 335 deviations and notable events occurred, affecting 385 products and/or patients. Deviations within the 'technical error' category were most common (37%). Thirteen percent of deviations had a patient and/or a product impact score > or = 2, a score indicating, at a minimum, potentially affected patient outcome or moderate effect upon product quality. Real-time analysis and quarterly review of deviations using our deviation management program allows for identification and correction of deviations. Monitoring of deviation trends allows for process improvement and overall successful functioning of the QA program in the cell therapy laboratory. Our deviation management program could serve as a model for other laboratories in

  15. Implementation of ISO 28218 quality system in the laboratory of body radioactivity counter CIEMAT

    International Nuclear Information System (INIS)

    Navarro Amaro, J. F.; Perez Lopez, B.; Lopez Ponte, M. A.; Perez Jimenez, C.

    2011-01-01

    The laboratory of body radioactivity counter has implemented IS0 28218 standard Performance Criteria for Radio bioassay in all measured in vivo techniques of internal contamination in the human organism in monitoring programs defined by the Personal Dosimetry Service Internal CIEMAT. The application of this rule in the laboratory's quality system is essential to meet the technical requirements of the standard IS0/IEC 17025 with the purpose of obtaining ENAC accreditation as a testing laboratory and calibration within the framework of the accreditation of Service CIEMAT Radiation Dosimetry. (Author)

  16. Continuing professional development training needs of medical laboratory personnel in Botswana.

    Science.gov (United States)

    Kasvosve, Ishmael; Ledikwe, Jenny H; Phumaphi, Othilia; Mpofu, Mulamuli; Nyangah, Robert; Motswaledi, Modisa S; Martin, Robert; Semo, Bazghina-Werq

    2014-08-18

    Laboratory professionals are expected to maintain their knowledge on the most recent advances in laboratory testing and continuing professional development (CPD) programs can address this expectation. In developing countries, accessing CPD programs is a major challenge for laboratory personnel, partly due to their limited availability. An assessment was conducted among clinical laboratory workforce in Botswana to identify and prioritize CPD training needs as well as preferred modes of CPD delivery. A self-administered questionnaire was disseminated to medical laboratory scientists and technicians registered with the Botswana Health Professions Council. Questions were organized into domains of competency related to (i) quality management systems, (ii) technical competence, (iii) laboratory management, leadership, and coaching, and (iv) pathophysiology, data interpretation, and research. Participants were asked to rank their self-perceived training needs using a 3-point scale in order of importance (most, moderate, and least). Furthermore, participants were asked to select any three preferences for delivery formats for the CPD. Out of 350 questionnaires that were distributed, 275 were completed and returned giving an overall response rate of 79%. The most frequently selected topics for training in rank order according to key themes were (mean, range) (i) quality management systems, most important (79%, 74-84%); (ii) pathophysiology, data interpretation, and research (68%, 52-78%); (iii) technical competence (65%, 44-73%); and (iv) laboratory management, leadership, and coaching (60%, 37-77%). The top three topics selected by the participants were (i) quality systems essentials for medical laboratory, (ii) implementing a quality management system, and (iii) techniques to identify and control sources of error in laboratory procedures. The top three preferred CPD delivery modes, in rank order, were training workshops, hands-on workshops, and internet-based learning

  17. Quality Control of Boar Sperm Processing : Implications from European AI Centres and Two Spermatology Reference Laboratories

    NARCIS (Netherlands)

    Riesenbeck, A; Schulze, M; Rüdiger, K; Henning, H; Waberski, D

    In recent years, increased automatization has resulted in a higher efficiency of boar semen processing in AI laboratories. Sophisticated laboratory management and efficient quality control programmes are needed for current tendencies in major pork-producing countries to reduce the sperm number per

  18. ASVCP quality assurance guidelines: control of preanalytical, analytical, and postanalytical factors for urinalysis, cytology, and clinical chemistry in veterinary laboratories.

    Science.gov (United States)

    Gunn-Christie, Rebekah G; Flatland, Bente; Friedrichs, Kristen R; Szladovits, Balazs; Harr, Kendal E; Ruotsalo, Kristiina; Knoll, Joyce S; Wamsley, Heather L; Freeman, Kathy P

    2012-03-01

    In December 2009, the American Society for Veterinary Clinical Pathology (ASVCP) Quality Assurance and Laboratory Standards committee published the updated and peer-reviewed ASVCP Quality Assurance Guidelines on the Society's website. These guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports: (1) general analytical factors for veterinary laboratory performance and comparisons; (2) hematology, hemostasis, and crossmatching; and (3) clinical chemistry, cytology, and urinalysis. This particular report is one of 3 reports and documents recommendations for control of preanalytical, analytical, and postanalytical factors related to urinalysis, cytology, and clinical chemistry in veterinary laboratories and is adapted from sections 1.1 and 2.2 (clinical chemistry), 1.3 and 2.5 (urinalysis), 1.4 and 2.6 (cytology), and 3 (postanalytical factors important in veterinary clinical pathology) of these guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimal guidelines for quality assurance and quality control for veterinary laboratory testing and a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts. © 2012 American Society for Veterinary Clinical Pathology.

  19. Perceptions of a medical microbiology service: a survey of laboratory users.

    Science.gov (United States)

    Morgan, M S

    1995-01-01

    AIM--To ascertain the perception of laboratory users regarding the quality of the medical microbiology services in a district general hospital. METHODS--Detailed questionnaires were circulated to all clinicians in the locality, with headings covering the quality of medical advice provided, the availability of information on specimen collection, format of request forms, specimen transport arrangements, turnaround times, the quality and need for interpretative advice, and the overall impression of the quality of the services provided. RESULTS--Two hundred and thirty five replies were received, giving a response rate of 69%. Transportation of specimens and communication of reports were identified as priority areas for improvement. The overall quality of the service was perceived as satisfactory, although areas were identified where substantial improvements could be made, some at little or no cost to the laboratory. CONCLUSIONS--The survey focused clinicians' attention on the service, raised the profile of the laboratory, and resulted in improved communications and a better understanding of customer needs. Overall, the exercise was felt to be extremely useful, and worthwhile repeating to gauge the effect of the changes instituted as a result. PMID:8537489

  20. Image Quality Assessment of JPEG Compressed Mars Science Laboratory Mastcam Images using Convolutional Neural Networks

    Science.gov (United States)

    Kerner, H. R.; Bell, J. F., III; Ben Amor, H.

    2017-12-01

    The Mastcam color imaging system on the Mars Science Laboratory Curiosity rover acquires images within Gale crater for a variety of geologic and atmospheric studies. Images are often JPEG compressed before being downlinked to Earth. While critical for transmitting images on a low-bandwidth connection, this compression can result in image artifacts most noticeable as anomalous brightness or color changes within or near JPEG compression block boundaries. In images with significant high-frequency detail (e.g., in regions showing fine layering or lamination in sedimentary rocks), the image might need to be re-transmitted losslessly to enable accurate scientific interpretation of the data. The process of identifying which images have been adversely affected by compression artifacts is performed manually by the Mastcam science team, costing significant expert human time. To streamline the tedious process of identifying which images might need to be re-transmitted, we present an input-efficient neural network solution for predicting the perceived quality of a compressed Mastcam image. Most neural network solutions require large amounts of hand-labeled training data for the model to learn the target mapping between input (e.g. distorted images) and output (e.g. quality assessment). We propose an automatic labeling method using joint entropy between a compressed and uncompressed image to avoid the need for domain experts to label thousands of training examples by hand. We use automatically labeled data to train a convolutional neural network to estimate the probability that a Mastcam user would find the quality of a given compressed image acceptable for science analysis. We tested our model on a variety of Mastcam images and found that the proposed method correlates well with image quality perception by science team members. When assisted by our proposed method, we estimate that a Mastcam investigator could reduce the time spent reviewing images by a minimum of 70%.

  1. Mozambique's journey toward accreditation of the National Tuberculosis Reference Laboratory.

    Science.gov (United States)

    Viegas, Sofia O; Azam, Khalide; Madeira, Carla; Aguiar, Carmen; Dolores, Carolina; Mandlaze, Ana P; Chongo, Patrina; Masamha, Jessina; Cirillo, Daniela M; Jani, Ilesh V; Gudo, Eduardo S

    2017-01-01

    Internationally-accredited laboratories are recognised for their superior test reliability, operational performance, quality management and competence. In a bid to meet international quality standards, the Mozambique National Institute of Health enrolled the National Tuberculosis Reference Laboratory (NTRL) in a continuous quality improvement process towards ISO 15189 accreditation. Here, we describe the road map taken by the NTRL to achieve international accreditation. The NTRL adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme as a strategy to implement a quality management system. After SLMTA, the Mozambique National Institute of Health committed to accelerate the NTRL's process toward accreditation. An action plan was designed to streamline the process. Quality indicators were defined to benchmark progress. Staff were trained to improve performance. Mentorship from an experienced assessor was provided. Fulfilment of accreditation standards was assessed by the Portuguese Accreditation Board. Of the eight laboratories participating in SLMTA, the NTRL was the best-performing laboratory, achieving a 53.6% improvement over the SLMTA baseline conducted in February 2011 to the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) assessment in June 2013. During the accreditation assessment in September 2014, 25 minor nonconformities were identified and addressed. In March 2015, the NTRL received Portuguese Accreditation Board recognition of technical competency for fluorescence smear microscopy, and solid and liquid culture. The NTRL is the first laboratory in Mozambique to achieve ISO 15189 accreditation. From our experience, accreditation was made possible by institutional commitment, strong laboratory leadership, staff motivation, adequate infrastructure and a comprehensive action plan.

  2. Minimum analytical quality specifications of inter-laboratory comparisons: agreement among Spanish EQAP organizers.

    Science.gov (United States)

    Ricós, Carmen; Ramón, Francisco; Salas, Angel; Buño, Antonio; Calafell, Rafael; Morancho, Jorge; Gutiérrez-Bassini, Gabriella; Jou, Josep M

    2011-11-18

    Four Spanish scientific societies organizing external quality assessment programs (EQAP) formed a working group to promote the use of common minimum quality specifications for clinical tests. Laboratories that do not meet the minimum specifications are encouraged to make immediate review of the analytical procedure affected and to implement corrective actions if necessary. The philosophy was to use the 95th percentile of results sent to EQAP (expressed in terms of percentage deviation from the target value) obtained for all results (except the outliers) during a cycle of 1 year. The target value for a number of analytes of the basic biochemistry program was established as the overall mean. However, because of the substantial discrepancies between routine methods for basic hematology, hormones, proteins, therapeutic drugs and tumor markers, the target in these cases was the peer group mean. The resulting specifications were quite similar to those established in the US (CLIA), and Germany (Richtlinie). The proposed specifications stand for the minimum level of quality to be attained for laboratories, to assure harmonized service performance. They have nothing to do with satisfying clinical requirements, which are the final level of quality to be reached, and that is strongly recommended in our organizations by means of documents, courses, symposiums and all types of educational activities.

  3. Reproducibility of cervical cytopathology following an intervention by an external quality control laboratory.

    Science.gov (United States)

    Ázara, Cinara Zago Silveira; Manrique, Edna Joana Claudio; Tavares, Suelene Brito do Nascimento; Alves de Souza, Nadja Lindany; Magalhães, Juliana Cristina; Amaral, Rita Goreti

    2016-04-01

    This study assessed the effects of a continued education program on the agreement between cervical cytopathology exams interpreted by local laboratories and interpretation made by an external quality control laboratory (LabMEQ). Overall, 9,798 exams were analyzed between 2007 and 2008, prior to implementation of a continued education program, and 10,028 between 2010 and 2011, following implementation. Continued education consisted of theoretical and practical classes held every two months. The chi-square test and the kappa coefficient were used in the statistical analysis. Following implementation of continued education, the rate of false-negative results, and those leading to delays in clinical management fell in eight laboratories and the rate of false-positive results in five. Agreement between the results reported by the laboratories and the findings of LabMEQ, evaluated according to clinical management, remained excellent in three laboratories (kappa >0.80 and 0.60 and clinical management. © 2016 Wiley Periodicals, Inc.

  4. Quality of Liver and Kidney Function Tests among Public Medical Laboratories in Western Region of Amhara National Regional State of Ethiopia.

    Science.gov (United States)

    Teka, Abaynesh; Kibatu, Girma

    2012-03-01

    Medical laboratories play essential roles in measurements of substances in body fluids for the purpose of diagnosis, treatment, prevention, and for greater understanding of the disease process. Thus, data generated from have to be reliable for which strict quality control, management and assurance are maintained. The aim of this study is to assess the accuracy and precision of clinical chemistry laboratories in western region of Amhara national regional state of Ethiopia in testing liver and kidney functions. Eight laboratories in hospitals and a Regional Health Research Laboratory Center participated in this study from February to March, 2011. Each participant was requested to measure six specimens for six chemistry tests from two control samples. Three hundred twenty four test results to be reported from all participant laboratories, if all measurements can be made, were designed to be collected and statistically evaluated. None of the study subject laboratories could deliver all the six tests for estimation of both liver and renal functions simultaneously during the study period. Only 213 values from the expected 324 values were reported and about 65 % of the 213 values reported fell outside of the allowable limits of errors for the chemistry tests of the control specimen used. This study finding showed that there were lack of accuracy and precision in chemistry measurements. A regular survey on medical laboratories should be conducted questioning the accuracy and precision of their analyses in order to sustain improvements in the quality of services provided by participating laboratories for the benefit of patients. Laboratory Quality Management Systems appreciate the need for regular quality control and quality assessment schemes in medical laboratories.

  5. The quality management system at the European tritium handling experimental laboratory

    International Nuclear Information System (INIS)

    Dizadji, F.; Ferrario, L.

    1992-01-01

    The main limitations of conventional Quality Assurance (QA) are discussed with reference to the operational phase of a radio-chemical research laboratory. The paper suggests a broader approach utilizing a Quality Management System (QMS) which focuses on the operational efficiency of a R ampersand D organization in terms of reliability, reproducibility, cost effectiveness and safety. The management's role is presented with particular reference to the best fit of managerial style to the organization's mission, culture, personnel and surrounding environment. Qt. QMS policies and QA criteria are suggested for ETHEL to replace conventional QA requirements. Finally, guidelines for designing the ETHEL organizational structure are discussed

  6. An approach to quality and performance control in a computer-assisted clinical chemistry laboratory.

    Science.gov (United States)

    Undrill, P E; Frazer, S C

    1979-01-01

    A locally developed, computer-based clinical chemistry laboratory system has been in operation since 1970. This utilises a Digital Equipment Co Ltd PDP 12 and an interconnected PDP 8/F computer. Details are presented of the performance and quality control techniques incorporated into the system. Laboratory performance is assessed through analysis of results from fixed-level control sera as well as from cumulative sum methods. At a simple level the presentation may be considered purely indicative, while at a more sophisticated level statistical concepts have been introduced to aid the laboratory controller in decision-making processes. PMID:438340

  7. Quality management in environmental programs: Los Alamos National Laboratory's approach

    International Nuclear Information System (INIS)

    Maassen, L.; Day, J.L.

    1998-03-01

    Since its inception in 1943, Los Alamos National Laboratory's (LANL's) primary mission has been nuclear weapons research and development, which involved the use of hazardous and radioactive materials, some of which were disposed of onsite. LANL has established an extensive Environmental Restoration Project (Project) to investigate and remediate those hazardous and radioactive waste disposal sites. This paper describes LANL's identification and resolution of critical issues associated with the integration and management of quality in the Project

  8. Quality assurance manual for the Department of Energy laboratory accreditation program for personnel dosimetry systems

    International Nuclear Information System (INIS)

    1987-02-01

    The overall purpose of this document is to establish a uniform approach to quality assurance. This will ensure that uniform, high-quality personnel dosimetry practices are followed by the participating testing laboratories. The document presents guidelines for calibrating and maintaining measurement and test equipment (M and TE), calibrating radiation fields, and subsequently irradiating and handling personnel dosimeters in laboratories involved in the DOE dosimetry systems testing program. Radiation energies for which the test procedures apply are photons with approximately 15 keV to 2 MeV, beta particles above 0.3 MeV, neutrons with approximately 1 keV to 2 MeV. 12 refs., 4 tabs

  9. Iterative Outlier Removal: A Method for Identifying Outliers in Laboratory Recalibration Studies.

    Science.gov (United States)

    Parrinello, Christina M; Grams, Morgan E; Sang, Yingying; Couper, David; Wruck, Lisa M; Li, Danni; Eckfeldt, John H; Selvin, Elizabeth; Coresh, Josef

    2016-07-01

    Extreme values that arise for any reason, including those through nonlaboratory measurement procedure-related processes (inadequate mixing, evaporation, mislabeling), lead to outliers and inflate errors in recalibration studies. We present an approach termed iterative outlier removal (IOR) for identifying such outliers. We previously identified substantial laboratory drift in uric acid measurements in the Atherosclerosis Risk in Communities (ARIC) Study over time. Serum uric acid was originally measured in 1990-1992 on a Coulter DACOS instrument using an uricase-based measurement procedure. To recalibrate previous measured concentrations to a newer enzymatic colorimetric measurement procedure, uric acid was remeasured in 200 participants from stored plasma in 2011-2013 on a Beckman Olympus 480 autoanalyzer. To conduct IOR, we excluded data points >3 SDs from the mean difference. We continued this process using the resulting data until no outliers remained. IOR detected more outliers and yielded greater precision in simulation. The original mean difference (SD) in uric acid was 1.25 (0.62) mg/dL. After 4 iterations, 9 outliers were excluded, and the mean difference (SD) was 1.23 (0.45) mg/dL. Conducting only one round of outlier removal (standard approach) would have excluded 4 outliers [mean difference (SD) = 1.22 (0.51) mg/dL]. Applying the recalibration (derived from Deming regression) from each approach to the original measurements, the prevalence of hyperuricemia (>7 mg/dL) was 28.5% before IOR and 8.5% after IOR. IOR is a useful method for removal of extreme outliers irrelevant to recalibrating laboratory measurements, and identifies more extraneous outliers than the standard approach. © 2016 American Association for Clinical Chemistry.

  10. Errors in clinical laboratories or errors in laboratory medicine?

    Science.gov (United States)

    Plebani, Mario

    2006-01-01

    Laboratory testing is a highly complex process and, although laboratory services are relatively safe, they are not as safe as they could or should be. Clinical laboratories have long focused their attention on quality control methods and quality assessment programs dealing with analytical aspects of testing. However, a growing body of evidence accumulated in recent decades demonstrates that quality in clinical laboratories cannot be assured by merely focusing on purely analytical aspects. The more recent surveys on errors in laboratory medicine conclude that in the delivery of laboratory testing, mistakes occur more frequently before (pre-analytical) and after (post-analytical) the test has been performed. Most errors are due to pre-analytical factors (46-68.2% of total errors), while a high error rate (18.5-47% of total errors) has also been found in the post-analytical phase. Errors due to analytical problems have been significantly reduced over time, but there is evidence that, particularly for immunoassays, interference may have a serious impact on patients. A description of the most frequent and risky pre-, intra- and post-analytical errors and advice on practical steps for measuring and reducing the risk of errors is therefore given in the present paper. Many mistakes in the Total Testing Process are called "laboratory errors", although these may be due to poor communication, action taken by others involved in the testing process (e.g., physicians, nurses and phlebotomists), or poorly designed processes, all of which are beyond the laboratory's control. Likewise, there is evidence that laboratory information is only partially utilized. A recent document from the International Organization for Standardization (ISO) recommends a new, broader definition of the term "laboratory error" and a classification of errors according to different criteria. In a modern approach to total quality, centered on patients' needs and satisfaction, the risk of errors and mistakes

  11. Average of delta: a new quality control tool for clinical laboratories.

    Science.gov (United States)

    Jones, Graham R D

    2016-01-01

    Average of normals is a tool used to control assay performance using the average of a series of results from patients' samples. Delta checking is a process of identifying errors in individual patient results by reviewing the difference from previous results of the same patient. This paper introduces a novel alternate approach, average of delta, which combines these concepts to use the average of a number of sequential delta values to identify changes in assay performance. Models for average of delta and average of normals were developed in a spreadsheet application. The model assessed the expected scatter of average of delta and average of normals functions and the effect of assay bias for different values of analytical imprecision and within- and between-subject biological variation and the number of samples included in the calculations. The final assessment was the number of patients' samples required to identify an added bias with 90% certainty. The model demonstrated that with larger numbers of delta values, the average of delta function was tighter (lower coefficient of variation). The optimal number of samples for bias detection with average of delta was likely to be between 5 and 20 for most settings and that average of delta outperformed average of normals when the within-subject biological variation was small relative to the between-subject variation. Average of delta provides a possible additional assay quality control tool which theoretical modelling predicts may be more valuable than average of normals for analytes where the group biological variation is wide compared with within-subject variation and where there is a high rate of repeat testing in the laboratory patient population. © The Author(s) 2015.

  12. Field Methods and Quality-Assurance Plan for Quality-of-Water Activities, U.S. Geological Survey, Idaho National Laboratory, Idaho

    Science.gov (United States)

    Knobel, LeRoy L.; Tucker, Betty J.; Rousseau, Joseph P.

    2008-01-01

    Water-quality activities conducted by the staff of the U.S. Geological Survey (USGS) Idaho National Laboratory (INL) Project Office coincide with the USGS mission of appraising the quantity and quality of the Nation's water resources. The activities are conducted in cooperation with the U.S. Department of Energy's (DOE) Idaho Operations Office. Results of the water-quality investigations are presented in various USGS publications or in refereed scientific journals. The results of the studies are highly regarded, and they are used with confidence by researchers, regulatory and managerial agencies, and interested civic groups. In its broadest sense, quality assurance refers to doing the job right the first time. It includes the functions of planning for products, review and acceptance of the products, and an audit designed to evaluate the system that produces the products. Quality control and quality assurance differ in that quality control ensures that things are done correctly given the 'state-of-the-art' technology, and quality assurance ensures that quality control is maintained within specified limits.

  13. Bridging the gap between sample collection and laboratory analysis: using dried blood spots to identify human exposure to chemical agents

    Science.gov (United States)

    Hamelin, Elizabeth I.; Blake, Thomas A.; Perez, Jonas W.; Crow, Brian S.; Shaner, Rebecca L.; Coleman, Rebecca M.; Johnson, Rudolph C.

    2016-05-01

    Public health response to large scale chemical emergencies presents logistical challenges for sample collection, transport, and analysis. Diagnostic methods used to identify and determine exposure to chemical warfare agents, toxins, and poisons traditionally involve blood collection by phlebotomists, cold transport of biomedical samples, and costly sample preparation techniques. Use of dried blood spots, which consist of dried blood on an FDA-approved substrate, can increase analyte stability, decrease infection hazard for those handling samples, greatly reduce the cost of shipping/storing samples by removing the need for refrigeration and cold chain transportation, and be self-prepared by potentially exposed individuals using a simple finger prick and blood spot compatible paper. Our laboratory has developed clinical assays to detect human exposures to nerve agents through the analysis of specific protein adducts and metabolites, for which a simple extraction from a dried blood spot is sufficient for removing matrix interferents and attaining sensitivities on par with traditional sampling methods. The use of dried blood spots can bridge the gap between the laboratory and the field allowing for large scale sample collection with minimal impact on hospital resources while maintaining sensitivity, specificity, traceability, and quality requirements for both clinical and forensic applications.

  14. National Laboratory Planning: Developing Sustainable Biocontainment Laboratories in Limited Resource Areas.

    Science.gov (United States)

    Yeh, Kenneth B; Adams, Martin; Stamper, Paul D; Dasgupta, Debanjana; Hewson, Roger; Buck, Charles D; Richards, Allen L; Hay, John

    2016-01-01

    Strategic laboratory planning in limited resource areas is essential for addressing global health security issues. Establishing a national reference laboratory, especially one with BSL-3 or -4 biocontainment facilities, requires a heavy investment of resources, a multisectoral approach, and commitments from multiple stakeholders. We make the case for donor organizations and recipient partners to develop a comprehensive laboratory operations roadmap that addresses factors such as mission and roles, engaging national and political support, securing financial support, defining stakeholder involvement, fostering partnerships, and building trust. Successful development occurred with projects in African countries and in Azerbaijan, where strong leadership and a clear management framework have been key to success. A clearly identified and agreed management framework facilitate identifying the responsibility for developing laboratory capabilities and support services, including biosafety and biosecurity, quality assurance, equipment maintenance, supply chain establishment, staff certification and training, retention of human resources, and sustainable operating revenue. These capabilities and support services pose rate-limiting yet necessary challenges. Laboratory capabilities depend on mission and role, as determined by all stakeholders, and demonstrate the need for relevant metrics to monitor the success of the laboratory, including support for internal and external audits. Our analysis concludes that alternative frameworks for success exist for developing and implementing capabilities at regional and national levels in limited resource areas. Thus, achieving a balance for standardizing practices between local procedures and accepted international standards is a prerequisite for integrating new facilities into a country's existing public health infrastructure and into the overall international scientific community.

  15. Implementation of the World Health Organization Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation

    Directory of Open Access Journals (Sweden)

    Jean-Bosco Ndihokubwayo

    2016-05-01

    SLIPTA implementation process: WHO AFRO defined a governance structure with roles and responsibilities for six main stakeholders. Laboratories were evaluated by auditors trained and certified by the African Society for Laboratory Medicine. Laboratory performance was measured using the WHO AFRO SLIPTA scoring checklist and recognition certificates rated with 1–5 stars were issued. Preliminary results: By March 2015, 27 of the 47 (57% WHO AFRO member states had appointed a SLIPTA focal point and 14 Ministers of Health had endorsed SLIPTA as the desired programme for continuous quality improvement. Ninety-eight auditors from 17 African countries, competent in the Portuguese (3, French (12 and English (83 languages, were trained and certified. The mean score for the 159 laboratories audited between May 2013 and March 2015 was 69% (median 70%; SD 11.5; interquartile range 62–77. Of these audited laboratories, 70% achieved 55% compliance or higher (2 or more stars and 1% scored at least 95% (5 stars. The lowest scoring sections of the WHO AFRO SLIPTA checklist were sections 6 (Internal Audit and 10 (Corrective Action, which both had mean scores below 50%. Conclusion: The WHO AFRO SLIPTA is a process that countries with limited resources can adopt for effective implementation of quality management systems. Political commitment, ownership and investment in continuous quality improvement are integral components of the process.

  16. Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England

    Directory of Open Access Journals (Sweden)

    Erhabor Osaro

    2014-06-01

    There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

  17. National Survey on Internal Quality Control for HbA(1c) Analytical Instruments in 331 Hospital Laboratories of China.

    Science.gov (United States)

    Zeng, Rong; Wang, Wei; Zhao, Haijian; Fei, Yang; Wang, Zhiguo

    2015-01-01

    The narrow gap of HbA1 value of mass fraction between "normal" (control of inter-assay standardization, assay precision, and trueness. This survey was initiated to obtain knowledge of the current situation of internal quality control (IQC) practice for HbA(1c) in China and find out the most appropriate quality specifications. Data of IQC for HbA(1c) in 331 institutions participating in the national proficiency testing (PT) programs in China were evaluated using four levels of quality specifications, and the percentages of laboratories meeting the quality requirement were calculated to find out the most appropriate quality specifications for control materials of HbA(1c) in China. The IQC data varied vastly among 331 clinical laboratories in China. The measurement of control materials covered a wide range from 4.52% to 12.24% (inter-quartile range) and there were significant differences among the CVs of different methods, including LPLC, CE-HPLC, AC-HPLC, immunoturbidimetry, and others. Among the four main methods, CE-HPLC and AC-HPLC achieved a better precision. As we can see, the performance of laboratories for HbA(1c) has yet to be improved. Clinical laboratories in China should improve their performance with a stricter imprecision criteria.

  18. Mozambique’s journey toward accreditation of the National Tuberculosis Reference Laboratory

    Directory of Open Access Journals (Sweden)

    Sofia O. Viegas

    2017-03-01

    Full Text Available Background: Internationally-accredited laboratories are recognised for their superior test reliability, operational performance, quality management and competence. In a bid to meet international quality standards, the Mozambique National Institute of Health enrolled the National Tuberculosis Reference Laboratory (NTRL in a continuous quality improvement process towards ISO 15189 accreditation. Here, we describe the road map taken by the NTRL to achieve international accreditation. Methods: The NTRL adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA programme as a strategy to implement a quality management system. After SLMTA, the Mozambique National Institute of Health committed to accelerate the NTRL’s process toward accreditation. An action plan was designed to streamline the process. Quality indicators were defined to benchmark progress. Staff were trained to improve performance. Mentorship from an experienced assessor was provided. Fulfilment of accreditation standards was assessed by the Portuguese Accreditation Board. Results: Of the eight laboratories participating in SLMTA, the NTRL was the best-performing laboratory, achieving a 53.6% improvement over the SLMTA baseline conducted in February 2011 to the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA assessment in June 2013. During the accreditation assessment in September 2014, 25 minor nonconformities were identified and addressed. In March 2015, the NTRL received Portuguese Accreditation Board recognition of technical competency for fluorescence smear microscopy, and solid and liquid culture. The NTRL is the first laboratory in Mozambique toachieve ISO 15189 accreditation. Conclusions: From our experience, accreditation was made possible by institutional commitment, strong laboratory leadership, staff motivation, adequate infrastructure and a comprehensive action plan.

  19. Mozambique’s journey toward accreditation of the National Tuberculosis Reference Laboratory

    Science.gov (United States)

    Madeira, Carla; Aguiar, Carmen; Dolores, Carolina; Mandlaze, Ana P.; Chongo, Patrina; Masamha, Jessina

    2017-01-01

    Background Internationally-accredited laboratories are recognised for their superior test reliability, operational performance, quality management and competence. In a bid to meet international quality standards, the Mozambique National Institute of Health enrolled the National Tuberculosis Reference Laboratory (NTRL) in a continuous quality improvement process towards ISO 15189 accreditation. Here, we describe the road map taken by the NTRL to achieve international accreditation. Methods The NTRL adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme as a strategy to implement a quality management system. After SLMTA, the Mozambique National Institute of Health committed to accelerate the NTRL’s process toward accreditation. An action plan was designed to streamline the process. Quality indicators were defined to benchmark progress. Staff were trained to improve performance. Mentorship from an experienced assessor was provided. Fulfilment of accreditation standards was assessed by the Portuguese Accreditation Board. Results Of the eight laboratories participating in SLMTA, the NTRL was the best-performing laboratory, achieving a 53.6% improvement over the SLMTA baseline conducted in February 2011 to the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) assessment in June 2013. During the accreditation assessment in September 2014, 25 minor nonconformities were identified and addressed. In March 2015, the NTRL received Portuguese Accreditation Board recognition of technical competency for fluorescence smear microscopy, and solid and liquid culture. The NTRL is the first laboratory in Mozambique to achieve ISO 15189 accreditation. Conclusions From our experience, accreditation was made possible by institutional commitment, strong laboratory leadership, staff motivation, adequate infrastructure and a comprehensive action plan. PMID:28879162

  20. Importance of the Primary Radioactivity Standard Laboratory and Implementation of its Quality Management

    Science.gov (United States)

    Sahagia, Maria; Razdolescu, Anamaria Cristina; Luca, Aurelian; Ivan, Constantin

    2007-04-01

    The paper presents some specific aspects of the implementation of the quality management in the Radionuclide Metrology Laboratory, from IFIN-HH, the owner of the primary Romanian standard in radioactivity. The description of the accreditation, according to the EN ISO/IEC 17025:2005, is presented.

  1. Importance of the Primary Radioactivity Standard Laboratory and Implementation of its Quality Management

    International Nuclear Information System (INIS)

    Sahagia, Maria; Razdolescu, Anamaria Cristina; Luca, Aurelian; Ivan, Constantin

    2007-01-01

    The paper presents some specific aspects of the implementation of the quality management in the Radionuclide Metrology Laboratory, from IFIN-HH, the owner of the primary Romanian standard in radioactivity. The description of the accreditation, according to the EN ISO/IEC 17025:2005, is presented

  2. Quality control in the histopathology laboratory: An overview with stress on the need for a structured national external quality assessment scheme

    Directory of Open Access Journals (Sweden)

    Iyengar Jayaram

    2009-01-01

    Full Text Available The concept of quality control in histopathology is relatively young and less well understood. Like in other disciplines of laboratory medicine, the concept of quality and its control is applicable to pre analytical, analytical and post analytical activities. Assessment of both precision and accuracy performances is possible by appropriate internal and external quality control and assessment schemes. This article is a review of all processes that achieve quality reporting in histopathology. There is a special focus on external quality assessment - a scheme that lacks organization on a national level in our country. Statistical data derived from a small scale external quality assurance program is also analyzed along with recommendations to organize an effective national scheme with the participation of authorized zonal centers.

  3. The Sources of Quality in the Pharmaceutical Industry

    OpenAIRE

    Enrique Yacuzzi; Fernando Martín; Gabriel Vignola; Verónica Mayochi; Dante Tollio

    2004-01-01

    This paper analyzes the sources of quality of a pharmaceutical product. After identifying eight quality dimensions, a framework of hypothetical sources that contribute the most to shape those dimensions is established. The framework, based on Garvin's pioneering work, is applied to case studies of laboratories operating in Argentina. Framework relevance is considered using correlation analysis. Laboratories are ranked through expert opinion by the quality of its products using the eight dimen...

  4. Improvement in the performance of external quality assessment in Korean HIV clinical laboratories using unrecalcified human plasma.

    Science.gov (United States)

    Wang, Jin-Sook; Kee, Mee-Kyung; Choi, Byeong-Sun; Kim, Chan-Wha; Kim, Hyon-Suk; Kim, Sung Soon

    2012-01-01

    The external quality assessment schemes (EQAS) organizer provides a suitable program to monitor and improve the quality of human immunodeficiency virus (HIV) testing laboratories with EQAS panels prepared under various conditions. The aim of the current study was to investigate the effects of human plasma samples on the EQAS results of HIV obtained from hospital-based clinical laboratories. From 2007 to 2009, HIV EQAS panels consisted of four to six samples that consisted of undiluted positive and negative samples and were provided to laboratories twice per year. Up until the first half EQAS in 2008, EQAS panel materials were obtained by converting acid citrate dextrose treated plasma to serum via chemical treatment with CaCl2. Beginning with the second EQAS in 2008, all materials were prepared without the defibrination process. Approximately 300 HIV clinical laboratories participated in this program. The overall performance of clinical laboratories was shown to be improved when using unrecalcified plasma panels compared with recalcified panels. Significant differences were observed in EIA analyses of plasma for both positive (plaboratories.

  5. Quality assurance in the measurement of internal radioactive contamination and dose assessment and the United States Department of Energy Laboratory Accreditation Program

    International Nuclear Information System (INIS)

    Bhatt, Anita

    2016-01-01

    The Quality Assurance for analytical measurement of internal radioactive contamination and dose assessment in the United States (US) is achieved through the US Department of Energy (DOE) Laboratory Accreditation Program (DOELAP) for both Dosimetry and Radio bioassay laboratories for approximately 150,000 radiation workers. This presentation will explain the link between Quality Assurance and the DOELAP Accreditation process. DOELAP is a DOE complex-wide safety program that ensures the quality of worker radiation protection programs. DOELAP tests the ability of laboratories to accurately measure and quantify radiation dose to workers and assures the laboratories quality systems are capable of defending and sustaining their measurement results. The United States Law in Title 10 of the Code of Federal Regulations 835 requires that personnel Dosimetry and Radio bioassay programs be tested and accredited

  6. Factoring quality laboratory diagnosis into the malaria control agenda for sub-Saharan Africa.

    Science.gov (United States)

    Aidoo, Michael

    2013-09-01

    Recent progress in malaria control in sub-Saharan Africa has been achieved primarily through provision of insecticide-treated nets, indoor residual spraying, and antimalarial drugs. Although these interventions are important, proper case identification and accurate measurement of their impact depend on quality diagnostic testing. Current availability of diagnostic testing for malaria in sub-Saharan Africa is inadequate to support disease management, prevention programs, and surveillance needs. Challenges faced include a dearth of skilled workforce, inadequate health systems infrastructure, and lack of political will. A coordinated approach to providing pre-service clinical and laboratory training together with systems that support a scale-up of laboratory services could provide means not only for effective malaria case management but also, management of non-malaria febrile illnesses, disease surveillance, and accurate control program evaluation. A synthesis of the challenges faced in ensuring quality malaria testing and how to include this information in the malaria control and elimination agenda are presented.

  7. Can current analytical quality performance of UK clinical laboratories support evidence-based guidelines for diabetes and ischaemic heart disease?--A pilot study and a proposal.

    Science.gov (United States)

    Jassam, Nuthar; Yundt-Pacheco, John; Jansen, Rob; Thomas, Annette; Barth, Julian H

    2013-08-01

    The implementation of national and international guidelines is beginning to standardise clinical practice. However, since many guidelines have decision limits based on laboratory tests, there is an urgent need to ensure that different laboratories obtain the same analytical result on any sample. A scientifically-based quality control process will be a pre-requisite to provide this level of analytical performance which will support evidence-based guidelines and movement of patients across boundaries while maintaining standardised outcomes. We discuss the finding of a pilot study performed to assess UK clinical laboratories readiness to work to a higher grade quality specifications such as biological variation-based quality specifications. Internal quality control (IQC) data for HbA1c, glucose, creatinine, cholesterol and high density lipoprotein (HDL)-cholesterol were collected from UK laboratories participating in the Bio-Rad Unity QC programme. The median of the coefficient of variation (CV%) of the participating laboratories was evaluated against the CV% based on biological variation. Except creatinine, the other four analytes had a variable degree of compliance with the biological variation-based quality specifications. More than 75% of the laboratories met the biological variation-based quality specifications for glucose, cholesterol and HDL-cholesterol. Slightly over 50% of the laboratories met the analytical goal for HBA1c. Only one analyte (cholesterol) had a performance achieving the higher quality specifications consistent with 5σ. Our data from IQC do not consistently demonstrate that the results from clinical laboratories meet evidence-based quality specifications. Therefore, we propose that a graded scale of quality specifications may be needed at this stage.

  8. Guidelines for establishing quality systems in veterinary diagnostic testing laboratories. Report of a Joint FAO/IAEA consultants meeting/workshop. Draft

    International Nuclear Information System (INIS)

    2002-01-01

    The purpose of this report is to assist veterinary testing laboratories to develop and implement a quality system based on the OIE Standard 'Management and Technical Requirements for Laboratories Conducting Tests for Infectious Animal Diseases'. The introduction to the OIE Standard states: This document describes the OIE Standard for management and technical competence that serves as the basis for accreditation of laboratories that conduct tests for infectious animal diseases, especially those laboratories involved in testing for international trade. It contains the specific requirements unique to laboratories conducting tests for infectious animal diseases. These specific requirements represent an interpretation of the generally stated requirements of ISO/IEC 17025:1999, General requirements for the competence of testing and calibration laboratories (as outlined in Annex B of ISO/IEC 17025). Accreditation bodies that recognize the competence of such testing laboratories may use this Standard as the basis for their accreditation. This report gives an example-oriented overview of the structure and contents of critical documents and procedures such as Quality Manual (QM), Standard Operating Procedures (SOPs), etc. inherent to a quality system and describes the different stages in the implementation of the OIE Standard. For that reason it can be used as a practical guide for the production of necessary documents but also as a help to determine the status of a laboratory during its journey towards establishing a QS

  9. Expert Assessment of Conditions for Accredited Quality Management System Functioning in Testing Laboratories

    Science.gov (United States)

    Mytych, Joanna; Ligarski, Mariusz J.

    2018-03-01

    The quality management systems compliant with the ISO 9001:2009 have been thoroughly researched and described in detail in the world literature. The accredited management systems used in the testing laboratories and compliant with the ISO/IEC 17025:2005 have been mainly described in terms of the system design and implementation. They have also been investigated from the analytical point of view. Unfortunately, a low number of studies concerned the management system functioning in the accredited testing laboratories. The aim of following study was to assess the management system functioning in the accredited testing laboratories in Poland. On 8 October 2015, 1,213 accredited testing laboratories were present in Poland. They investigated various scientific areas and substances/objects. There are more and more such laboratories that have various problems and different long-term experience when it comes to the implementation, maintenance and improvement of the management systems. The article describes the results of the conducted expert assessment (survey) carried out to examine the conditions for the functioning of a management system in an accredited laboratory. It also focuses on the characteristics of the accredited research laboratories in Poland. The authors discuss the selection of the external and internal conditions that may affect the accredited management system. They show how the experts assessing the selected conditions were chosen. The survey results are also presented.

  10. Quality improvement project in cervical cancer screening: practical measures for monitoring laboratory performance.

    Science.gov (United States)

    Tarkkanen, Jussi; Geagea, Antoine; Nieminen, Pekka; Anttila, Ahti

    2003-01-01

    We conducted a quality improvement project in a cervical cancer screening programme in Helsinki in order to see if detection of precancerous lesions could be influenced by external (participation rate) and internal (laboratory praxis) quality measures. In order to increase the participation rate, a second personal invitation to Pap-test was mailed to nonparticipants of the first call. In order to improve the quality of screening, the cytotechnicians monitored their performance longitudinally by recording the number of slides reviewed per day, the pick-up rate of abnormal smears, the report of the consulting cytopathologist, and the number of histologically verified lesions detected from the cases that they had screened. Regular sessions were held to compare the histological findings with the cytological findings of all cases referred for colposcopy. No pressure was applied on the cytotechnicians to ensure that they felt comfortable with their daily workload. A total of 110 000 smears were screened for cervical cancer at the Helsinki City Hospital during 1996-99. Initially, the overall participation rate increased from 62% to 71%. The number of histologically confirmed precancerous lesions (CIN 1-3) more than doubled and their detection rate increased from 0.32% to 0.72%. Continuous education and feedback from daily work performance were important, yet rather inexpensive means in increasing laboratory performance. Additional measures are needed to further increase the participation rate. Impact of the quality measures on cancer incidence needs to be assessed later on.

  11. Los Alamos National Laboratory Yucca Mountain Site Characterization Project 1995 quality program status report

    International Nuclear Information System (INIS)

    Bolivar, S.L.

    1996-07-01

    This status report summarizes the activities and accomplishments of the Los Alamos National Laboratory Yucca Mountain Site Characterization Project's (YMP's) quality assurance program for January 1 to September 30, 1995. The report includes major sections on program activities and trend analysis

  12. Quality and future of clinical laboratories: the Vico's whole cyclical theory of the recurring cycles.

    Science.gov (United States)

    Plebani, Mario

    2018-05-24

    In the last few decades, laboratory medicine has undergone monumental changes, and laboratory technology, which has made enormous advances, now has new clinical applications thanks to the identification of a growing number of biomarkers and risk factors conducive to the promotion of predictive and preventive interventions that have enhanced the role of laboratory medicine in health care delivering. However, the paradigm shift in the past 50 years has led to a gap between laboratory and clinic, with an increased risk of inappropriateness in test request and interpretation, as well as the consolidation of analytical work in focused factories and megastructurers oriented only toward achieving greater volumes, decreasing cost per test and generating a vision of laboratory services as simple commodities. A careful historical revision of the changing models for delivering laboratory services in the United States leads to the prediction that there are several reasons for counteracting the vision of clinical laboratory as a commodity, and restoring the true nature of laboratory services as an integral part of the diagnosis and therapy process. The present study, which reports on internal and external drivers for change, proposes an integrated vision of quality in laboratory medicine.

  13. Quality Evaluation of Zirconium Dioxide Frameworks Produced in Five Dental Laboratories from Different Countries.

    Science.gov (United States)

    Schneebeli, Esther; Brägger, Urs; Scherrer, Susanne S; Keller, Andrea; Wittneben, Julia G; Hicklin, Stefan P

    2017-07-01

    The aim of this study was to assess and compare quality as well as economic aspects of CAD/CAM high strength ceramic three-unit FDP frameworks ordered from dental laboratories located in emerging countries and Switzerland. The master casts of six cases were sent to five dental laboratories located in Thailand (Bangkok), China (Peking and Shenzhen), Turkey (Izmir), and Switzerland (Bern). Each laboratory was using a different CAD/CAM system. The clinical fit of the frameworks was qualitatively assessed, and the thickness of the framework material, the connector height, the width, and the diameter were evaluated using a measuring sensor. The analysis of the internal fit of the frameworks was performed by means of a replica technique, whereas the inner and outer surfaces of the frameworks were evaluated for traces of postprocessing and damage to the intaglio surface with light and electronic microscopes. Groups (dental laboratories and cases) were compared for statistically significant differences using Mann-Whitney U-tests after Bonferroni correction. An acceptable clinical fit was found at 97.9% of the margins produced in laboratory E, 87.5% in B, 93.7% in C, 79.2% in A, and 62.5% in D. The mean framework thicknesses were not statistically significantly different for the premolar regions; however, for the molar area 4/8 of the evaluated sites were statistically significantly different. Circumference, surface, and width of the connectors produced in the different laboratories were statistically significantly different but not the height. There were great differences in the designs for the pontic and connector regions, and some of the frameworks would not be recommended for clinical use. Traces of heavy postprocessing were found in frameworks from some of the laboratories. The prices per framework ranged from US$177 to US$896. By ordering laboratory work in developing countries, a considerable price reduction was obtained compared to the price level in Switzerland

  14. Historical return on investment and improved quality resulting from development and mining of a hospital laboratory relational database.

    Science.gov (United States)

    Brimhall, Bradley B; Hall, Timothy E; Walczak, Steven

    2006-01-01

    A hospital laboratory relational database, developed over eight years, has demonstrated significant cost savings and a substantial financial return on investment (ROI). In addition, the database has been used to measurably improve laboratory operations and the quality of patient care.

  15. Quality control of calibration system for area monitors at National Laboratory of Metrology from Ionizing Radiations (LNMRI)

    International Nuclear Information System (INIS)

    Ramos, M.M.O.; Freitas, L.C. de

    1992-01-01

    The quality control of equipment used in calibration from the National Laboratory of Metrology on Ionizing Radiations is presented, with results of standard measure systems and irradiation system. Tables and graphics with the quality of systems are also shown. (C.G.C.)

  16. [THE VIRTUAL CYTOLOGIC SLIDES FOR EXTERNAL EVALUATION OF QUALITY OF IMPLEMENTATION OF CYTOLOGIC ANALYSES IN CLINICAL DIAGNOSTIC LABORATORIES: POSSIBILITIES AND PERSPECTIVES].

    Science.gov (United States)

    Djangirova, T V; Shabalova, I P; Pronichev, A N; Polyakov, E V

    2015-08-01

    The article considers application of technology of analysis of cytological slides in external quality control of clinical diagnostic laboratories. The advantages of virtual slides are demonstrated against other applied technologies of external evaluation of quality i.e. slide plate and digital micro-photography. The conditions of formation of virtual slides for external evaluation of quality of clinical diagnostic laboratories. The technology of their application is described. The success of practical application of considered technology in the Federal system of external evaluation of quality is emphasized.

  17. Feasibility of establishing a biosafety level 3 tuberculosis culture laboratory of acceptable quality standards in a resource-limited setting: an experience from Uganda.

    Science.gov (United States)

    Ssengooba, Willy; Gelderbloem, Sebastian J; Mboowa, Gerald; Wajja, Anne; Namaganda, Carolyn; Musoke, Philippa; Mayanja-Kizza, Harriet; Joloba, Moses Lutaakome

    2015-01-15

    Despite the recent innovations in tuberculosis (TB) and multi-drug resistant TB (MDR-TB) diagnosis, culture remains vital for difficult-to-diagnose patients, baseline and end-point determination for novel vaccines and drug trials. Herein, we share our experience of establishing a BSL-3 culture facility in Uganda as well as 3-years performance indicators and post-TB vaccine trials (pioneer) and funding experience of sustaining such a facility. Between September 2008 and April 2009, the laboratory was set-up with financial support from external partners. After an initial procedure validation phase in parallel with the National TB Reference Laboratory (NTRL) and legal approvals, the laboratory registered for external quality assessment (EQA) from the NTRL, WHO, National Health Laboratories Services (NHLS), and the College of American Pathologists (CAP). The laboratory also instituted a functional quality management system (QMS). Pioneer funding ended in 2012 and the laboratory remained in self-sustainability mode. The laboratory achieved internationally acceptable standards in both structural and biosafety requirements. Of the 14 patient samples analyzed in the procedural validation phase, agreement for all tests with NTRL was 90% (P 80% in all years from NTRL, CAP, and NHLS, and culture was 100% for CAP panels and above regional average scores for all years with NHLS. Quarterly DST scores from WHO-EQA ranged from 78% to 100% in 2010, 80% to 100% in 2011, and 90 to 100% in 2012. From our experience, it is feasible to set-up a BSL-3 TB culture laboratory with acceptable quality performance standards in resource-limited countries. With the demonstrated quality of work, the laboratory attracted more research groups and post-pioneer funding, which helped to ensure sustainability. The high skilled experts in this research laboratory also continue to provide an excellent resource for the needed national discussion of the laboratory and quality management systems.

  18. Los Alamos National Laboratory Yucca Mountain Site Characterization Project 1995 quality program status report

    Energy Technology Data Exchange (ETDEWEB)

    Bolivar, S.L.

    1996-07-01

    This status report summarizes the activities and accomplishments of the Los Alamos National Laboratory Yucca Mountain Site Characterization Project`s (YMP`s) quality assurance program for January 1 to September 30, 1995. The report includes major sections on program activities and trend analysis.

  19. Los Alamos National Laboratory Yucca Mountain Site Characterization Project: 1991 quality program status report

    International Nuclear Information System (INIS)

    1992-07-01

    This status report summarizes the activities and accomplishments of the Los Alamos National Laboratory (Los Alamos) Yucca Mountain Site Characterization Project's (YMP) quality assurance program for calendar year 1991. The report is divided into three Sections: Program Activities, Verification Activities, and Trend Analysis

  20. Environmental Monitoring Of Microbiological Laboratory: Expose Plate Method

    International Nuclear Information System (INIS)

    Yahaya Talib; Othman Mahmud; Noraisyah Mohd Yusof; Asmah Mohibat; Muhamad Syazwan Zulkifli

    2013-01-01

    Monitoring of microorganism is important and conducted regularly on environment of microbiological laboratory at Medical Technology Division. Its objective is to ensure the quality of working environment is maintained according to microbial contamination, consequently to assure the quality of microbiological tests. This paper presents report of environmental monitoring since year 2007. The test involved was bacterial colony counts after the growth media was exposed to air at identified location. (author)

  1. National survey on turnaround time of clinical biochemistry tests in 738 laboratories in China.

    Science.gov (United States)

    Zhang, Xiaoyan; Fei, Yang; Wang, Wei; Zhao, Haijian; Wang, Minqi; Chen, Bingquan; Zhou, Jie; Wang, Zhiguo

    2018-02-01

    This survey was initiated to estimate the current status of turnaround time (TAT) monitoring of clinical biochemistry in China, provide baseline data for establishment of quality specifications and analyze the impact factors of TAT. 738 laboratories were included. Questionnaires involved general information and data of related indicators of TAT during 1 week were provided to participating laboratories. Nine quality indicators were covered, which were medians, 90th and outlier rates of pre-examination, examination, and post-examination TAT. The 25th percentile, median, and 75th percentile of TATs were calculated as optimum, desirable, and minimum quality specifications. Percentages and sigma values were used to describe the outlier rates. Mann-Whitney and Kruskal-Wallis tests were used to identify the potential impacts of TAT. Response rate of this survey was 46.44%. More than 50% of the laboratories indicated they had set up target TATs in three time intervals and monitored TATs generally. The post-examination TAT of most laboratories was 0min, while the pre-examination and examination TAT varied. Sigma values of outlier rates for 45%~60% of laboratories were above 4, while 15%~20% of labs whose sigma values were below 3. Group comparisons suggested nurse or mechanical pipeline transportation, link laboratory information system with hospital information system, and using computer reporting instead of printing report were related to shorter TATs. Despite of the remarkable progresses of TATs in China, there was also room to improve. Laboratories should strengthen the construction of information systems, identify reasons for TAT delay to improve the service quality continuously. © 2017 Wiley Periodicals, Inc.

  2. Informatics solutions for bridging the gap between clinical and laboratory services in a low-resource setting

    Directory of Open Access Journals (Sweden)

    Julia Driessen

    2015-06-01

    Full Text Available Background: There has been little formal analysis of laboratory systems in resource-limited settings, despite widespread consensus around the importance of a strong laboratory infrastructure. Objectives: This study details the informational challenges faced by the laboratory at Kamuzu Central Hospital, a tertiary health facility in Malawi; and proposes ways in which informatics can bolster the efficiency and role of low-resource laboratory systems. Methods: We evaluated previously-collected data on three different aspects of laboratory use. A four-week quality audit of laboratory test orders quantified challenges associated with collecting viable specimens for testing. Data on tests run by the laboratory over a one yearperiod described the magnitude of the demand for laboratory services. Descriptive information about the laboratory workflow identified informational process breakdowns in the pre-analytical and post-analytical phases and was paired with a 24-hour sample of laboratory data on results reporting. Results: The laboratory conducted 242 242 tests over a 12-month period. The four-week quality audit identified 54% of samples as untestable. Prohibitive paperwork errors were identified in 16% of samples. Laboratory service workflows indicated a potential process breakdown in sample transport and results reporting resulting from the lack of assignment of these tasks to any specific employee cadre. The study of result reporting time showed a mean of almost six hours, with significant variation. Conclusions: This analysis identified challenges in each phase of laboratory testing. Informatics could improve the management of this information by streamlining test ordering and the communication of test orders to the laboratory and results back to the ordering physician.

  3. Using Focused Laboratory Management and Quality Improvement Projects to Enhance Resident Training and Foster Scholarship

    Science.gov (United States)

    Ford, Bradley A.; Klutts, J. Stacey; Jensen, Chris S.; Briggs, Angela S.; Robinson, Robert A.; Bruch, Leslie A.; Karandikar, Nitin J.

    2017-01-01

    Training in patient safety, quality, and management is widely recognized as an important element of graduate medical education. These concepts have been intertwined in pathology graduate medical education for many years, although training programs face challenges in creating explicit learning opportunities in these fields. Tangibly involving pathology residents in management and quality improvement projects has the potential to teach and reinforce key concepts and further fulfill Accreditation Council for Graduate Medical Education goals for pursuing projects related to patient safety and quality improvement. In this report, we present our experience at a pathology residency program (University of Iowa) in engaging pathology residents in projects related to practical issues of laboratory management, process improvement, and informatics. In this program, at least 1 management/quality improvement project, typically performed during a clinical chemistry/management rotation, was required and ideally resulted in a journal publication. The residency program also initiated a monthly management/informatics series for pathology externs, residents, and fellows that covers a wide range of topics. Since 2010, all pathology residents at the University of Iowa have completed at least 1 management/quality improvement project. Many of the projects involved aspects of laboratory test utilization, with some projects focused on other areas such as human resources, informatics, or process improvement. Since 2012, 31 peer-reviewed journal articles involving effort from 26 residents have been published. Multiple projects resulted in changes in ongoing practice, particularly within the hospital electronic health record. Focused management/quality improvement projects involving pathology residents can result in both meaningful quality improvement and scholarly output. PMID:28913416

  4. Using Focused Laboratory Management and Quality Improvement Projects to Enhance Resident Training and Foster Scholarship.

    Science.gov (United States)

    Krasowski, Matthew D; Ford, Bradley A; Klutts, J Stacey; Jensen, Chris S; Briggs, Angela S; Robinson, Robert A; Bruch, Leslie A; Karandikar, Nitin J

    2017-01-01

    Training in patient safety, quality, and management is widely recognized as an important element of graduate medical education. These concepts have been intertwined in pathology graduate medical education for many years, although training programs face challenges in creating explicit learning opportunities in these fields. Tangibly involving pathology residents in management and quality improvement projects has the potential to teach and reinforce key concepts and further fulfill Accreditation Council for Graduate Medical Education goals for pursuing projects related to patient safety and quality improvement. In this report, we present our experience at a pathology residency program (University of Iowa) in engaging pathology residents in projects related to practical issues of laboratory management, process improvement, and informatics. In this program, at least 1 management/quality improvement project, typically performed during a clinical chemistry/management rotation, was required and ideally resulted in a journal publication. The residency program also initiated a monthly management/informatics series for pathology externs, residents, and fellows that covers a wide range of topics. Since 2010, all pathology residents at the University of Iowa have completed at least 1 management/quality improvement project. Many of the projects involved aspects of laboratory test utilization, with some projects focused on other areas such as human resources, informatics, or process improvement. Since 2012, 31 peer-reviewed journal articles involving effort from 26 residents have been published. Multiple projects resulted in changes in ongoing practice, particularly within the hospital electronic health record. Focused management/quality improvement projects involving pathology residents can result in both meaningful quality improvement and scholarly output.

  5. Laboratory audit as part of the quality assessment of a primary HPV-screening program.

    Science.gov (United States)

    Hortlund, Maria; Sundström, Karin; Lamin, Helena; Hjerpe, Anders; Dillner, Joakim

    2016-02-01

    As primary HPV screening programs are rolled out, methods are needed for routine quality assurance of HPV laboratory analyzes. To explore the use of similar design for audit as currently used in cytology-based screening, to estimate the clinical sensitivity to identify women at risk for CIN 3 or worse (CIN3+). Population-based cohort study conducted within the cervical screening program in Stockholm, Sweden, in 2011-2012. All women with histopathologically confirmed CIN3+ in the following two years were identified by registry analysis. Primary HPV and cytology screening results were collected. For women who had not been HPV tested, biobanked cytology samples were HPV-tested. If the original HPV result had been negative, the sample and subsequent biopsies were analyzed with broad HPV typing (general primer PCR and Luminex). 154 women had a biobanked prediagnostic cytology sample taken up to 2 years before a histopathologically confirmed CIN3+. The high-risk HPV-positivity was 97% (148/154 women), whereas 143/154 (94%) women had had a cytological abnormality. Among the six HPV-negative samples, one sample was HPV 33 positive in repeat testing whereas the other five cases were HPV-negative also on repeat testing, but HPV-positive in the subsequent tumor tissue. A sensitivity of the HPV test that is higher than the sensitivity of cytology suggests adequate quality of the testing. Regular audits of clinical sensitivity, similar to those of cytology-based screening, should be used also in HPV-based screening programs, in order to continuously monitor the performance of the analyzes. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Power supplies for space systems quality assurance by Sandia Laboratories

    International Nuclear Information System (INIS)

    Hannigan, R.L.; Harnar, R.R.

    1976-07-01

    The Sandia Laboratories' participation in Quality Assurance programs for Radioisotopic Thermoelectric Generators which have been used in space systems over the past 10 years is summarized. Basic elements of this QA program are briefly described and recognition of assistance from other Sandia organizations is included. Descriptions of the various systems for which Sandia has had the QA responsibility are presented, including SNAP 19 (Nimbus, Pioneer, Viking), SNAP 27 (Apollo), Transit, Multi-Hundred Watt (LES 8/9 and MJS), and a new program, High-Performance Generator Mod 3. The outlook for Sandia participation in RTG programs for the next several years is noted

  7. The Hazardous-Drums Project: A Multiweek Laboratory Exercise for General Chemistry Involving Environmental, Quality Control, and Cost Evaluation

    Science.gov (United States)

    Hayes, David; Widanski, Bozena

    2013-01-01

    A laboratory experiment is described that introduces students to "real-world" hazardous waste management issues chemists face. The students are required to define an analytical problem, choose a laboratory analysis method, investigate cost factors, consider quality-control issues, interpret the meaning of results, and provide management…

  8. From grass to grace: How SLMTA revolutionised the Bamenda Regional Hospital Laboratory in Cameroon

    Directory of Open Access Journals (Sweden)

    Siyem C. Nkwawir

    2014-11-01

    Objectives: To evaluate the results of SLMTA implementation at BRHL and discuss lessons learned. Method: In 2010, the SLMTA programme was rolled out in Cameroon to improve laboratory quality management systems in five laboratories, including BRHL. Three workshops were conducted (the first centralised, the remaining two on-site at each laboratory and improvement projects were implemented after each workshop with the assistance of mentors. Audits were used in order to evaluate performance and to identify areas for further improvement. Results: BRHL had the lowest score (18% amongst the cohort at the baseline audit and the highest (81% at the official Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA audit conducted in August 2013 by the African Society for Laboratory Medicine. Improvements were observed in each of the 12 Quality System Essentials; improvement was especially noteworthy in the areas of facilities and safety, and purchasing and inventory. Staff investment and pride in the quality of laboratory services increased. Conclusion: BRHL’s remarkable improvement was achieved with a combination of SLMTA training activities, intensive on-site mentorship and the collective focus of all laboratory staff. The experience at Bamenda Hospital illustrates what can be achieved when a laboratory successfully harnesses the energy of its staff and implements changes to improve the quality of services in a transformation taking them from grass to grace.

  9. Identifying the physical and anthropometric qualities explanatory of paddling adolescents.

    Science.gov (United States)

    Sinclair, Wade H; Leicht, Anthony S; Eady, Troy W; Marshall, Nick J; Woods, Carl T

    2017-12-01

    This study aimed to identify the physical and/or anthropometric qualities explanatory of adolescent surf lifesavers participating in paddling activities. Cross-sectional observational study. A total of 53 (14-18years) male participants were recruited and classified into two groups; paddlers (n=30; actively participating in paddling), non-paddlers (n=23; not actively participating in paddling). All participants completed a testing battery that consisted of 16 physical (isometric strength and muscular endurance) and anthropometric (height, mass, segment lengths and breadths) assessments. Binary logistic regression models and receiver operating characteristic curves were built to identify the physical and/or anthropometric qualities most explanatory of paddling status (two levels: 1=paddlers, 0=non-paddlers). Significant between group differences were noted for 14 of the 16 assessments (Ptalent detection programs focused toward the recognition of performance potential in paddling-oriented sports. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  10. [RESAOLAB: West African network of laboratories to enhance the quality of clinical biology].

    Science.gov (United States)

    Delorme, L; Machuron, J L; Sow, I; Diagne, R; Sakandé, J; Nikiéma, A; Bougoudogo, F; Keita, A; Longuet, C

    2015-02-01

    The Fondation Mérieux, in partnership with the Ministries of Health of Burkina Faso, Mali and Senegal, implemented for four years a project to reinforce the laboratory sector in the three participating countries: the RESAOLAB project (West African Network of Biomedical Analysis Laboratories).The objective of RESAOLAB project, in partnership with the WHO Office for West Africa and the West African Health Organization, was to strengthen the systems of biomedical laboratories to improve diagnostic services, access, monitoring and management of infectious diseases. Following the successful results achieved under the RESAOLAB project and due to the demand of the neighbour countries ministries, the RESAOLAB project is now extended to four other countries of the West African region: Benin, Guinea-Conakry, Niger and Togo. The RESAOLAB project has become the RESAOLAB programme, its purpose is to strengthen the quality of the medical biology services thanks to a regional and transversal approach.

  11. Clinical laboratory accreditation in India.

    Science.gov (United States)

    Handoo, Anil; Sood, Swaroop Krishan

    2012-06-01

    Test results from clinical laboratories must ensure accuracy, as these are crucial in several areas of health care. It is necessary that the laboratory implements quality assurance to achieve this goal. The implementation of quality should be audited by independent bodies,referred to as accreditation bodies. Accreditation is a third-party attestation by an authoritative body, which certifies that the applicant laboratory meets quality requirements of accreditation body and has demonstrated its competence to carry out specific tasks. Although in most of the countries,accreditation is mandatory, in India it is voluntary. The quality requirements are described in standards developed by many accreditation organizations. The internationally acceptable standard for clinical laboratories is ISO15189, which is based on ISO/IEC standard 17025. The accreditation body in India is the National Accreditation Board for Testing and Calibration Laboratories, which has signed Mutual Recognition Agreement with the regional cooperation the Asia Pacific Laboratory Accreditation Cooperation and with the apex cooperation the International Laboratory Accreditation Cooperation.

  12. Quality control at the Regional Centre of Nuclear Sciences chemical dosimetry laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Vivianne L.B. de; Melo, Roberto T. de; Silva, Danubia B. da; Pedroza, Eryka H.; Rodrigues, Kelia R.G.; Cunha, Manuela S. da; Figueiredo, Marcela D.C. de [Centro Regional de Ciencias Nucleares (CRCN-NE/CNEN-PE), Recife, PE (Brazil); Oliveira, Aristides, E-mail: vlsouza@cnen.gov.b, E-mail: rtmelo@cnen.gov.b [Hospital de Cancer de Pernambuco, Recife, PE (Brazil)

    2011-07-01

    Standards for accreditation of laboratories as in ISO 9001 in section: 4.11 require inspection, measuring and equipment testing; likewise, IEC 17025: 2005 in section: 5.5.2 requires the equipment to be calibrated or verified before being put into use. In our laboratory, quality control is often accomplished by standards set done by the laboratory scientists themselves; however, at present, Hellma secondary calibration standards (4026 - Holmium oxide - Filters: F0, F2, F3, F4 and filter didymium - F7) have been used in order to verify if errors in the laboratory have been close to the 1-2% margin. Control graphs were made by using the results of synthetically prepared standards and standardized spectral calibration certificates. The set of secondary calibration standards permits to check the accuracy of the spectrophotometers used in research for both the absorbance in the visible spectrum (at 440, 465, 546, 590 and 635 nm wavelengths) and for the wavelengths (270, 280, 300, 320 nm) of the ultraviolet light. Filters (F0, F2, F3, F4 and F7) are stable and do not suffer the influence of temperature (the influence is negligible), the F0 filter was being used as a blank. The purpose is to verify whether the spectrometer needs adjustments, an important procedure to check absorbance stability, baseline flatness, slit width accuracy and stray radiation. The calibration tests are performed annually in our laboratory and recalibration of Hellma secondary standards is recommended every two years. The results show that the Chemical Dosimetry Laboratory in CRCN has a calibrated spectrophotometer and their synthetic standards for Fricke dosimetry could be used as an alternative method for testing the proficiency and competence of calibration laboratories in accordance with the regulations and standards. (author)

  13. [The system of quality management in medical laboratory: the problematic issues of implementation of GOST RKS 9001-2008, GOST R ISO 15189-2009 and GOST R ISO 53079-2008].

    Science.gov (United States)

    Dolgikh, T I

    2013-04-01

    The article presents the approaches to development and implementation of system of quality management in laboratory as an integral part of the given system in whole medical institution. The costs of works execution concerning quality support are to be weighted with economic profitability and timeliness of medical care provision to ill people considering pre-analytic stage (out-laboratory and in-laboratory) laboratory analysis. Factually it is a matter of development of system of balanced indicators concerning quality management of institution and laboratory functioning. The problematic issues are presented concerning maintenance of particular requirements of GOSTR ISO 15189 about quality of production. The emphasis is made on the necessity of training of administrations of laboratories in the field of quality management and economics of laboratory business.

  14. Sample requirements and design of an inter-laboratory trial for radiocarbon laboratories

    International Nuclear Information System (INIS)

    Bryant, Charlotte; Carmi, Israel; Cook, Gordon; Gulliksen, Steinar; Harkness, Doug; Heinemeier, Jan; McGee, Edward; Naysmith, Philip; Possnert, Goran; Scott, Marian; Plicht, Hans van der; Strydonck, Mark van

    2000-01-01

    An on-going inter-comparison programme which is focused on assessing and establishing consensus protocols to be applied in the identification, selection and sub-sampling of materials for subsequent 14 C analysis is described. The outcome of the programme will provide a detailed quantification of the uncertainties associated with 14 C measurements including the issues of accuracy and precision. Such projects have become recognised as a fundamental aspect of continuing laboratory quality assurance schemes, providing a mechanism for the harmonisation of measurements and for demonstrating the traceability of results. The design of this study and its rationale are described. In summary, a suite of core samples has been defined which will be made available to both AMS and radiometric laboratories. These core materials are representative of routinely dated material and their ages span the full range of the applied 14 C time-scale. Two of the samples are of wood from the German and Irish dendrochronologies, thus providing a direct connection to the master dendrochronological calibration curve. Further samples link this new inter-comparison to past studies. Sample size and precision have been identified as being of paramount importance in defining dating confidence, and so several core samples have been identified for more in-depth study of these practical issues. In addition to the core samples, optional samples have been identified and prepared specifically for either AMS and/or radiometric laboratories. For AMS laboratories, these include bone, textile, leather and parchment samples. Participation in the study requires a commitment to a minimum of 10 core analyses, with results to be returned within a year

  15. The impact of laboratory characteristics on molecular detection of respiratory syncytial virus in a European multicentre quality control study

    NARCIS (Netherlands)

    Meerhoff, T. J.; MacKay, W. G.; Meijer, A.; Paget, W. J.; Niesters, H. G. M.; Kimpen, J. L. L.; Schellevis, F.

    2008-01-01

    The performance of nucleic acid amplification techniques for detecting respiratory syncytial virus (RSV) was evaluated in 25 laboratories across Europe by an external quality assessment study. In addition, factors related to the diagnostic performance of laboratories were explored. The results of

  16. [The quality management in clinical diagnostic laboratory in conditions of the Federal Center of traumatology, orthopedics and endoprosthesis replacement of Minzdrav of Russia (Cheboksary)].

    Science.gov (United States)

    Nikolaev, N S; Nazarova, V V; Dobrovol'skaia, N Iu; Orlova, A V; Pchelova, N N

    2014-10-01

    The article presents experience of clinical diagnostic laboratory of the Federal Center of traumatology, orthopedics and endoprosthesis replacement of Minzdrav of Russia (Cheboksary) in the area of quality management of medical laboratory services on the basis of evaluation of efficacy and effectiveness of processes. The factors effecting quality of functioning of clinical diagnostic laboratory are indicated. The criteria and indicators of efficacy of work of employees of clinical diagnostic laboratory are presented.

  17. Effect of clinical and laboratory parameters on quality of life in celiac patients using celiac disease-specific quality of life scores.

    Science.gov (United States)

    Lee, Jungmin; Clarke, Kofi

    2017-11-01

    Health-related quality of life (HR-QOL) in patients with celiac disease is reduced compared to the general population. We investigated the association between HR-QOL and clinical, laboratory findings using the previously validated CD-QOL (celiac disease-specific quality of life) instrument in patients with celiac disease. To our knowledge, no study has previously explored the relationship between HR-QOL and clinical, laboratory parameters in celiac patients. Patients who received care at the Allegheny Health Network Celiac Center, Pittsburgh, PA were asked to complete the CD-QOL questionnaire. A cross sectional study with predetermined clinical and laboratory parameters was performed. Data collected included IgA anti-tissue transglutaminase (tTG) antibody titers, iron studies, calcium, vitamin A, B12, 25 OH vitamin D, and E levels. Correlation between clinical findings and CD-QOL was also assessed. Seventy-eight out of 124 patients who completed the questionnaire was included in the analysis. Patients with concomitant irritable bowel syndrome (IBS) had significantly reduced HR-QOL with CD-QOL score of 52.4 ± 11.3 vs. 44.6 ± 12.9 in those without IBS (p = .009). There was no difference in HR-QOL in relation to IgA tTG titers or vitamin D levels. Of note, there was a trend towards correlation between higher level of vitamin E and better QOL (r = -0.236, p = .074). Celiac patients with concomitant IBS have reduced HR-QOL. There was no statistically significant association between HR-QOL and laboratory parameters or levels of micronutrients.

  18. Proficiency Test Program Involvement as a Tool for External Quality Control for Radiochemistry and Environmental Laboratory, Malaysian Nuclear Agency

    International Nuclear Information System (INIS)

    Nurrul Assyikeen Mohd Jaffary; Wo, Y.M.; Zal U'yun Wan Mahmood; Norfaizal Mohamed; Abdul Kadir Ishak; Noor Fadzilah Yusof; Jalal Sharib

    2016-01-01

    As the only Laboratory in Malaysia under the IAEA Analytical Laboratories for the Measurement of Environmental Radioactivity (ALMERA) Network, the Radiochemistry and Environmental Laboratory (RAS), Malaysian Nuclear Agency participates in the proficiency test programmes organised by ALMERA to achieve mutual acceptance of analytical data. The ALMERA has been providing quality support of proficiency tests using sets of different samples matrices and radionuclide levels typically encountered in environmental and food monitoring laboratories. The involvement of RAS laboratory in the IAEA proficiency tests gives opportunity to improve the laboratory capability and personnel skills in the field of radioactivity testing. (author)

  19. Components of laboratory accreditation.

    Science.gov (United States)

    Royal, P D

    1995-12-01

    Accreditation or certification is a recognition given to an operation or product that has been evaluated against a standard; be it regulatory or voluntary. The purpose of accreditation is to provide the consumer with a level of confidence in the quality of operation (process) and the product of an organization. Environmental Protection Agency/OCM has proposed the development of an accreditation program under National Environmental Laboratory Accreditation Program for Good Laboratory Practice (GLP) laboratories as a supplement to the current program. This proposal was the result of the Inspector General Office reports that identified weaknesses in the current operation. Several accreditation programs can be evaluated and common components identified when proposing a structure for accrediting a GLP system. An understanding of these components is useful in building that structure. Internationally accepted accreditation programs provide a template for building a U.S. GLP accreditation program. This presentation will discuss the traditional structure of accreditation as presented in the Organization of Economic Cooperative Development/GLP program, ISO-9000 Accreditation and ISO/IEC Guide 25 Standard, and the Canadian Association for Environmental Analytical Laboratories, which has a biological component. Most accreditation programs are managed by a recognized third party, either privately or with government oversight. Common components often include a formal review of required credentials to evaluate organizational structure, a site visit to evaluate the facility, and a performance evaluation to assess technical competence. Laboratory performance is measured against written standards and scored. A formal report is then sent to the laboratory indicating accreditation status. Usually, there is a scheduled reevaluation built into the program. Fee structures vary considerably and will need to be examined closely when building a GLP program.

  20. The quality of impressions for crowns and bridges: an assessment of the work received at three commercial dental laboratories. assessing the quality of the impressions of prepared teeth.

    Science.gov (United States)

    Storey, D; Coward, T J

    2013-06-01

    The literature is limited in studies directly assessing the quality of impressions for crowns and bridges in the UK. The aim of the study was to assess the quality of impressions for conventional crown and bridgework received by commercial dental laboratories. Three dental laboratories were visited over a 3-month period. All impressions for conventional crowns and bridges that arrived on the days of the visits were examined prior to any laboratory processing. A total of 206 impression cases were examined and assessed against criteria laid out in a custom-designed assessment form. Defects were commonly found in the recording of prepared teeth. Overall, 44.2% of impression cases were unsatisfactory. NHS impressions were more than twice as likely to be unsatisfactory compared to private impressions. If the results of this survey are typical then the general quality of impressions for fixed crown and bridgework is unacceptable. This is particularly true for work completed under the NHS contract.

  1. [Application of laboratory information system in the management of the key indicators of quality inspection].

    Science.gov (United States)

    Guo, Ye; Chen, Qian; Wu, Wei; Cui, Wei

    2015-03-31

    To establish a system of monitoring the key indicator of quality for inspection (KIQI) on a laboratory information system (LIS), and to have a better management of KIQI. Clinical sample made in PUMCH were collected during the whole of 2014. Next, interactive input program were designed to accomplish data collecting of the disqualification rate of samples, the mistake rate of samples and the occasions of losing samples, etc. Then, a series moment of sample collection, laboratory sample arrived, sample test, sample check, response to critical value, namely, trajectory information left on LIS were recorded and the qualification rate of TAT, the notification rate of endangering result were calculated. Finally, the information about quality control were collected to build an internal quality control database and the KIQI, such as the out-of-control rate of quality control and the total error of test items were monitored. The inspection of the sample management shows the disqualification rates in 2014 were all below the target, but the rates in January and February were a little high and the rates of four wards were above 2%. The mistake rates of samples was 0.47 cases/10 000 cases, attaining the target (laboratory reports shows the qualification rates of TAT was within the acceptable range (> 95%), however the rates of blood routine in November (94.75%) was out of range. We have solved the problem by optimizing the processes. The notification rate of endangering result attained the target (≥ 98%), while the rate of timely notification is needed to improve. Quality inspection shows the CV of APTT in August (5.02%) was rising significantly, beyond the accepted CV (5.0%). We have solved the problem by changing the reagent. The CV of TT in 2014 were all below the allowable CV, thus the allowable CV of the next year lower to 10%. It is an objective and effective method to manage KIQI with the powerful management mode of database and information process capability on LIS.

  2. [Laboratory accreditation and proficiency testing].

    Science.gov (United States)

    Kuwa, Katsuhiko

    2003-05-01

    ISO/TC 212 covering clinical laboratory testing and in vitro diagnostic test systems will issue the international standard for medical laboratory quality and competence requirements, ISO 15189. This standard is based on the ISO/IEC 17025, general requirements for competence of testing and calibration laboratories and ISO 9001, quality management systems-requirements. Clinical laboratory services are essential to patient care and therefore should be available to meet the needs of all patients and clinical personnel responsible for human health care. If a laboratory seeks accreditation, it should select an accreditation body that operates according to this international standard and in a manner which takes into account the particular requirements of clinical laboratories. Proficiency testing should be available to evaluate the calibration laboratories and reference measurement laboratories in clinical medicine. Reference measurement procedures should be of precise and the analytical principle of measurement applied should ensure reliability. We should be prepared to establish a quality management system and proficiency testing in clinical laboratories.

  3. ASVCP quality assurance guidelines: control of preanalytical and analytical factors for hematology for mammalian and nonmammalian species, hemostasis, and crossmatching in veterinary laboratories.

    Science.gov (United States)

    Vap, Linda M; Harr, Kendal E; Arnold, Jill E; Freeman, Kathleen P; Getzy, Karen; Lester, Sally; Friedrichs, Kristen R

    2012-03-01

    In December 2009, the American Society for Veterinary Clinical Pathology (ASVCP) Quality Assurance and Laboratory Standards committee published the updated and peer-reviewed ASVCP Quality Assurance Guidelines on the Society's website. These guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports: (1) general analytical factors for veterinary laboratory performance and comparisons; (2) hematology, hemostasis, and crossmatching; and (3) clinical chemistry, cytology, and urinalysis. This particular report is one of 3 reports and provides recommendations for control of preanalytical and analytical factors related to hematology for mammalian and nonmammalian species, hemostasis testing, and crossmatching and is adapted from sections 1.1 and 2.3 (mammalian hematology), 1.2 and 2.4 (nonmammalian hematology), 1.5 and 2.7 (hemostasis testing), and 1.6 and 2.8 (crossmatching) of the complete guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimal guidelines for quality assurance and quality control for veterinary laboratory testing and a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts. © 2012 American Society for Veterinary Clinical Pathology.

  4. Identifying key hospital service quality factors in online health communities.

    Science.gov (United States)

    Jung, Yuchul; Hur, Cinyoung; Jung, Dain; Kim, Minki

    2015-04-07

    The volume of health-related user-created content, especially hospital-related questions and answers in online health communities, has rapidly increased. Patients and caregivers participate in online community activities to share their experiences, exchange information, and ask about recommended or discredited hospitals. However, there is little research on how to identify hospital service quality automatically from the online communities. In the past, in-depth analysis of hospitals has used random sampling surveys. However, such surveys are becoming impractical owing to the rapidly increasing volume of online data and the diverse analysis requirements of related stakeholders. As a solution for utilizing large-scale health-related information, we propose a novel approach to identify hospital service quality factors and overtime trends automatically from online health communities, especially hospital-related questions and answers. We defined social media-based key quality factors for hospitals. In addition, we developed text mining techniques to detect such factors that frequently occur in online health communities. After detecting these factors that represent qualitative aspects of hospitals, we applied a sentiment analysis to recognize the types of recommendations in messages posted within online health communities. Korea's two biggest online portals were used to test the effectiveness of detection of social media-based key quality factors for hospitals. To evaluate the proposed text mining techniques, we performed manual evaluations on the extraction and classification results, such as hospital name, service quality factors, and recommendation types using a random sample of messages (ie, 5.44% (9450/173,748) of the total messages). Service quality factor detection and hospital name extraction achieved average F1 scores of 91% and 78%, respectively. In terms of recommendation classification, performance (ie, precision) is 78% on average. Extraction and

  5. Sandia software guidelines: Software quality planning

    Energy Technology Data Exchange (ETDEWEB)

    1987-08-01

    This volume is one in a series of Sandia Software Guidelines intended for use in producing quality software within Sandia National Laboratories. In consonance with the IEEE Standard for Software Quality Assurance Plans, this volume identifies procedures to follow in producing a Software Quality Assurance Plan for an organization or a project, and provides an example project SQA plan. 2 figs., 4 tabs.

  6. Quality assurance plan for the Molten Salt Reactor Experiment Remediation Project at the Oak Ridge National Laboratory. Phase 1 -- Interim corrective measures and Phase 2 -- Purge and trap reactive gases

    International Nuclear Information System (INIS)

    1995-11-01

    This Quality Assurance Plan (QAP) identifies and describes the systems utilized by the Molten Salt Reactor Experiment Remediation Project (MSRERP) personnel to implement the requirements and associated applicable guidance contained in the Quality Program Description Y/QD-15 Rev. 2 (Energy Systems 1995f). This QAP defines the quality assurance (QA) requirements applicable to all activities and operations in and directly pertinent to the MSRERP Phase 1--Interim Corrective Measures and Phase 2--Purge and Trap objectives. This QAP will be reviewed, revised, and approved as necessary for Phase 3 and Phase 4 activities. This QAP identifies and describes the QA activities and procedures implemented by the various Oak Ridge National Laboratory support organizations and personnel to provide confidence that these activities meet the requirements of this project. Specific support organization (Division) quality requirements, including the degree of implementation of each, are contained in the appendixes of this plan

  7. The current status of radiopharmacy laboratories in Turkey, conveniences to good radiopharmacy practice (GRP) and quality management systems (ISO)

    International Nuclear Information System (INIS)

    Atak, I.E.

    2004-01-01

    This study ha been conducted in the Radiopharmacy Laboratories of Nuclear Medicine departments of various hospitals and private nuclear medicine laboratories. A total of 35 laboratories from 7 regions of Turkey have been selected by layered sampling method from 131 Radiopharmacy Laboratories located in 30 different cities. During the study, a GRP investigation list with 67 questions and direct communication technique have been used. The aim was determine the current status of the Radiopharmacy Laboratories in general and the administration of radiopharmaceuticals on patients, and good practices in radiopharmacy and conformance with quality assurance systems. In this respect, questions have been asked to determine a) General status, b) Information level of lab workers regarding to the GRP and ISO concepts (i-Status of lab managers, ii- Responsibilities and knowledge of lab workers and iii- regarding to GRP and ISO-9000), c) Conditions of infrastructure, and lab services and its quality, d) Status of organizations. Results showed that only two of the 35 managers of laboratories were radiopharmacists, the rest were Nuclear Medicine specialists. There were less knowledge on GRP than ISO, the labs holding ISO certificate were in minority even though ISO is known concept, radiopharmacist were more knowledgeable in GRP while nuclear medicine specialists were in ISO, the labs with better GRP knowledge have better infrastructure, the GRP knowledge were better in the university and armed forces hospitals while ISO knowledge and certificates were more in private labs and hospitals, the armed forces hospitals better paraphernalia, practically almost all radiopharmaceutical kits were imported goods and there were important problems in quality control

  8. Improvement of the quality control program of the clinical dosimeters calibration laboratory of the IPEN/CNEN-SP

    Energy Technology Data Exchange (ETDEWEB)

    Damatto, Willian B.; Potiens, Maria da Penha A.; Vivolo, Vitor, E-mail: wbdamatto@ipen.br, E-mail: mppotiens@ipen.br, E-mail: vivolo@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2013-07-01

    A set of clinical dosimeters (thimble ionization chamber coupled to an electrometer) commonly used in radiotherapy in Brazil and sent to the Calibration Laboratory of IPEN were under several tests and analysis parameters for the dosimeters behaviour were established, specifying their sensitivities and operating characteristics. Applied tests were: repeatability, reproducibility and current leakage. Thus it was possible to determine the most common defects found in these equipment and the actions that could be taken to prevent it (clinical dosimeters quality control programs). The behaviour of 167 dosimeters was analyzed and in this study, 62 of them have been tested. The main problem detected during calibration tests was current leakage, i.e. electronic noise. The tests were applied to the routine measurements at the Calibration Laboratory implementing an ideal calibration procedure. New calibration criteria were established following international recommendations. Therefore, it was made the improvement of the quality control programme of the clinical dosimeters calibration laboratory, benefiting the users of such equipment with better consistent calibration measurements. (author)

  9. Improvement of the quality control program of the clinical dosimeters calibration laboratory of the IPEN/CNEN-SP

    International Nuclear Information System (INIS)

    Damatto, Willian B.; Potiens, Maria da Penha A.; Vivolo, Vitor

    2013-01-01

    A set of clinical dosimeters (thimble ionization chamber coupled to an electrometer) commonly used in radiotherapy in Brazil and sent to the Calibration Laboratory of IPEN were under several tests and analysis parameters for the dosimeters behaviour were established, specifying their sensitivities and operating characteristics. Applied tests were: repeatability, reproducibility and current leakage. Thus it was possible to determine the most common defects found in these equipment and the actions that could be taken to prevent it (clinical dosimeters quality control programs). The behaviour of 167 dosimeters was analyzed and in this study, 62 of them have been tested. The main problem detected during calibration tests was current leakage, i.e. electronic noise. The tests were applied to the routine measurements at the Calibration Laboratory implementing an ideal calibration procedure. New calibration criteria were established following international recommendations. Therefore, it was made the improvement of the quality control programme of the clinical dosimeters calibration laboratory, benefiting the users of such equipment with better consistent calibration measurements. (author)

  10. Evaluation of controls for the assurance of quality data in a radiochemistry laboratory

    International Nuclear Information System (INIS)

    Morton, J.S.

    1993-01-01

    The paper describes the controls implemented by the U.S. Department of Energy (DOE) at the Radiological and Environmental Sciences Laboratory (RESL) to secure data quality. A description of the analytical instrumentation and methodology employed by RESL is provided. The results of the intercomparison program with the National Institute of Standards and Technology (NIST) are provided to demonstrate traceability to a primary source. A description of the methods and techniques used to ensure quality control on a daily basis is given. The techniques used to evaluate the sources of uncertainty are reviewed and specific examples cited. The intercomparison programs operated by RESL are discussed

  11. Evaluation of controls for the assurance of quality data in a radiochemistry laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Morton, J.S. [Radiological and Environmental Sciences Lab., Idaho Falls, ID (United States)

    1993-12-31

    The paper describes the controls implemented by the U.S. Department of Energy (DOE) at the Radiological and Environmental Sciences Laboratory (RESL) to secure data quality. A description of the analytical instrumentation and methodology employed by RESL is provided. The results of the intercomparison program with the National Institute of Standards and Technology (NIST) are provided to demonstrate traceability to a primary source. A description of the methods and techniques used to ensure quality control on a daily basis is given. The techniques used to evaluate the sources of uncertainty are reviewed and specific examples cited. The intercomparison programs operated by RESL are discussed.

  12. [Quality use of commercial laboratory for clinical testing services - considering laboratory's role].

    Science.gov (United States)

    Ogawa, Shinji

    2014-12-01

    The number of commercial laboratories for clinical testing in Japan run privately has decreased to about 30 companies, and their business is getting tougher. Branch Lab. and FMS businesses have not expanded recently due to the new reimbursement system which adds an additional sample management fee, becoming effective in 2010. This presentation gives an outline of each role for hospital and commercial laboratories, and their pros & cons considering the current medical situation. Commercial laboratories have investigated how to utilize ICT systems for sharing test information between hospitals and our facilities. It would be very helpful to clarify issues for each hospital. We will develop and create new values for clinical laboratory testing services and forge mutually beneficial relationships with medical institutions. (Review).

  13. Implementation of the OECD principles of good laboratory practice in test facilities complying with a quality system accredited to the ISO/IEC 17025 standard.

    Science.gov (United States)

    Feller, Etty

    2008-01-01

    Laboratories with a quality system accredited to the ISO/IEC 17025 standard have a definite advantage, compared to non-accredited laboratories, when preparing their facilities for the implementation of the principles of good laboratory practice (GLP) of the Organisation for Economic Co-operation and Development (OECD). Accredited laboratories have an established quality system covering the administrative and technical issues specified in the standard. The similarities and differences between the ISO/IEC 17025 standard and the OECD principles of GLP are compared and discussed.

  14. A utilidade dos indicadores da qualidade no gerenciamento de laboratórios clínicos Usefulness of quality indicators in the management of clinical laboratories

    Directory of Open Access Journals (Sweden)

    Keila Furtado Vieira

    2011-06-01

    Full Text Available O uso dos indicadores da qualidade vem sendo valorizado na gestão dos laboratórios clínicos para otimizar a qualificação e a quantificação das falhas nos diferentes processos laboratoriais, bem como para auxiliar a implantação de medidas corretivas e preventivas e apontar a eficácia das ações tomadas. O objetivo deste trabalho é discorrer sobre a evolução da qualidade na área da saúde, com ênfase na área laboratorial. Alguns indicadores laboratoriais citados na literatura nas fases pré-analítica, analítica e pós-analítica também são apresentados e discutidos neste artigo. Por fim, destaca-se a experiência brasileira do Programa de Indicadores Laboratoriais desenvolvido pela Sociedade Brasileira de Patologia Clínica/Medicina Laboratorial (SBPC/ML em parceria com a Control-Lab e o projeto Model of Quality Indicator, em fase de desenvolvimento pela International Federation of Clinical Chemistry and Laboratory Medicine (IFCC.The use of quality indicators has been appreciated in laboratory management so as to optimize quality and error quantification in several laboratory processes. Furthermore, it assists in the implementation of preventive and corrective measures and it shows their corresponding efficiency. The objective of the present study is to discuss the evolution of quality, mainly in the laboratory area, focusing on the importance of quality indicators in laboratory management. Some pre-analytical, analytical and post-analytical laboratory indicators are also presented and discussed in this work. Finally, we highlight the Brazilian initiative in the Laboratory Indicator Program developed by the Brazilian Society of Clinical Pathology and Laboratory Medicine (SBPC/ML in partnership with Control-Lab and the Model of Quality Indicator project, which has been developed by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC.

  15. Los Alamos National Laboratory Meteorology Monitoring Program: 2016 Data Completeness/ Quality Report

    Energy Technology Data Exchange (ETDEWEB)

    Bruggeman, David Alan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-06-15

    This report summarizes data completeness by tower and by instrument for 2016 and compares that data with the Los Alamos National Laboratory (LANL) and American National Standards Institute (ANSI) 2015 standards. This report is designed to make data users aware of data completeness and any data quality issues. LANL meteorology monitoring goals include 95% completeness for all measurements. The ANSI 2015 standard requires 90% completeness for all measurements. This report documents instrument/tower issues as they impact data completeness.

  16. External quality assessment programs in the context of ISO 15189 accreditation.

    Science.gov (United States)

    Sciacovelli, Laura; Secchiero, Sandra; Padoan, Andrea; Plebani, Mario

    2018-05-23

    Effective management of clinical laboratories participating in external quality assessment schemes (EQAS) is of fundamental importance in ensuring reliable analytical results. The International Standard ISO 15189:2012 requires participation in interlaboratory comparison [e.g. external quality assessment (EQA)] for all tests provided by an individual laboratory. If EQAS is not commercially available, alternative approaches should be identified, although clinical laboratories may find it challenging to choose the EQAS that comply with the international standards and approved guidelines. Great competence is therefore required, as well as knowledge of the characteristics and key elements affecting the reliability of an EQAS, and the analytical quality specifications stated in approved documents. Another skill of fundamental importance is the ability to identify an alternative approach when the available EQAS are inadequate or missing. Yet the choice of the right EQA program alone does not guarantee its effectiveness. In fact, the fundamental steps of analysis of the information provided in EQA reports and the ability to identify improvement actions to be undertaken call for the involvement of all laboratory staff playing a role in the specific activity. The aim of this paper was to describe the critical aspects that EQA providers and laboratory professionals should control in order to guarantee effective EQAS management and compliance with ISO 15189 accreditation requirements.

  17. [Future roles of clinical laboratories and clinical laboratory technologists in university hospitals].

    Science.gov (United States)

    Yokota, Hiromitsu; Yatomi, Yutaka

    2013-08-01

    Clinical laboratories in university hospitals should be operated with a good balance of medical practice, education, research, and management. The role of a clinical laboratory is to promptly provide highly reliable laboratory data to satisfy the needs of clinicians involved in medical practice and health maintenance of patients. Improvement and maintenance of the quality of the laboratory staff and environment are essential to achieve this goal. In order to implement these requirements efficiently, an appropriate quality management system should be introduced and established, and evaluated objectively by a third party (e.g. by obtaining ISO 15189 certification). ISO 15189 is an international standard regarding the quality and competence of clinical laboratories, and specifies a review of the efficient operational system and technical requirements such as competence in implementing practical tests and calibration. This means the results of laboratory tests reported by accredited laboratories withstand any international evaluation, which is very important to assure the future importance of the existence and management of clinical laboratories as well as internationalization of medical practice. "Education" and "research" have important implications in addition to "medical practice" and "management", as the roles that clinical laboratories should play in university hospitals. University hospital laboratories should be operated by keeping these four factors in good balance. Why are "education" and "research" required in addition to "medical practice" services? If individual clinical laboratory technologists can provide an appropriate response to this question, the importance of the existence of clinical laboratories would be reinforced, without being compromised.

  18. A national clinical quality program for Veterans Affairs catheterization laboratories (from the Veterans Affairs clinical assessment, reporting, and tracking program).

    Science.gov (United States)

    Maddox, Thomas M; Plomondon, Mary E; Petrich, Megan; Tsai, Thomas T; Gethoffer, Hans; Noonan, Gregory; Gillespie, Brian; Box, Tamara; Fihn, Stephen D; Jesse, Robert L; Rumsfeld, John S

    2014-12-01

    A "learning health care system", as outlined in a recent Institute of Medicine report, harnesses real-time clinical data to continuously measure and improve clinical care. However, most current efforts to understand and improve the quality of care rely on retrospective chart abstractions complied long after the provision of clinical care. To align more closely with the goals of a learning health care system, we present the novel design and initial results of the Veterans Affairs (VA) Clinical Assessment, Reporting, and Tracking (CART) program-a national clinical quality program for VA cardiac catheterization laboratories that harnesses real-time clinical data to support clinical care and quality-monitoring efforts. Integrated within the VA electronic health record, the CART program uses a specialized software platform to collect real-time patient and procedural data for all VA patients undergoing coronary procedures in VA catheterization laboratories. The program began in 2005 and currently contains data on 434,967 catheterization laboratory procedures, including 272,097 coronary angiograms and 86,481 percutaneous coronary interventions, performed by 801 clinicians on 246,967 patients. We present the initial data from the CART program and describe 3 quality-monitoring programs that use its unique characteristics-procedural and complications feedback to individual labs, coronary device surveillance, and major adverse event peer review. The VA CART program is a novel approach to electronic health record design that supports clinical care, quality, and safety in VA catheterization laboratories. Its approach holds promise in achieving the goals of a learning health care system. Published by Elsevier Inc.

  19. Health laboratories in the Tanga region of Tanzania: the quality of diagnostic services for malaria and other communicable diseases

    DEFF Research Database (Denmark)

    Ishengoma, D R S; Rwegoshora, R T; Mdira, K Y

    2009-01-01

    Although critical for good case management and the monitoring of health interventions, the health-laboratory services in sub-Saharan Africa are grossly compromised by poor infrastructures and a lack of trained personnel, essential reagents and other supplies. The availability and quality of diagn......Although critical for good case management and the monitoring of health interventions, the health-laboratory services in sub-Saharan Africa are grossly compromised by poor infrastructures and a lack of trained personnel, essential reagents and other supplies. The availability and quality...... of diagnostic services in 37 health laboratories in three districts of the Tanga region of Tanzania have recently been assessed. The results of the survey, which involved interviews with health workers, observations and a documentary review, revealed that malaria accounted for >50% of admissions and out...

  20. Does laboratory automation for the preanalytical phase improve data quality?

    Science.gov (United States)

    Lima-Oliveira, Gabriel; Lippi, Giuseppe; Salvagno, Gian Luca; Danese, Elisa; Montagnana, Martina; Brocco, Giorgio; Voi, Monica; Picheth, Geraldo; Guidi, Gian Cesare

    2013-10-01

    Our aim was to evaluate whether automation for the preanalytical phase improves data quality. Blood from 100 volunteers was collected into two vacuum tubes. One sample from each volunteer was respectively assigned to (G1) traditional processing, starting with centrifugation at 1200 g for 10 min, and (G2) the MODULAR PRE-ANALYTICALS EVO-MPA system. The routine clinical chemistry tests were performed in duplicate on the same instrument Cobas 6000 module. G1 samples were uncapped manually and immediately placed into the instrument. G2 samples were directly fed from the MPA system to the instrument without further staff intervention. At the end, (1) the G1 samples were stored for 6 h at 4 °C as prescribed in our accredited laboratory and (2) the G2 samples were stored for 6 h in the MPA output buffer. Results from G1 and G2, before and after storage, were compared. Significant increases were observed in G1 compared with G2 samples as follows: (1) before storage for alkaline phosphatase (ALP), lactate dehydrogenase (LDH), phosphate (P), magnesium (MG), iron (FE), and hemolysis index and (2) after storage for total cholesterol (COL), triglycerides (TG), total protein (TP), albumin (ALB), blood urea nitrogen (BUN), creatinine (CRE), uric acid (UA), ALP, pancreatic amylase, aspartate aminotransferase (AST), alanine aminotransferase (ALT), g-glutamyltransferase (GGT), LDH, creatine kinase (CK), calcium (CA), FE, sodium (NA), potassium (K), and hemolysis index. Moreover, significant increases were observed in (3) G1-after versus G1-before storage samples for COL, high-density lipoprotein cholesterol, TG, TP, ALB, BUN, CRE, UA, AST, ALT, GGT, LDH, P, CA, MG, FE, NA, K, and hemolysis index and (4) G2-after versus G2-before storage only for BUN, AST, LDH, P, and CA. In conclusion, our results show that the MPA system improves the quality of laboratory testing.

  1. Diagnosis and improvement proposals for the Ezeiza Atomic Center quality management system by carrying out the third laboratories workshop

    International Nuclear Information System (INIS)

    Eliosoff, Nilda M.

    2003-01-01

    By the end of 2001 the management of the Ezeiza Atomic Center (EAC) under the National Atomic Energy Commission of Argentina, stated the necessity of carrying out a survey of its laboratories. The purpose of this survey was to get information that would allow to assess the quality of the laboratories and the services they perform, including the degree of implementation of the management systems. In order to comply with this purpose fourteen EAC's laboratories were studied. The information obtained was related to the staff, their training, the kind of tasks they perform as services or as research and development, the customers, the amount of invoicing, the premises, the equipment and the adapting and implementation of the quality management system. With the results obtained from the survey a report was issued. Economic, Financial, Commercial and Human Resources workshops as well as Technical Aspects and Quality Management workshops were organized. These workshops were to go deep into the analysis of the information obtained and to generate improvement proposals of the different subjects. (author)

  2. Creating a sustainable culture of quality through the SLMTA programme in a district hospital laboratory in Kenya

    Directory of Open Access Journals (Sweden)

    Phidelis M. Maruti

    2014-09-01

    Objectives: To describe how the SLMTA programme and enhanced quality interventions changed the culture and management style at BDHL and instilled a quality system designed to sustain progress for years to come. Methods: SLMTA implementation followed the standard three-workshop series, mentorship site visits and audits. In order to build sustainability of progress, BDHL integrated quality improvement processes into its daily operations. The lab undertook a process of changing its internal culture to align all hospital stakeholders – including upper management, clinicians, laboratory staff and maintenance staff – to the mission of sustainable quality practices at BDHL. Results: After 16 months in the SLMTA programme, BDHL improved from zero stars (38% to four stars (89%. Over a period of two to three years, external quality assessment results improved from 47% to 87%; staff punctuality increased from 49% to 82%; clinician complaints decreased from 83% to 16; rejection rates decreased from 12% to 3%; and annual equipment repairs decreased from 40 to 15. Twelve months later the laboratory scored three stars (81% in an external surveillance audit conducted by Kenya Accreditation Service (KENAS. Conclusion: Management buy-in, staff participation, use of progress-monitoring tools and feedback systems, as well as incorporation of improvement processes into routine daily activities, were vital in developing and sustaining a culture of quality improvement.

  3. Evaluation of quality assurance/quality control data collected by the U.S. Geological Survey for water-quality activities at the Idaho National Engineering and Environmental Laboratory, Idaho, 1994 through 1995

    International Nuclear Information System (INIS)

    Williams, L.M.

    1997-03-01

    More than 4,000 water samples were collected by the US Geological Survey (USGS) from 179 monitoring sites for the water-quality monitoring program at the Idaho National Engineering Laboratory from 1994 through 1995. Approximately 500 of the water samples were replicate or blank samples collected for the quality assurance/quality control program. Analyses were performed to determine the concentrations of major ions, nutrients, trace elements, gross radioactivity and radionuclides, total organic carbon, and volatile organic compounds in the samples. To evaluate the precision of field and laboratory methods, analytical results of the replicate pairs of samples were compared statistically for equivalence on the basis of the precision associated with each result. In all, the statistical comparison of the data indicated that 95% of the replicate pairs were equivalent. Within the major ion analyses, 97% were equivalent; nutrients, 88%; trace elements, 95%; gross radioactivity and radionuclides, 93%; and organic constituents, 98%. Ninety percent or more of the analytical results for each constituent were equivalent, except for nitrite, orthophosphate, phosphorus, aluminum, iron, strontium-90, and total organic carbon

  4. Quality assurance for radon exposure chambers at the National Air and Radiation Environmental Laboratory, Montgomery, Alabama

    Energy Technology Data Exchange (ETDEWEB)

    Semler, M.O.; Sensintaffar, E.L. [National Air and Radiation Environmental Laboratory, Montgomery, AL (United States)

    1993-12-31

    The Office of Radiation and Indoor Air, U.S. Environmental Protection Agency (EPA), operates six radon exposure chambers in its two laboratories, the National Air and Radiation Environmental Laboratory (NAREL) in Montgomery, Alabama, and the Las Vegas Facility, Las Vegas, Nevada. These radon exposure chambers are used to calibrate and test portable radon measuring instruments, test commercial suppliers of radon measurement services through the Radon Measurement Proficiency Program, and expose passive measurement devices to known radon concentrations as part of a quality assurance plan for federal and state studies measuring indoor radon concentrations. Both laboratories participate in national and international intercomparisons for the measurement of radon and are presently working with the National Institute of Standards and Technology (NIST) to receive a certificate of traceability for radon measurements. NAREL has developed an estimate of the total error in its calibration of each chamber`s continuous monitors as part of an internal quality assurance program. This paper discusses the continuous monitors and their calibration for the three chambers located in Montgomery, Alabama, as well as the results of the authors intercomparisons and total error analysis.

  5. Validation of the Six Sigma Z-score for the quality assessment of clinical laboratory timeliness.

    Science.gov (United States)

    Ialongo, Cristiano; Bernardini, Sergio

    2018-03-28

    The International Federation of Clinical Chemistry and Laboratory Medicine has introduced in recent times the turnaround time (TAT) as mandatory quality indicator for the postanalytical phase. Classic TAT indicators, namely, average, median, 90th percentile and proportion of acceptable test (PAT), are in use since almost 40 years and to date represent the mainstay for gauging the laboratory timeliness. In this study, we investigated the performance of the Six Sigma Z-score, which was previously introduced as a device for the quantitative assessment of timeliness. A numerical simulation was obtained modeling the actual TAT data set using the log-logistic probability density function. Five thousand replicates for each size of the artificial TAT random sample (n=20, 50, 250 and 1000) were generated, and different laboratory conditions were simulated manipulating the PDF in order to generate more or less variable data. The Z-score and the classic TAT indicators were assessed for precision (%CV), robustness toward right-tailing (precision at different sample variability), sensitivity and specificity. Z-score showed sensitivity and specificity comparable to PAT (≈80% with n≥250), but superior precision that ranged within 20% by moderately small sized samples (n≥50); furthermore, Z-score was less affected by the value of the cutoff used for setting the acceptable TAT, as well as by the sample variability that reflected into the magnitude of right-tailing. The Z-score was a valid indicator of laboratory timeliness and a suitable device to improve as well as to maintain the achieved quality level.

  6. Evaluating dissection in the gross anatomy course: Correlation between quality of laboratory dissection and students outcomes.

    Science.gov (United States)

    Nwachukwu, Chika; Lachman, Nirusha; Pawlina, Wojciech

    2015-01-01

    Anatomy learned by active exploration through dissection has many proven benefits including improvement of anatomic knowledge. Decreased laboratory time may affect the quality of dissection and ultimately lower student performance in anatomy translating to lower knowledge acquisition. The aim of this study was to determine whether the quality of students' dissection in teams correlates with their performance in the gross anatomy course. Quality of dissections for each team enrolled in a gross anatomy course at Mayo Medical School was evaluated biweekly using a five-point rubric based on course learning objectives. Assessment of anatomic knowledge was based on sequential laboratory practice practical examination scores, achievements on daily audience response system (ARS) quizzes, and final practical, written, and National Board of Medical Examiners(®) (NBME(®) ) Gross Anatomy and Embryology Subject Examinations. Twelve teams comprising 48 students were included in the study. There was a positive correlation between dissection quality and practice practical examination score (R = 0.83) and a negative correlation between dissection quality and ARS quizzes (R = -0.985). Dissection teams with a passing score on their dissection evaluations (>70%) performed better on their final examinations. Based on an end of course survey, students agreed that dissection evaluations should continue to be a part of the course. This study showed that better quality of dissection was associated with higher scores on practice practical examinations, final practical, written, and NBME examinations. The study demonstrated a positive correlation between dissection evaluations, accompanied by formative feedback during the course, and higher scores on final course assessments. © 2014 American Association of Anatomists.

  7. Proposal of a methodology for quality control in thermoluminescent dosimetry laboratory

    International Nuclear Information System (INIS)

    Feital, Joao Carlos da S.; Almeida, Claudio Domingues de; Bezerra, Marcos A.

    2005-01-01

    Taken into account that in thermoluminescence dosimetry adequate selection procedures as well as accurate TLD readings are necessary, this paper presents results of methodology that can be applied as part of quality control programs in thermoluminescence dosimetry laboratories. For the experiment, a set of 200 TLDs ( LiF 100 ) were used and 9 from which were selected, a standard source of Cs -137 , a PTW kiln, a TL 'Harshaw' reader - model 5500 operating under the 'Win Rem' software and a Sr 90 / Y 90 'Bicron' irradiator. In the proceeding the selected dosimeters were irradiated and read 28 times during 18 months, then by one of the standard deviation properties, values up to 14 % were found, for a confidence level of 95 %. The results found and the bibliographic data related to the responses (arbitrary reading) in the crystals used in TLDs, have shown that this methodology can be applied in quality control programs. (author)

  8. The Cost-Effective Laboratory: Implementation of Economic Evaluation of Laboratory Testing

    Directory of Open Access Journals (Sweden)

    Bogavac-Stanojevic Natasa

    2017-09-01

    Full Text Available Laboratory testing as a part of laboratory in vitro diagnostic (IVD has become required tool in clinical practice for diagnosing, monitoring and prognosis of diseases, as well as for prediction of treatment response. The number of IVD tests available in laboratory practice has increased over the past decades and is likely to further increase in the future. Consequently, there is growing concern about the overutilization of laboratory tests and rising costs for laboratory testing. It is estimated that IVD accounts for between 1.4 and 2.3% of total healthcare expenditure and less than 5% of total hospital cost (Lewin Group report. These costs are rather low when compared to pharmaceuticals and medical aids which account for 15 and 5%, respectively. On the other hand, IVD tests play an important role in clinical practice, as they influence from 60% to 70% of clinical decision-making. Unfortunately, constant increases in healthcare spending are not directly related to healthcare benefit. Since healthcare resources are limited, health payers are interested whether the benefits of IVD tests are actually worth their cost. Many articles have introduced frameworks to assess the economic value of IVD tests. The most appropriate tool for quantitative assessment of their economic value is cost-effectiveness (CEA and cost-utility (CUA analysis. The both analysis determine cost in terms of effectiveness or utilities (combine quantity and quality of life of new laboratory test against its alternative. On the other hand, some investigators recommended calculation of laboratory test value as product of two ratios: Laboratory test value = (Technical accuracy/Turnaround time × (Utility/Costs. Recently, some researches used multicriteria decision analysis which allows comparison of diagnostic strategies in terms of benefits, opportunities, costs and risks. All analyses are constructed to identify laboratory test that produce the greatest healthcare benefit with

  9. The use of citation indicators to identify and support high-quality research in Poland.

    Science.gov (United States)

    Pilc, Andrzej

    2008-01-01

    In large, mostly English-speaking countries, where the "critical mass" of scientists working in different subfields of science is achieved, the peer review system may be sufficient to assess the quality of scientific research. However, in smaller countries, outside the Anglo-American circle, it is important to introduce different systems to identify research of high quality. In Poland, a parametric system for assessing the quality of research has been introduced. It was largely based on the impact factor of scientific journals. While the use of this indicator to assess research quality is highly questionable, the implementation of the system in the Polish reality is even worse. Therefore it is important to change and improve the system currently used by the Ministry of Science and Higher Education to both evaluate and, more importantly, finance science in Poland. Here, a system based on three factors, i.e. the impact factor, the institutional h-index, and the institutional number of citations, is proposed. The scientific quality of institutions in Division VI: Medical Sciences of the Polish Academy of Sciences were evaluated and the results were compared with the existing system. Moreover, a method to identify high-quality researchers and institutions at the national level based on the quantity of highly cited papers is shown. Additionally, an attempt to identify the highest quality Polish research on an international level is proposed. This is based on the number of individual citations, the individual h-index, the number of publications, and the priority of the discovery.

  10. Field methods and quality-assurance plan for water-quality activities and water-level measurements, U.S. Geological Survey, Idaho National Laboratory, Idaho

    Science.gov (United States)

    Bartholomay, Roy C.; Maimer, Neil V.; Wehnke, Amy J.

    2014-01-01

    Water-quality activities and water-level measurements by the personnel of the U.S. Geological Survey (USGS) Idaho National Laboratory (INL) Project Office coincide with the USGS mission of appraising the quantity and quality of the Nation’s water resources. The activities are carried out in cooperation with the U.S. Department of Energy (DOE) Idaho Operations Office. Results of the water-quality and hydraulic head investigations are presented in various USGS publications or in refereed scientific journals and the data are stored in the National Water Information System (NWIS) database. The results of the studies are used by researchers, regulatory and managerial agencies, and interested civic groups. In the broadest sense, quality assurance refers to doing the job right the first time. It includes the functions of planning for products, review and acceptance of the products, and an audit designed to evaluate the system that produces the products. Quality control and quality assurance differ in that quality control ensures that things are done correctly given the “state-of-the-art” technology, and quality assurance ensures that quality control is maintained within specified limits.

  11. Recent trends in laboratory automation in the pharmaceutical industry.

    Science.gov (United States)

    Rutherford, M L; Stinger, T

    2001-05-01

    The impact of robotics and automation on the pharmaceutical industry over the last two decades has been significant. In the last ten years, the emphasis of laboratory automation has shifted from the support of manufactured products and quality control of laboratory applications, to research and development. This shift has been the direct result of an increased emphasis on the identification, development and eventual marketing of innovative new products. In this article, we will briefly identify and discuss some of the current trends in laboratory automation in the pharmaceutical industry as they apply to research and development, including screening, sample management, combinatorial chemistry, ADME/Tox and pharmacokinetics.

  12. Assessing Clinical Laboratory Quality: A College of American Pathologists Q-Probes Study of Prothrombin Time INR Structures, Processes, and Outcomes in 98 Laboratories.

    Science.gov (United States)

    Howanitz, Peter J; Darcy, Theresa P; Meier, Frederick A; Bashleben, Christine P

    2015-09-01

    The anticoagulant warfarin has been identified as the second most frequent drug responsible for serious, disabling, and fatal adverse drug events in the United States, and its effect on blood coagulation is monitored by the laboratory test called international normalized ratio (INR). To determine the presence of INR policies and procedures, INR practices, and completeness and timeliness of reporting critical INR results in participants' clinical laboratories. Participants reviewed their INR policies and procedure requirements, identified their practices by using a questionnaire, and studied completeness of documentation and timeliness of reporting critical value INR results for outpatients and emergency department patients. In 98 participating institutions, the 5 required policies and procedures were in place in 93% to 99% of clinical laboratories. Fifteen options for the allowable variations among duplicate results from different analyzers, 12 different timeliness goals for reporting critical values, and 18 unique critical value limits were used by participants. All required documentation elements were present in 94.8% of 192 reviewed INR validation reports. Critical value INR results were reported within the time frame established by the laboratory for 93.4% of 2604 results, but 1.0% of results were not reported. Although the median laboratories successfully communicated all critical results within their established time frames and had all the required validation elements based in their 2 most recent INR calculations, those participants at the lowest 10th percentile were successful in 80.0% and 85.7% of these requirements, respectively. Significant opportunities exist for adherence to INR procedural requirements and for practice patterns and timeliness goals for INR critical results' reporting.

  13. Parents of children referred to a sleep laboratory for disordered breathing reported anxiety, daytime sleepiness and poor sleep quality.

    Science.gov (United States)

    Cadart, Marion; De Sanctis, Livio; Khirani, Sonia; Amaddeo, Alessandro; Ouss, Lisa; Fauroux, Brigitte

    2018-07-01

    We evaluated the impact that having a child with sleep-disordered breathing had on their parents, including their own sleep quality. Questionnaires were completed by 96 parents of 86 children referred for a sleep study or control of continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) at the sleep laboratory of the Necker Hospital, Paris, France, between October 2015 and January 2016. The questionnaires evaluated anxiety and depression, family functioning, the parents' quality of life, daytime sleepiness and sleep quality. The children had a mean age of seven ±five years and most of the responses (79%) came from their mothers. These showed that 26% of parents showed moderate-to-severe anxiety, 8% moderate-to-severe depression, 6% complex family cohesion, 59% moderate-to-severe daytime sleepiness and 54% poor sleep quality. Anxiety was higher in mothers than in fathers (p parents of children referred to a sleep laboratory reported frequent anxiety, daytime sleepiness and poor sleep quality. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  14. National continuous surveys on internal quality control for HbA1c in 306 clinical laboratories of China from 2012 to 2016: Continual improvement.

    Science.gov (United States)

    Li, Tingting; Wang, Wei; Zhao, Haijian; He, Falin; Zhong, Kun; Yuan, Shuai; Wang, Zhiguo

    2017-09-01

    This study aimed to evaluate whether the quality performance of clinical laboratories in China has been greatly improved and whether Internal Quality Control (IQC) practice of HbA1c has also been changed since National Center for Clinical Laboratories (NCCL) of China organized laboratories to report IQC data for HbA1c in 2012. Internal Quality Control information of 306 External Quality Assessment (EQA) participant laboratories which kept reporting IQC data in February from 2012 to 2016 were collected by Web-based EQA system. Then percentages of laboratories meeting four different imprecision specifications for current coefficient of variations (CVs) of HbA1c measurements were calculated. Finally, we comprehensively analyzed analytical systems and IQC practice of HbA1c measurements. The current CVs of HbA1c tests have decreased significantly from 2012 to 2016. And percentages of laboratories meeting four imprecision specifications for CVs all showed the increasing tendency year by year. As for analytical system, 52.1% (159/306) laboratories changed their systems with the change in principle of assay. And many laboratories began to use cation exchange high-performance liquid chromatography (CE-HPLC) instead of Immunoturbidimetry, because CE-HPLC owed a lower intra-laboratory CVs. The data of IQC practice, such as IQC rules and frequency, also showed significant variability among years with overall tendency of meeting requirements. The imprecision performance of HbA1c tests has been improved in these 5 years with the change in IQC practice, but it is still disappointing in China. Therefore, laboratories should actively find existing problems and take action to promote performance of HbA1c measurements. © 2016 Wiley Periodicals, Inc.

  15. Materials capability review Los Alamos National Laboratory, May 3-6, 2010

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Antoinette [Los Alamos National Laboratory

    2010-01-01

    The 2010 'Capability Review' process at LANL significantly differs from the Division reviews of prior years. The Capabilities being reviewed (some 4-8 per year) are deliberately chosen to be crosscutting over the Laboratory, and therefore will include not only several experimental, theoretical and simulation disciplines, but also contributions from multiple line organizations. This approach is consistent with the new Laboratory organizational structure, focusing on agile and integrated capabilities applied to present national security missions, and also nurtured to be available for rapid application to future missions. The overall intent is that the Committee assess the quality of the science, engineering, and technology identified in the agenda, and advise the LANS Board of Governors and Laboratory management. Specifically, the Committees will: (1) Assess the quality of science, technology and engineering within the Capability in the areas defined in the agenda. Identify issues to develop or enhance the core competencies within this capability. (2) Evaluate the integration of this capability across the Laboratory organizations that are listed in the agenda in terms of joint programs, projects, proposals, and/or publications. Describe the integration of this capability in the wider scientific community using the recognition as a leader within the community, ability to set research agendas, and attraction and retention of staff. (3) Assess the quality and relevance of this capability's science, technology and engineering contributions to current and emerging Laboratory programs, including Nuclear Weapons, Threat Reduction/Homeland Security, and Energy Security. (4) Advise the Laboratory Director/Principal Associate Director for Science, Technology and Engineering on the health of the Capability including the current and future (5 year) science, technology and engineering staff needs, mix of research and development activities, program opportunities

  16. Calibrations and evaluation of the quality assurance during 1999 at the National Laboratory for ionising radiation

    International Nuclear Information System (INIS)

    Grindborg, Jan-Erik; Israelsson, Karl-Erik; Kylloenen, Jan-Erik; Samuelson, Goeran

    2000-06-01

    The Swedish Radiation Protection Institute is the National Laboratory for the dosimetric quantities kerma, absorbed dose and dose equivalent. The activity is based on established calibration procedures and a quality assurance program for the used standards. This report gives a brief summary of the calibrations performed during 1999 and a more detailed description and analysis of the quality assurance during this year. The report makes it easier to draw conclusions about the long-term stability and possible malfunctions

  17. [ISO 15189 accreditation in clinical microbiology laboratory: general concepts and the status in our laboratory].

    Science.gov (United States)

    Akyar, Işin

    2009-10-01

    One important trend in the laboratory profession and quality management is the global convergence of laboratory operations. The goal of an accredited medical laboratory is to continue "offering useful laboratory service for diagnosis and treatment of the patients and also aid to the health of the nation". An accredited clinical laboratory is managed by a quality control system, it is competent technically and the laboratory service meets the needs of all its patients and physicians by taking the responsibility of all the medical tests and therapies. For this purpose, ISO 15189 international standard has been prepared by 2003. ISO 15189 standard is originated from the arrangement of ISO 17025 and ISO 9001:2000 standards. Many countries such as England, Germany, France, Canada and Australia have preferred ISO 15189 as their own laboratory accreditation programme, meeting all the requirements of their medical laboratories. The accreditation performance of a clinical microbiology laboratory is mainly based on five essential points; preanalytical, analytical, postanalytical, quality control programmes (internal, external, interlaboratory) and audits (internal, external). In this review article, general concepts on ISO 15189 accreditation standards for the clinical microbiology laboratories have been summarized and the status of a private laboratory (Acibadem LabMed, Istanbul) in Turkey has been discussed.

  18. Sigma metrics as a tool for evaluating the performance of internal quality control in a clinical chemistry laboratory.

    Science.gov (United States)

    Kumar, B Vinodh; Mohan, Thuthi

    2018-01-01

    Six Sigma is one of the most popular quality management system tools employed for process improvement. The Six Sigma methods are usually applied when the outcome of the process can be measured. This study was done to assess the performance of individual biochemical parameters on a Sigma Scale by calculating the sigma metrics for individual parameters and to follow the Westgard guidelines for appropriate Westgard rules and levels of internal quality control (IQC) that needs to be processed to improve target analyte performance based on the sigma metrics. This is a retrospective study, and data required for the study were extracted between July 2015 and June 2016 from a Secondary Care Government Hospital, Chennai. The data obtained for the study are IQC - coefficient of variation percentage and External Quality Assurance Scheme (EQAS) - Bias% for 16 biochemical parameters. For the level 1 IQC, four analytes (alkaline phosphatase, magnesium, triglyceride, and high-density lipoprotein-cholesterol) showed an ideal performance of ≥6 sigma level, five analytes (urea, total bilirubin, albumin, cholesterol, and potassium) showed an average performance of sigma level and for level 2 IQCs, same four analytes of level 1 showed a performance of ≥6 sigma level, and four analytes (urea, albumin, cholesterol, and potassium) showed an average performance of sigma level. For all analytes sigma level, the quality goal index (QGI) was 1.2 indicated inaccuracy. This study shows that sigma metrics is a good quality tool to assess the analytical performance of a clinical chemistry laboratory. Thus, sigma metric analysis provides a benchmark for the laboratory to design a protocol for IQC, address poor assay performance, and assess the efficiency of existing laboratory processes.

  19. Identify High-Quality Protein Structural Models by Enhanced K-Means.

    Science.gov (United States)

    Wu, Hongjie; Li, Haiou; Jiang, Min; Chen, Cheng; Lv, Qiang; Wu, Chuang

    2017-01-01

    Background. One critical issue in protein three-dimensional structure prediction using either ab initio or comparative modeling involves identification of high-quality protein structural models from generated decoys. Currently, clustering algorithms are widely used to identify near-native models; however, their performance is dependent upon different conformational decoys, and, for some algorithms, the accuracy declines when the decoy population increases. Results. Here, we proposed two enhanced K -means clustering algorithms capable of robustly identifying high-quality protein structural models. The first one employs the clustering algorithm SPICKER to determine the initial centroids for basic K -means clustering ( SK -means), whereas the other employs squared distance to optimize the initial centroids ( K -means++). Our results showed that SK -means and K -means++ were more robust as compared with SPICKER alone, detecting 33 (59%) and 42 (75%) of 56 targets, respectively, with template modeling scores better than or equal to those of SPICKER. Conclusions. We observed that the classic K -means algorithm showed a similar performance to that of SPICKER, which is a widely used algorithm for protein-structure identification. Both SK -means and K -means++ demonstrated substantial improvements relative to results from SPICKER and classical K -means.

  20. Quantification of histochemical stains using whole slide imaging: development of a method and demonstration of its usefulness in laboratory quality control.

    Science.gov (United States)

    Gray, Allan; Wright, Alex; Jackson, Pete; Hale, Mike; Treanor, Darren

    2015-03-01

    Histochemical staining of tissue is a fundamental technique in tissue diagnosis and research, but it suffers from significant variability. Efforts to address this include laboratory quality controls and quality assurance schemes, but these rely on subjective interpretation of stain quality, are laborious and have low reproducibility. We aimed (1) to develop a method for histochemical stain quantification using whole slide imaging and image analysis and (2) to demonstrate its usefulness in measuring staining variation. A method to quantify the individual stain components of histochemical stains on virtual slides was developed. It was evaluated for repeatability and reproducibility, then applied to control sections of an appendix to quantify H&E staining (H/E intensities and H:E ratio) between automated staining machines and to measure differences between six regional diagnostic laboratories. The method was validated with laboratories from 0.57 to 0.89. A simple method using whole slide imaging can be used to quantify and compare histochemical staining. This method could be deployed in routine quality assurance and quality control. Work is needed on whole slide imaging devices to improve reproducibility. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Supporting Concept Extraction and Identifier Quality Improvement through Programmers' Lexicon Analysis

    OpenAIRE

    Abebe, Surafel Lemma

    2013-01-01

    Identifiers play an important role in communicating the intentions associated with the program entities they represent. The information captured in identifiers support programmers to (re-)build the “mental model” of the software and facilitates understanding. (Re-)building the “mental model” and understanding large software, however, is difficult and expensive. Besides, the effort involved in the process heavily depends on the quality of the programmers’ lexicon used to construct th...

  2. Quality system of the Chemical Analysis Laboratory to fulfill the requirements with Certification Organizations

    International Nuclear Information System (INIS)

    Merlo S, L.; Rodriguez L, R.; Cota S, G.

    1996-01-01

    In the present work was described the Quality System established in the Chemical Analysis Department to fulfill with the Organization requirements, personnel, measurement equipment, calibration, working procedures, etc. to get official acknowledgment by the National Assurance System for Testing laboratories, dependent of the General Standards Direction. There are described the available resources, the performance and control of each of one principal points of the system. (Author)

  3. Promoting Good Clinical Laboratory Practices and Laboratory Accreditation to Support Clinical Trials in Sub-Saharan Africa

    Science.gov (United States)

    Shott, Joseph P.; Saye, Renion; Diakité, Moussa L.; Sanogo, Sintry; Dembele, Moussa B.; Keita, Sekouba; Nagel, Mary C.; Ellis, Ruth D.; Aebig, Joan A.; Diallo, Dapa A.; Doumbo, Ogobara K.

    2012-01-01

    Laboratory capacity in the developing world frequently lacks quality management systems (QMS) such as good clinical laboratory practices, proper safety precautions, and adequate facilities; impacting the ability to conduct biomedical research where it is needed most. As the regulatory climate changes globally, higher quality laboratory support is needed to protect study volunteers and to accurately assess biological parameters. The University of Bamako and its partners have undertaken a comprehensive QMS plan to improve quality and productivity using the Clinical and Laboratory Standards Institute standards and guidelines. The clinical laboratory passed the College of American Pathologists inspection in April 2010, and received full accreditation in June 2010. Our efforts to implement high-quality standards have been valuable for evaluating safety and immunogenicity of malaria vaccine candidates in Mali. Other disease-specific research groups in resource-limited settings may benefit by incorporating similar training initiatives, QMS methods, and continual improvement practices to ensure best practices. PMID:22492138

  4. Improvement of laboratory turnaround time using lean methodology.

    Science.gov (United States)

    Gupta, Shradha; Kapil, Sahil; Sharma, Monica

    2018-05-14

    Purpose The purpose of this paper is to discuss the implementation of lean methodology to reduce the turnaround time (TAT) of a clinical laboratory in a super speciality hospital. Delays in report delivery lead to delayed diagnosis increased waiting time and decreased customer satisfaction. The reduction in TAT will lead to increased patient satisfaction, quality of care, employee satisfaction and ultimately the hospital's revenue. Design/methodology/approach The generic causes resulting in increasing TAT of clinical laboratories were identified using lean tools and techniques such as value stream mapping (VSM), Gemba, Pareto Analysis and Root Cause Analysis. VSM was used as a tool to analyze the current state of the process and further VSM was used to design the future state with suggestions for process improvements. Findings This study identified 12 major non-value added factors for the hematology laboratory and 5 major non-value added factors for the biochemistry lab which were acting as bottlenecks resulting in limiting throughput. A four-month research study by the authors together with hospital quality department and laboratory staff members led to reduction of the average TAT from 180 to 95minutes in the hematology lab and from 268 to 208 minutes in the biochemistry lab. Practical implications Very few improvement initiatives in Indian healthcare are based on industrial engineering tools and techniques, which might be due to a lack of interaction between healthcare and engineering. The study provides a positive outcome in terms of improving the efficiency of services in hospitals and identifies a scope for lean in the Indian healthcare sector. Social implications Applying lean in the Indian healthcare sector gives its own potential solution to the problem caused, due to a wide gap between lean accessibility and lean implementation. Lean helped in changing the mindset of an organization toward providing the highest quality of services with faster delivery at

  5. Study on the internal quality control of thyroid hormones assays in a hospital laboratory

    International Nuclear Information System (INIS)

    Hu Haiqiang; Chu Shaolin; Ye Peihong; Lei Qiufang; Chai Luhua; Xia Wei

    2004-01-01

    Objective: With the aim of providing more reliable information for clinical diagnosis, this study investigated the possible causes of the occasional instability of thyroid hormones (T 3 , T 4 , FT 3 , FT 4 TSH) assays in this laboratory and tried to seek plausible explanation for some seemingly contradictory (mismatching) readings of the laboratory reports. Methods: Regular monitoring and checks were enforced on laboratory equipment from sampling pipet to gamma-counters. Results of separation with PR reagent and solid - phase coated tube were compared for superiority (FT 3 ). Collected specimens were tested in monthly sets; this study consisted of 10 sets with total 964 specimens. Serum T 3 , T 4 , FT 3 , FT 4 levels were measured with RIA. For every hormone tested, values of parameters of the standard cure (B 0 , NSB, a, b, r, ED 20 , ED 50 , ED 80 , ABCV) were recorded in detail, from which the QC (quality control) table was derived. For complementary sake , mean level in patients' sera was noted along with the quality control sera. Shewart control chart was drawn for quick reference. Serum TSH levels were measured with IRMA; the parameters involved were: B 0 NSB, ED 80 , ED 50 , ED 20 , standard point deviation. Results: Among the 964 specimens tested, there were 154 specimens with seemingly contradictory (mismatching) results, of which, the majority (n=145) were not erroneous and were compatible with the clinical manifestations of thyroid dysfunction other than plain simple hyper-or hypothyroidism. Only 9 (5.8% of the 154) were due to technical errors (defective technic in removing the supernatant n=7, lipid blood separated with PR reagent n=2). Conclusion: Faulty technic in separation is the main source of random error. From the data of this laboratory, authors believe that solid-phase separation method is better than the conventional homogenous-phase separation method and is the preferred one. With meticulous adherence to standard laboratory procedures and

  6. SALE: Safeguards Analytical Laboratory Evaluation computer code

    International Nuclear Information System (INIS)

    Carroll, D.J.; Bush, W.J.; Dolan, C.A.

    1976-09-01

    The Safeguards Analytical Laboratory Evaluation (SALE) program implements an industry-wide quality control and evaluation system aimed at identifying and reducing analytical chemical measurement errors. Samples of well-characterized materials are distributed to laboratory participants at periodic intervals for determination of uranium or plutonium concentration and isotopic distributions. The results of these determinations are statistically-evaluated, and each participant is informed of the accuracy and precision of his results in a timely manner. The SALE computer code which produces the report is designed to facilitate rapid transmission of this information in order that meaningful quality control will be provided. Various statistical techniques comprise the output of the SALE computer code. Assuming an unbalanced nested design, an analysis of variance is performed in subroutine NEST resulting in a test of significance for time and analyst effects. A trend test is performed in subroutine TREND. Microfilm plots are obtained from subroutine CUMPLT. Within-laboratory standard deviations are calculated in the main program or subroutine VAREST, and between-laboratory standard deviations are calculated in SBLV. Other statistical tests are also performed. Up to 1,500 pieces of data for each nuclear material sampled by 75 (or fewer) laboratories may be analyzed with this code. The input deck necessary to run the program is shown, and input parameters are discussed in detail. Printed output and microfilm plot output are described. Output from a typical SALE run is included as a sample problem

  7. Harmonization of clinical laboratories in Africa: a multidisciplinary approach to identify innovative and sustainable technical solutions.

    Science.gov (United States)

    Putoto, Giovanni; Cortese, Antonella; Pecorari, Ilaria; Musi, Roberto; Nunziata, Enrico

    2015-06-01

    In an effective and efficient health system, laboratory medicine should play a critical role. This is not the case in Africa, where there is a lack of demand for diagnostic exams due to mistrust of health laboratory performance. Doctors with Africa CUAMM (Collegio Universitario Aspiranti Medici Missionari) is a non-profit organization, working mainly in sub-Saharan Africa (Angola, Ethiopia, Mozambique, Sierra Leone, South Sudan, Tanzania and Uganda) to help and sustain local health systems. Doctors with Africa CUAMM has advocated the need for a harmonized model for health laboratories to assess and evaluate the performance of the facilities in which they operate. In order to develop a harmonized model for African health laboratories, previous attempts at strengthening them through standardization were taken into consideration and reviewed. A survey with four Italian clinicians experienced in the field was then performed to try and understand the actual needs of health facilities. Finally a market survey was conducted to find new technologies able to update the resulting model. Comparison of actual laboratories with the developed standard - which represents the best setting any African health laboratory could aim for - allowed shortcomings in expected services to be identified and interventions subsequently prioritized. The most appropriate equipment was proposed to perform the envisaged techniques. The suitability of appliances was evaluated in consideration of recognized international recommendations, reported experiences in the field, and the availability of innovative solutions that can be performed on site in rural areas, but require minimal sample preparation and little technical expertise. The present work has developed a new, up-to-date, harmonized model for African health laboratories. The authors suggest lists of procedures to challenge the major African health problems - HIV/AIDS, malaria, tubercolosis (TB) - at each level of pyramidal health system. This

  8. Genome-wide transcriptome study in wheat identified candidate genes related to processing quality, majority of them showing interaction (quality x development) and having temporal and spatial distributions

    Science.gov (United States)

    2014-01-01

    Background The cultivated bread wheat (Triticum aestivum L.) possesses unique flour quality, which can be processed into many end-use food products such as bread, pasta, chapatti (unleavened flat bread), biscuit, etc. The present wheat varieties require improvement in processing quality to meet the increasing demand of better quality food products. However, processing quality is very complex and controlled by many genes, which have not been completely explored. To identify the candidate genes whose expressions changed due to variation in processing quality and interaction (quality x development), genome-wide transcriptome studies were performed in two sets of diverse Indian wheat varieties differing for chapatti quality. It is also important to understand the temporal and spatial distributions of their expressions for designing tissue and growth specific functional genomics experiments. Results Gene-specific two-way ANOVA analysis of expression of about 55 K transcripts in two diverse sets of Indian wheat varieties for chapatti quality at three seed developmental stages identified 236 differentially expressed probe sets (10-fold). Out of 236, 110 probe sets were identified for chapatti quality. Many processing quality related key genes such as glutenin and gliadins, puroindolines, grain softness protein, alpha and beta amylases, proteases, were identified, and many other candidate genes related to cellular and molecular functions were also identified. The ANOVA analysis revealed that the expression of 56 of 110 probe sets was involved in interaction (quality x development). Majority of the probe sets showed differential expression at early stage of seed development i.e. temporal expression. Meta-analysis revealed that the majority of the genes expressed in one or a few growth stages indicating spatial distribution of their expressions. The differential expressions of a few candidate genes such as pre-alpha/beta-gliadin and gamma gliadin were validated by RT

  9. Genome-wide transcriptome study in wheat identified candidate genes related to processing quality, majority of them showing interaction (quality x development) and having temporal and spatial distributions.

    Science.gov (United States)

    Singh, Anuradha; Mantri, Shrikant; Sharma, Monica; Chaudhury, Ashok; Tuli, Rakesh; Roy, Joy

    2014-01-16

    The cultivated bread wheat (Triticum aestivum L.) possesses unique flour quality, which can be processed into many end-use food products such as bread, pasta, chapatti (unleavened flat bread), biscuit, etc. The present wheat varieties require improvement in processing quality to meet the increasing demand of better quality food products. However, processing quality is very complex and controlled by many genes, which have not been completely explored. To identify the candidate genes whose expressions changed due to variation in processing quality and interaction (quality x development), genome-wide transcriptome studies were performed in two sets of diverse Indian wheat varieties differing for chapatti quality. It is also important to understand the temporal and spatial distributions of their expressions for designing tissue and growth specific functional genomics experiments. Gene-specific two-way ANOVA analysis of expression of about 55 K transcripts in two diverse sets of Indian wheat varieties for chapatti quality at three seed developmental stages identified 236 differentially expressed probe sets (10-fold). Out of 236, 110 probe sets were identified for chapatti quality. Many processing quality related key genes such as glutenin and gliadins, puroindolines, grain softness protein, alpha and beta amylases, proteases, were identified, and many other candidate genes related to cellular and molecular functions were also identified. The ANOVA analysis revealed that the expression of 56 of 110 probe sets was involved in interaction (quality x development). Majority of the probe sets showed differential expression at early stage of seed development i.e. temporal expression. Meta-analysis revealed that the majority of the genes expressed in one or a few growth stages indicating spatial distribution of their expressions. The differential expressions of a few candidate genes such as pre-alpha/beta-gliadin and gamma gliadin were validated by RT-PCR. Therefore, this study

  10. Report of investigation into allegations of retaliation for raising safety and quality of work issues regarding Argonne National Laboratory's Integral Fast Reactor project

    International Nuclear Information System (INIS)

    1991-12-01

    In August 1990 James A. Smith resigned his position as an experimenter at Argonne National Laboratory-West (ANL-W), located near Idaho Falls, Idaho. Smith who holds a Ph.D. in metallurgy, had worked at the Laboratory since 1988, primarily on its Integral Fast Reactor (IFR) project. He alleged that the quality of the Laboratory's work on that project had been undermined by fundamental errors in metallurgy and related sciences, at least some of which had nuclear safety implications; that the Laboratory had published false and misleading accounts of its work; that prevailing attitudes at the Laboratory were antithetical to quality scientific work; and that because he had expressed concerns about these matters his job was threatened by his managers. Evidence gathered during an investigation by the Department of Energy's Office of Nuclear Safety (NS) is presented and conclusions and recommendations are provided

  11. Evaluation of Performance of Laboratories and Manufacturers Within the Framework of the IFCC model for Quality Targets of HbA1c.

    Science.gov (United States)

    Weykamp, Cas; Siebelder, Carla

    2017-11-01

    HbA1c is a key parameter in diabetes management. For years the test has been used exclusively for monitoring of long-term diabetic control. However, due to improvement of the performance, HbA1c is considered more and more for diagnosis and screening. With this new application, quality demands further increase. A task force of the International Federation of Clinical Chemistry and Laboratory Medicine developed a model to set and evaluate quality targets for HbA1c. The model is based on the concept of total error and takes into account the major sources of analytical errors in the medical laboratory: bias and imprecision. Performance criteria are derived from sigma-metrics and biological variation. This review shows 2 examples of the application of the model: at the level of single laboratories, and at the level of a group of laboratories. In the first example data of 125 individual laboratories of a recent external quality assessment program in the Netherlands are evaluated. Differences between laboratories as well as their relation to method principles are shown. The second example uses recent and 3-year-old data of the proficiency test of the College of American Pathologists. The differences in performance between 26 manufacturer-related groups of laboratories are shown. Over time these differences are quite consistent although some manufacturers improved substantially either by better standardization or by replacing a test. The IFCC model serves all who are involved in HbA1c testing in the ongoing process of better performance and better patient care.

  12. Pacific Northwest National Laboratory Apatite Investigation at the 100-NR-2 Quality Assurance Project Plan

    Energy Technology Data Exchange (ETDEWEB)

    Fix, N. J.

    2008-03-28

    This Quality Assurance Project Plan provides the quality assurance requirements and processes that will be followed by staff working on the 100-NR-2 Apatite Project. The U.S. Department of Energy, Fluor Hanford, Inc., Pacific Northwest National Laboratory, and the Washington Department of Ecology agreed that the long-term strategy for groundwater remediation at 100-N would include apatite sequestration as the primary treatment, followed by a secondary treatment. The scope of this project covers the technical support needed before, during, and after treatment of the targeted subsurface environment using a new high-concentration formulation.

  13. Use of laboratory test results in patient management by clinicians in Malawi.

    Science.gov (United States)

    Moyo, Kundai; Porter, Carol; Chilima, Ben; Mwenda, Reuben; Kabue, Mark; Zungu, Lutho; Sarr, Abdoulaye

    2015-11-18

    Malawi has a high burden of infectious disease. The expansion of programmes targeting these diseases requires a strong laboratory infrastructure to support both diagnosis and treatment. To assess the use of laboratory test results in patient management and to determine the requirements for improving laboratory services. A cross-sectional study was conducted in 2012 to survey practising clinicians. Two hospitals were purposively selected for observations of clinicians ordering laboratory tests. Twelve management-level key informants were interviewed. Descriptive statistics were conducted. A total of 242 clinicians were identified and 216 (89%) were interviewed. Of these, 189 (87%) reported doubting laboratory test results at some point. Clinicians most often doubted the quality of haematology (67%), followed by malaria (53%) and CD4 (22%) test results. A total of 151 (70%) clinicians reported using laboratory tests results in patient management. Use of laboratory test results at all times in patient management varied by the type of health facility ( P management. Key informants reported that the quality of laboratory services was good and useful, but that services were often unavailable. Gaps in the public laboratory system were evident. Key recommendations to enhance the use of laboratory test results in patient management were to strengthen the supply chain, reduce turn-around times, improve the test menu and improve the laboratory infrastructure.

  14. Replicating the microbial community and water quality performance of full-scale slow sand filters in laboratory-scale filters.

    Science.gov (United States)

    Haig, Sarah-Jane; Quince, Christopher; Davies, Robert L; Dorea, Caetano C; Collins, Gavin

    2014-09-15

    Previous laboratory-scale studies to characterise the functional microbial ecology of slow sand filters have suffered from methodological limitations that could compromise their relevance to full-scale systems. Therefore, to ascertain if laboratory-scale slow sand filters (L-SSFs) can replicate the microbial community and water quality production of industrially operated full-scale slow sand filters (I-SSFs), eight cylindrical L-SSFs were constructed and were used to treat water from the same source as the I-SSFs. Half of the L-SSFs sand beds were composed of sterilized sand (sterile) from the industrial filters and the other half with sand taken directly from the same industrial filter (non-sterile). All filters were operated for 10 weeks, with the microbial community and water quality parameters sampled and analysed weekly. To characterize the microbial community phyla-specific qPCR assays and 454 pyrosequencing of the 16S rRNA gene were used in conjunction with an array of statistical techniques. The results demonstrate that it is possible to mimic both the water quality production and the structure of the microbial community of full-scale filters in the laboratory - at all levels of taxonomic classification except OTU - thus allowing comparison of LSSF experiments with full-scale units. Further, it was found that the sand type composing the filter bed (non-sterile or sterile), the water quality produced, the age of the filters and the depth of sand samples were all significant factors in explaining observed differences in the structure of the microbial consortia. This study is the first to the authors' knowledge that demonstrates that scaled-down slow sand filters can accurately reproduce the water quality and microbial consortia of full-scale slow sand filters. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Ernest Orlando Lawrence Berkeley National Laboratory institutional plan, FY 1996--2001

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-11-01

    The FY 1996--2001 Institutional Plan provides an overview of the Ernest Orlando Lawrence Berkeley National Laboratory mission, strategic plan, core business areas, critical success factors, and the resource requirements to fulfill its mission in support of national needs in fundamental science and technology, energy resources, and environmental quality. The Laboratory Strategic Plan section identifies long-range conditions that will influence the Laboratory, as well as potential research trends and management implications. The Core Business Areas section identifies those initiatives that are potential new research programs representing major long-term opportunities for the Laboratory, and the resources required for their implementation. It also summarizes current programs and potential changes in research program activity, science and technology partnerships, and university and science education. The Critical Success Factors section reviews human resources; work force diversity; environment, safety, and health programs; management practices; site and facility needs; and communications and trust. The Resource Projections are estimates of required budgetary authority for the Laboratory`s ongoing research programs. The Institutional Plan is a management report for integration with the Department of Energy`s strategic planning activities, developed through an annual planning process. The plan identifies technical and administrative directions in the context of the national energy policy and research needs and the Department of Energy`s program planning initiatives. Preparation of the plan is coordinated by the Office of Planning and Communications from information contributed by the Laboratory`s scientific and support divisions.

  16. Application of failure mode and effects analysis in a clinical chemistry laboratory.

    Science.gov (United States)

    Jiang, Yuanyuan; Jiang, Hongmin; Ding, Siyi; Liu, Qin

    2015-08-25

    Timely delivery of correct results has long been considered as the goal of quality management in clinical laboratory. With increasing workload as well as complexities of laboratory testing and patient care, the traditional technical adopted like internal quality control (IQC) and external quality assessment (EQA) may not enough to cope with quality management problems for clinical laboratories. We applied failure mode and effects analysis (FMEA), a proactive tool, to reduce errors associated with the process beginning with sample collection and ending with a test report in a clinical chemistry laboratory. Our main objection was to investigate the feasibility of FMEA in a real-world situation, namely the working environment of hospital. A team of 8 people (3 laboratory workers, 2 couriers, 2 nurses, and 1 physician) from different departments who were involved in the testing process were recruited and trained. Their main responsibility was to analyze and score all possible clinical chemistry laboratory failures based on three aspects: the severity of the outcome (S), the likeliness of occurrence (O), and the probability of being detected (D). These three parameters were multiplied to calculate risk priority numbers (RPNs), which were used to prioritize remedial measures. Failure modes with RPN≥200 were deemed as high risk, meaning that they needed immediate corrective action. After modifications that were put, we compared the resulting RPN with the previous one. A total of 33 failure modes were identified. Many of the failure modes, including the one with the highest RPN (specimen hemolysis) appeared in the pre-analytic phase, whereas no high-risk failure modes (RPN≥200) were found during the analytic phase. High-priority risks were "sample hemolysis" (RPN, 336), "sample delivery delay" (RPN, 225), "sample volume error" (RPN, 210), "failure to release results in a timely manner" (RPN, 210), and "failure to identify or report critical results" (RPN, 200). The

  17. Quality assurance programme at the National Calibration Laboratory in Tanzania

    International Nuclear Information System (INIS)

    Muhogora, W.E.; Yoloye, O.; Ngaile, J.; Lema, U.S.

    2000-01-01

    A quality assurance programme at the National Calibration Laboratory for ionizing radiation in Tanzania is described. The programme focuses mainly on regular stability check source and reference output measurements, performance testing of TLD systems as well as some external audit checks. It is found that the stability check source measurements are within ± 1%. Similarly, the air kerma rate measurements agree well with calibration uncertainties, that is ± 2% for protection level measurements and ± 1.5% for clinical dosimetry. The results of comparison of dose measurements done on site and those obtained from some external audit checks are also within requirements. This shows that the working standards have been kept with good care, and that the traceability to the international measurement system is adequately maintained. Some examples on calibration transfer activities are briefly discussed

  18. Quality assurance guidance for laboratory assessment plates in support of EM environmental sampling and analysis activities

    International Nuclear Information System (INIS)

    1994-05-01

    This document is one of several guidance documents developed to support the EM (DOE Environmental Restoration and Waste Management) Analytical Services program. Its purpose is to introduce assessment plates that can be used to conduct performance assessments of an organization's or project's ability to meet quality goals for analytical laboratory activities. These assessment plates are provided as non-prescriptive guidance to EM-support organizations responsible for collection of environmental data for remediation and waste management programs at DOE facilities. The assessments evaluate objectively all components of the analytical laboratory process to determine their proper selection and use

  19. National surveys on internal quality control for blood gas analysis and related electrolytes in clinical laboratories of China.

    Science.gov (United States)

    Duan, Min; Wang, Wei; Zhao, Haijian; Zhang, Chuanbao; He, Falin; Zhong, Kun; Yuan, Shuai; Wang, Zhiguo

    2018-05-01

    Internal quality control (IQC) is essential for precision evaluation and continuous quality improvement. This study aims to investigate the IQC status of blood gas analysis (BGA) in clinical laboratories of China from 2014 to 2017. IQC information on BGA (including pH, pCO2, pO2, Na+, K+, Ca2+, Cl-) was submitted by external quality assessment (EQA) participant laboratories and collected through Clinet-EQA reporting system in March from 2014 to 2017. First, current CVs were compared among different years and measurement systems. Then, percentages of laboratories meeting five allowable imprecision specifications for each analyte were calculated, respectively. Finally, laboratories were divided into different groups based on control rules and frequency to compare their variation trend. The current CVs of BGA were significantly decreasing from 2014 to 2017. pH and pCO2 got the highest pass rates when compared with the minimum imprecision specification, whereas pO2, Na+, K+, Ca2+, Cl- got the highest pass rates when 1/3 TEa imprecision specification applied. The pass rates of pH, pO2, Na+, K+, Ca2+, Cl- were significantly increasing during the 4 years. The comparisons of current CVs among different measurement systems showed that the precision performance of different analytes among different measurement systems had no regular distribution from 2014 to 2017. The analysis of IQC practice indicated great progress and improvement among different years. The imprecision performance of BGA has improved from 2014 to 2017, but the status of imprecision performance in China remains unsatisfying. Therefore, further investigation and continuous improvement measures should be taken.

  20. Synthetic salt cake standards for analytical laboratory quality control

    International Nuclear Information System (INIS)

    Schilling, A.E.; Miller, A.G.

    1980-01-01

    The validation of analytical results in the characterization of Hanford Nuclear Defense Waste requires the preparation of synthetic waste for standard reference materials. Two independent synthetic salt cake standards have been prepared to monitor laboratory quality control for the chemical characterization of high-level salt cake and sludge waste in support of Rockwell Hanford Operations' High-Level Waste Management Program. Each synthetic salt cake standard contains 15 characterized chemical species and was subjected to an extensive verification/characterization program in two phases. Phase I consisted of an initial verification of each analyte in salt cake form in order to determine the current analytical capability for chemical analysis. Phase II consisted of a final characterization of those chemical species in solution form where conflicting verification data were observed. The 95 percent confidence interval on the mean for the following analytes within each standard is provided: sodium, nitrate, nitrite, phosphate, carbonate, sulfate, hydroxide, chromate, chloride, fluoride, aluminum, plutonium-239/240, strontium-90, cesium-137, and water

  1. Service quality: understanding and implementing the concept in the clinical laboratory. Match service quality to consumer expectations.

    Science.gov (United States)

    O'Connor, S J

    1989-01-01

    The increasingly competitive health-care marketplace has mandated that health-care managers pay careful attention to the issue of quality from the perspective of the consumer. The importance of this issue is underscored by the fact that numerous health-care institutions and associations have recently begun to recognize the urgent need to obtain a greater understanding of service quality in a health-care situation. This article suggests means to understand, identify, improve, and implement effective approaches to this vital aspect of the marketing mix.

  2. Identifying continuous quality improvement publications: what makes an improvement intervention 'CQI'?

    Science.gov (United States)

    O'Neill, Sean M; Hempel, Susanne; Lim, Yee-Wei; Danz, Marjorie S; Foy, Robbie; Suttorp, Marika J; Shekelle, Paul G; Rubenstein, Lisa V

    2011-12-01

    The term continuous quality improvement (CQI) is often used to refer to a method for improving care, but no consensus statement exists on the definition of CQI. Evidence reviews are critical for advancing science, and depend on reliable definitions for article selection. As a preliminary step towards improving CQI evidence reviews, this study aimed to use expert panel methods to identify key CQI definitional features and develop and test a screening instrument for reliably identifying articles with the key features. We used a previously published method to identify 106 articles meeting the general definition of a quality improvement intervention (QII) from 9427 electronically identified articles from PubMed. Two raters then applied a six-item CQI screen to the 106 articles. Per cent agreement ranged from 55.7% to 75.5% for the six items, and reviewer-adjusted intra-class correlation ranged from 0.43 to 0.62. 'Feedback of systematically collected data' was the most common feature (64%), followed by being at least 'somewhat' adapted to local conditions (61%), feedback at meetings involving participant leaders (46%), using an iterative development process (40%), being at least 'somewhat' data driven (34%), and using a recognised change method (28%). All six features were present in 14.2% of QII articles. We conclude that CQI features can be extracted from QII articles with reasonable reliability, but only a small proportion of QII articles include all features. Further consensus development is needed to support meaningful use of the term CQI for scientific communication.

  3. An approach for estimating measurement uncertainty in medical laboratories using data from long-term quality control and external quality assessment schemes.

    Science.gov (United States)

    Padoan, Andrea; Antonelli, Giorgia; Aita, Ada; Sciacovelli, Laura; Plebani, Mario

    2017-10-26

    The present study was prompted by the ISO 15189 requirements that medical laboratories should estimate measurement uncertainty (MU). The method used to estimate MU included the: a) identification of quantitative tests, b) classification of tests in relation to their clinical purpose, and c) identification of criteria to estimate the different MU components. Imprecision was estimated using long-term internal quality control (IQC) results of the year 2016, while external quality assessment schemes (EQAs) results obtained in the period 2015-2016 were used to estimate bias and bias uncertainty. A total of 263 measurement procedures (MPs) were analyzed. On the basis of test purpose, in 51 MPs imprecision only was used to estimate MU; in the remaining MPs, the bias component was not estimable for 22 MPs because EQAs results did not provide reliable statistics. For a total of 28 MPs, two or more MU values were calculated on the basis of analyte concentration levels. Overall, results showed that uncertainty of bias is a minor factor contributing to MU, the bias component being the most relevant contributor to all the studied sample matrices. The model chosen for MU estimation allowed us to derive a standardized approach for bias calculation, with respect to the fitness-for-purpose of test results. Measurement uncertainty estimation could readily be implemented in medical laboratories as a useful tool in monitoring the analytical quality of test results since they are calculated using a combination of both the long-term imprecision IQC results and bias, on the basis of EQAs results.

  4. Evaluation of quality-control data collected by the U.S. Geological Survey for routine water-quality activities at the Idaho National Laboratory and vicinity, southeastern Idaho, 2002-08

    Science.gov (United States)

    Rattray, Gordon W.

    2014-01-01

    Quality-control (QC) samples were collected from 2002 through 2008 by the U.S. Geological Survey, in cooperation with the U.S. Department of Energy, to ensure data robustness by documenting the variability and bias of water-quality data collected at surface-water and groundwater sites at and near the Idaho National Laboratory. QC samples consisted of 139 replicates and 22 blanks (approximately 11 percent of the number of environmental samples collected). Measurements from replicates were used to estimate variability (from field and laboratory procedures and sample heterogeneity), as reproducibility and reliability, of water-quality measurements of radiochemical, inorganic, and organic constituents. Measurements from blanks were used to estimate the potential contamination bias of selected radiochemical and inorganic constituents in water-quality samples, with an emphasis on identifying any cross contamination of samples collected with portable sampling equipment. The reproducibility of water-quality measurements was estimated with calculations of normalized absolute difference for radiochemical constituents and relative standard deviation (RSD) for inorganic and organic constituents. The reliability of water-quality measurements was estimated with pooled RSDs for all constituents. Reproducibility was acceptable for all constituents except dissolved aluminum and total organic carbon. Pooled RSDs were equal to or less than 14 percent for all constituents except for total organic carbon, which had pooled RSDs of 70 percent for the low concentration range and 4.4 percent for the high concentration range. Source-solution and equipment blanks were measured for concentrations of tritium, strontium-90, cesium-137, sodium, chloride, sulfate, and dissolved chromium. Field blanks were measured for the concentration of iodide. No detectable concentrations were measured from the blanks except for strontium-90 in one source solution and one equipment blank collected in September

  5. Network Performance and Quality of Experience of Remote Access Laboratories

    Directory of Open Access Journals (Sweden)

    Alexander A. Kist

    2012-11-01

    Full Text Available Remote Access Laboratories (RAL have become important learning and teaching tools. This paper presents a performance study that targets a specific remote access architecture implemented within a universities operational environment. This particular RAL system provides globally authenticated and arbitrated remote access to virtualized computers as well as computer controlled hardware experiments. This paper presents system performance results that have been obtained utilizing both a set of automated and human subject tests. Principle objectives of the study were: To gain a better understanding of the nature of network traffic caused by experimental activity usage; to obtain an indication of user expectations of activity performance; and to develop a measure to predict Quality of Experience, based on easily measurable Quality of Service parameters. The study emulates network layer variation of access-bandwidth and round-trip-time of typical usage scenarios and contrasts against user perception results that allow classifying expected user performance. It demonstrates that failure rate is excellent measure of usability, and that round-trip-time predominantly affects user experience. Thin-client and remote desktop architectures are popular to separate the location of users and the actual data processing and use similar structures, hence results of this study to be applied in these application areas as well.

  6. Improving pathology and laboratory medicine in low-income and middle-income countries: roadmap to solutions.

    Science.gov (United States)

    Sayed, Shahin; Cherniak, William; Lawler, Mark; Tan, Soo Yong; El Sadr, Wafaa; Wolf, Nicholas; Silkensen, Shannon; Brand, Nathan; Looi, Lai Meng; Pai, Sanjay A; Wilson, Michael L; Milner, Danny; Flanigan, John; Fleming, Kenneth A

    2018-05-12

    Insufficient awareness of the centrality of pathology and laboratory medicine (PALM) to a functioning health-care system at policy and governmental level, with the resultant inadequate investment, has meant that efforts to enhance PALM in low-income and middle-income countries have been local, fragmented, and mostly unsustainable. Responding to the four major barriers in PALM service delivery that were identified in the first paper of this Series (workforce, infrastructure, education and training, and quality assurance), this second paper identifies potential solutions that can be applied in low-income and middle-income countries (LMICs). Increasing and retaining a quality PALM workforce requires access to mentorship and continuing professional development, task sharing, and the development of short-term visitor programmes. Opportunities to enhance the training of pathologists and allied PALM personnel by increasing and improving education provision must be explored and implemented. PALM infrastructure must be strengthened by addressing supply chain barriers, and ensuring laboratory information systems are in place. New technologies, including telepathology and point-of-care testing, can have a substantial role in PALM service delivery, if used appropriately. We emphasise the crucial importance of maintaining PALM quality and posit that all laboratories in LMICs should participate in quality assurance and accreditation programmes. A potential role for public-private partnerships in filling PALM services gaps should also be investigated. Finally, to deliver these solutions and ensure equitable access to essential services in LMICs, we propose a PALM package focused on these countries, integrated within a nationally tiered laboratory system, as part of an overarching national laboratory strategic plan. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Identifying quality improvement intervention publications - A comparison of electronic search strategies

    Directory of Open Access Journals (Sweden)

    Rubenstein Lisa V

    2011-08-01

    Full Text Available Abstract Background The evidence base for quality improvement (QI interventions is expanding rapidly. The diversity of the initiatives and the inconsistency in labeling these as QI interventions makes it challenging for researchers, policymakers, and QI practitioners to access the literature systematically and to identify relevant publications. Methods We evaluated search strategies developed for MEDLINE (Ovid and PubMed based on free text words, Medical subject headings (MeSH, QI intervention components, continuous quality improvement (CQI methods, and combinations of the strategies. Three sets of pertinent QI intervention publications were used for validation. Two independent expert reviewers screened publications for relevance. We compared the yield, recall rate, and precision of the search strategies for the identification of QI publications and for a subset of empirical studies on effects of QI interventions. Results The search yields ranged from 2,221 to 216,167 publications. Mean recall rates for reference publications ranged from 5% to 53% for strategies with yields of 50,000 publications or fewer. The 'best case' strategy, a simple text word search with high face validity ('quality' AND 'improv*' AND 'intervention*' identified 44%, 24%, and 62% of influential intervention articles selected by Agency for Healthcare Research and Quality (AHRQ experts, a set of exemplar articles provided by members of the Standards for Quality Improvement Reporting Excellence (SQUIRE group, and a sample from the Cochrane Effective Practice and Organization of Care Group (EPOC register of studies, respectively. We applied the search strategy to a PubMed search for articles published in 10 pertinent journals in a three-year period which retrieved 183 publications. Among these, 67% were deemed relevant to QI by at least one of two independent raters. Forty percent were classified as empirical studies reporting on a QI intervention. Conclusions The presented

  8. Information Quality in Regulatory Decision Making: Peer Review versus Good Laboratory Practice.

    Science.gov (United States)

    McCarty, Lynn S; Borgert, Christopher J; Mihaich, Ellen M

    2012-07-01

    There is an ongoing discussion on the provenance of toxicity testing data regarding how best to ensure its validity and credibility. A central argument is whether journal peer-review procedures are superior to Good Laboratory Practice (GLP) standards employed for compliance with regulatory mandates. We sought to evaluate the rationale for regulatory decision making based on peer-review procedures versus GLP standards. We examined pertinent published literature regarding how scientific data quality and validity are evaluated for peer review, GLP compliance, and development of regulations. Some contend that peer review is a coherent, consistent evaluative procedure providing quality control for experimental data generation, analysis, and reporting sufficient to reliably establish relative merit, whereas GLP is seen as merely a tracking process designed to thwart investigator corruption. This view is not supported by published analyses pointing to subjectivity and variability in peer-review processes. Although GLP is not designed to establish relative merit, it is an internationally accepted quality assurance, quality control method for documenting experimental conduct and data. Neither process is completely sufficient for establishing relative scientific soundness. However, changes occurring both in peer-review processes and in regulatory guidance resulting in clearer, more transparent communication of scientific information point to an emerging convergence in ensuring information quality. The solution to determining relative merit lies in developing a well-documented, generally accepted weight-of-evidence scheme to evaluate both peer-reviewed and GLP information used in regulatory decision making where both merit and specific relevance inform the process.

  9. Quality of determinations obtained from laboratory reference samples used in the calibration of X-ray electron probe microanalysis of silicate minerals

    International Nuclear Information System (INIS)

    Pavlova, Ludmila A.; Suvorova, Ludmila F.; Belozerova, Olga Yu.; Pavlov, Sergey M.

    2003-01-01

    Nine simple minerals and oxides, traditionally used as laboratory reference samples in the electron probe microanalysis (EPMA) of silicate minerals, have been quantitatively evaluated. Three separate series of data, comprising the average concentration, standard deviation, relative standard deviation, confidence interval and the z-score of data quality, were calculated for 21 control samples derived from calibrations obtained from three sets of reference samples: (1) simple minerals; (2) oxides; and (3) certified glass reference materials. No systematic difference was observed between the concentrations obtained from these three calibration sets when analyzed results were compared to certified compositions. The relative standard deviations obtained for each element were smaller than target values for all determinations. The z-score values for all elements determined fell within acceptable limits (-2< z<2) for concentrations ranging from 0.1 to 100%. These experiments show that the quality of data obtained from laboratory reference calibration samples is not inferior to that from certified reference glasses. The quality of results obtained corresponds to the 'applied geochemistry' type of analysis (category 2) as defined in the GeoPT proficiency testing program. Therefore, the laboratory reference samples can be used for calibrating EPMA techniques in the analysis of silicate minerals and for controlling the quality of results

  10. Role of maintenance of analytical instruments in the proceedings of quality control laboratory

    International Nuclear Information System (INIS)

    Haribabu, A.; Sailoo, C.C.; Balaji Rao, Y.; Subba Rao, Y.

    2015-01-01

    Control Laboratory being a centralized analytical facility of Nuclear Fuel Complex (NFC) is engaged in chemical qualification of all nuclear materials processed/produced at NFC. The primary responsibility of control laboratory is to provide timely analytical results of raw materials, intermediates and final products to all the production plants of NFC for downstream processing. Annual analytical load of nearly five lakhs of estimations are being carried out at laboratory. For this purpose a gamut of analytical facilities ranging from classical methods like gravimetry, volumetry etc. to fully automated state-of-art analytical instruments like ICP-AES, Gas Analysers, Flame and Graphite Furnace-AAS, Direct Reading Emission Spectrometer (DRES), RF GD-OES, TIMS, WD-XRFS, ED-XRFS, Laser based PSD Analyser, Laser Fluorimeter, UV-Vis Spectrophotometer, Gamma Ray Spectrometer, Ion-Chromatography, Gas Chromatography are used to acquire analytical data to see the suitability of products for their intended use. Depending on the applications, analysts validate their procedures, calibrate their instruments, and perform additional instrument checks, such as system suitability tests and analysis of in-process quality control check samples. With the increasing sophistication and automation of analytical instruments, an increasing demand has been placed on maintenance engineers to qualify these instruments for the purpose

  11. Laboratory accreditation in developing economies

    International Nuclear Information System (INIS)

    Loesener, O.

    2004-01-01

    Full text: Accreditation of laboratories has been practiced for well over one hundred years with the primary objective of seeking a formal recognition for the competence of a laboratory to perform specified tests or measurements. While first accreditation schemes intended initially to serve only the immediate needs of the body making the evaluation with the purpose of minimizing testing and inspection to be conducted by laboratories, third-party accreditation enables a laboratory to demonstrate its capability as well as availability of all necessary resources to undertake particular tests correctly and that is managed in such a way that it is likely to do this consistently, taking into consideration standards developed by national and international standards-setting bodies. The international standard ISO/IEC 17025 and laboratory accreditation are concerned with competence and quality management of laboratories only, thus requiring a single common set of criteria applicable to them. Quality assurance is therefore fully relevant to laboratories in general and analytical laboratories in particular; it should not be confused with the certification approach according to ISO/IEC 9000 family of standards, that is concerned with quality management applicable to any organization as a whole. The role of laboratory accreditation can be manifold, but in all cases the recipient of the test report needs to have confidence that the data in it is reliable, particularly if the test data is important in a decision-making process. As such, it offers a comprehensive way to ensure: - the availability of managerial and technical staff with the authority and resources needed; - the effectiveness of equipment management, traceability of measurement and safety procedures; - the performance of tests, taking into consideration laboratory accommodation and facilities as well as laboratory practices. The presentation will include also some practical aspects of quality management system

  12. Going paperless: implementing an electronic laboratory notebook in a bioanalytical laboratory.

    Science.gov (United States)

    Beato, Brian; Pisek, April; White, Jessica; Grever, Timothy; Engel, Brian; Pugh, Michael; Schneider, Michael; Carel, Barbara; Branstrator, Laurel; Shoup, Ronald

    2011-07-01

    AIT Bioscience, a bioanalytical CRO, implemented a highly configurable, Oracle-based electronic laboratory notebook (ELN) from IDBS called E-WorkBook Suite (EWBS). This ELN provides a high degree of connectivity with other databases, including Watson LIMS. Significant planning and training, along with considerable design effort and template validation for dozens of laboratory workflows were required prior to EWBS being viable for either R&D or regulated work. Once implemented, EWBS greatly reduced the need for traditional quality review upon experiment completion. Numerous real-time error checks occur automatically when conducting EWBS experiments, preventing the majority of laboratory errors by pointing them out while there is still time to correct any issues. Auditing and reviewing EWBS data are very efficient, because all data are forever securely (and even remotely) accessible, provided a reviewer has appropriate credentials. Use of EWBS significantly increases both data quality and laboratory efficiency.

  13. X radiation qualities characterization following the standard IEC 61267 recommendations at the calibration laboratory of IPEN

    International Nuclear Information System (INIS)

    Franciscatto, Priscila Cerutti

    2009-01-01

    This work presents a methodology for the X radiation qualities characterization following the new recommendations of the standard 61267 of the International Electrotechnical Commission (IEC) to establish a new procedure for calibration of dosimetric systems used in the field of diagnostic radiology. The reference qualities radiation of IEC 61267: RQR 2 to RQR 10, RQA 2 to RQA 10, RQB 2 to RQB 10 and RQN 2 to RQN 10 were implanted at the calibration laboratory of IPEN (LCI). Their characteristics were analyzed through measurements of beam parameters such as: Practical peak voltage (PPV), specific additional filtrations for each qualities (high purity aluminum of about 99.9%), 1st and 2nd Half Value Layers, homogeneity coefficient. The inherent filtration of the X ray tube was also determined. With the establishment of these radiation qualities, the LCI will be ready to calibrate the measuring instruments of radiation in the new qualities, allowing an improvement in radiological services offered by IPEN. (author)

  14. Proposed quality control guidelines for National Committee for Clinical Laboratory Standards Susceptibility Tests using the veterinary antimicrobial agent tiamulin.

    Science.gov (United States)

    Pfaller, M A; Jones, R N; Walter, D H

    2001-01-01

    Quality control guidelines for standardized antimicrobial susceptibility test methods are critical for the continuing accuracy of these clinical tests. In this report, quality control limits were proposed for the veterinary antimicrobial agent tiamulin with minimum inhibitory concentration (MIC) ranges of three or four log(2) dilution steps in two different medium formulations. Disk diffusion zone diameter ranges were proposed for tiamulin tested against Actinobacillus pleuropneumoniae ATCC 27090 (12-18 mm) and Staphylococcus aureus ATCC 25923 (25-32 mm). The data from eight participating laboratories produced 100% of results within proposed MIC limits (8-32 microg/mL), and 95.8-97.0% of zones were found within suggested zone diameter QC guidelines. These proposed QC ranges should be validated by in-use results from veterinary clinical laboratories.

  15. European external quality control study on the competence of laboratories to recognize rare sequence variants resulting in unusual genotyping results.

    Science.gov (United States)

    Márki-Zay, János; Klein, Christoph L; Gancberg, David; Schimmel, Heinz G; Dux, László

    2009-04-01

    Depending on the method used, rare sequence variants adjacent to the single nucleotide polymorphism (SNP) of interest may cause unusual or erroneous genotyping results. Because such rare variants are known for many genes commonly tested in diagnostic laboratories, we organized a proficiency study to assess their influence on the accuracy of reported laboratory results. Four external quality control materials were processed and sent to 283 laboratories through 3 EQA organizers for analysis of the prothrombin 20210G>A mutation. Two of these quality control materials contained sequence variants introduced by site-directed mutagenesis. One hundred eighty-nine laboratories participated in the study. When samples gave a usual result with the method applied, the error rate was 5.1%. Detailed analysis showed that more than 70% of the failures were reported from only 9 laboratories. Allele-specific amplification-based PCR had a much higher error rate than other methods (18.3% vs 2.9%). The variants 20209C>T and [20175T>G; 20179_20180delAC] resulted in unusual genotyping results in 67 and 85 laboratories, respectively. Eighty-three (54.6%) of these unusual results were not recognized, 32 (21.1%) were attributed to technical issues, and only 37 (24.3%) were recognized as another sequence variant. Our findings revealed that some of the participating laboratories were not able to recognize and correctly interpret unusual genotyping results caused by rare SNPs. Our study indicates that the majority of the failures could be avoided by improved training and careful selection and validation of the methods applied.

  16. Guidelines for the processing and quality assurance of benthic invertebrate samples collected as part of the National Water-Quality Assessment Program

    Science.gov (United States)

    Cuffney, T.F.; Gurtz, M.E.; Meador, M.R.

    1993-01-01

    Benthic invertebrate samples are collected as part of the U.S. Geological Survey's National Water-Quality Assessment Program. This is a perennial, multidisciplinary program that integrates biological, physical, and chemical indicators of water quality to evaluate status and trends and to develop an understanding of the factors controlling observed water quality. The Program examines water quality in 60 study units (coupled ground- and surface-water systems) that encompass most of the conterminous United States and parts of Alaska and Hawaii. Study-unit teams collect and process qualitative and semi-quantitative invertebrate samples according to standardized procedures. These samples are processed (elutriated and subsampled) in the field to produce as many as four sample components: large-rare, main-body, elutriate, and split. Each sample component is preserved in 10-percent formalin, and two components, large-rare and main-body, are sent to contract laboratories for further processing. The large-rare component is composed of large invertebrates that are removed from the sample matrix during field processing and placed in one or more containers. The main-body sample component consists of the remaining sample materials (sediment, detritus, and invertebrates) and is subsampled in the field to achieve a volume of 750 milliliters or less. The remaining two sample components, elutriate and split, are used for quality-assurance and quality-control purposes. Contract laboratories are used to identify and quantify invertebrates from the large-rare and main-body sample components according to the procedures and guidelines specified within this document. These guidelines allow the use of subsampling techniques to reduce the volume of sample material processed and to facilitate identifications. These processing procedures and techniques may be modified if the modifications provide equal or greater levels of accuracy and precision. The intent of sample processing is to

  17. Towards accreditation of MINT pesticide residue laboratory - a journey

    International Nuclear Information System (INIS)

    Nashriyah Mat; Salmah Moosa; Misman Sumin; Maizatul Akmam Mohd Nasir; Norimah Yusof

    2005-01-01

    The laboratory accreditation process under ISO/IEC 17025 is a complex journey, due to several compulsory inputs necessary for obtaining the accreditation. This paper dwells on most of those inputs in the context of MINT Pesticide Residue Laboratory (MPRL), including: 1) Quality work culture; 2) Management commitment; 3) Sustainability of laboratory service appointment; 4) Laboratory personnel; 5) Laboratory equipment; 6) Continual training of personnel; 7) Technical co-operation; 8) Laboratory safety; 9) Special and general budget; 10) Consultancy service; 11) Quality Manual, Procedure, Work Instruction and related documents; 12) Internal Quality Audit (IQA) by MINT Quality Unit, and 13) Teamwork spirit. Based on experience faced and knowledge gained, multiple problems arising during this journey towards MINT Pesticide Residue Laboratory accreditation are also discussed in general, including their solutions. (Author)

  18. Modern clinical laboratory diagnostics

    International Nuclear Information System (INIS)

    Balakhovskij, I.S.

    1986-01-01

    Laboratory diagnosis is auxillary medical discipline studying specific laboratory symptoms of diseases, revealed by investigations of materials taken from patients. The structure of laboratory servie in our country and abroad, items of laboratory investigations, organizational principles are described. Attention is being given to the cost of analyses, the amount of conducted investigations, methods of result presentation, problems of accuracy, quality control and information content

  19. Motivation and Strategies for Implementing Digital Object Identifiers (DOIs at NCAR’s Earth Observing Laboratory – Past Progress and Future Collaborations

    Directory of Open Access Journals (Sweden)

    Janine Aquino

    2017-03-01

    Full Text Available In an effort to lead our community in following modern data citation practices by formally citing data used in published research and implementing standards to facilitate reproducible research results and data, while also producing meaningful metrics that help assess the impact of our services, the National Center for Atmospheric Research (NCAR Earth Observing Laboratory (EOL has implemented the use of Digital Object Identifiers (DOIs (DataCite 2017 for both physical objects (e.g., research platforms and instruments and datasets. We discuss why this work is important and timely, and review the development of guidelines for the use of DOIs at EOL by focusing on how decisions were made. We discuss progress in assigning DOIs to physical objects and datasets, summarize plans to cite software, describe a current collaboration to develop community tools to display citations on websites, and touch on future plans to cite workflows that document dataset processing and quality control. Finally, we will review the status of efforts to engage our scientific community in the process of using DOIs in their research publications.

  20. Development of standardized laboratory methods and quality processes for a phase III study of the RTS, S/AS01 candidate malaria vaccine

    Directory of Open Access Journals (Sweden)

    Carter Terrell

    2011-08-01

    Full Text Available Abstract Background A pivotal phase III study of the RTS,S/AS01 malaria candidate vaccine is ongoing in several research centres across Africa. The development and establishment of quality systems was a requirement for trial conduct to meet international regulatory standards, as well as providing an important capacity strengthening opportunity for study centres. Methods Standardized laboratory methods and quality assurance processes were implemented at each of the study centres, facilitated by funding partners. Results A robust protocol for determination of parasite density based on actual blood cell counts was set up in accordance with World Health Organization recommendations. Automated equipment including haematology and biochemistry analyzers were put in place with standard methods for bedside testing of glycaemia, base excess and lactacidaemia. Facilities for X-rays and basic microbiology testing were also provided or upgraded alongside health care infrastructure in some centres. External quality assurance assessment of all major laboratory methods was established and method qualification by each laboratory demonstrated. The resulting capacity strengthening has ensured laboratory evaluations are conducted locally to the high standards required in clinical trials. Conclusion Major efforts by study centres, together with support from collaborating parties, have allowed standardized methods and robust quality assurance processes to be put in place for the phase III evaluation of the RTS, S/AS01 malaria candidate vaccine. Extensive training programmes, coupled with continuous commitment from research centre staff, have been the key elements behind the successful implementation of quality processes. It is expected these activities will culminate in healthcare benefits for the subjects and communities participating in these trials. Trial registration Clinicaltrials.gov NCT00866619

  1. Comparability between NQA-1 and the QA programs for analytical laboratories within the nuclear industry and EPA hazardous waste laboratories

    International Nuclear Information System (INIS)

    English, S.L.; Dahl, D.R.

    1989-01-01

    There is increasing cooperation between the Department of Energy (DOE), Department of Defense (DOD), and the Environmental Protection Agency (EPA) in the activities associated with monitoring and clean-up of hazardous wastes. Pacific Northwest Laboratory (PNL) examined the quality assurance/quality control programs that the EPA requires of the private sector when performing routine analyses of hazardous wastes to confirm how or if the requirements correspond with PNL's QA program based upon NQA-1. This paper presents the similarities and differences between NQA-1 and the QA program identified in ASTM-C1009-83, Establishing a QA Program for Analytical Chemistry Laboratories within the Nuclear Industry; EPA QAMS-005/80, Interim Guidelines and Specifications for Preparing Quality Assurance Project Plans, which is referenced in Statements of Work for CERCLA analytical activities; and Chapter 1 of SW-846, which is used in analyses of RCRA samples. The EPA QA programs for hazardous waste analyses are easily encompassed within an already established NQA-1 QA program. A few new terms are introduced and there is an increased emphasis upon the QC/verification, but there are many of the same basic concepts in all the programs

  2. The changing face of clinical laboratories.

    Science.gov (United States)

    Plebani, M

    1999-07-01

    Laboratory medicine has undergone a sea change, and medical laboratories must now adapt to, and meet new, customer-supplier needs springing from shifts in the patterns of disease prevalence, medical practice, and demographics. Managed care and other cost-containment processes have forced those involved in health care to cooperate to develop a full picture of patient care, and this has affected clinical laboratory objectives, the main focus now being on improvement in medical outcomes. More recently, the resource shortages in health care and results of cost/effectiveness analysis have demonstrated that the value of a laboratory test must be ascertained not only on the basis of its chemical or clinical performance characteristics, but also by its impact on patient management, the only true assessment of the quality of testing being quality of patient outcomes. The time is ripe for changing the vision of laboratory medicine, and some of the reasons for this are the availability of results in real-time, the introduction of more specific tests, and the trend to prevent diseases rather than cure them. The information from laboratory tests designed to evaluate biochemical or genetic risk and/or prognostic factors cannot be replaced either by physical examination and/or the assessment of symptoms. Today, the importance of laboratory scientists must be proven in three broad areas: a) guaranteeing the quality of tests, irrespective of where they are performed; b) improving the quality of the service; c) maximizing the impact of laboratory information on patient management.

  3. Does external evaluation of laboratories improve patient safety?

    Science.gov (United States)

    Noble, Michael A

    2007-01-01

    Laboratory accreditation and External Quality Assessment (also called proficiency testing) are mainstays of laboratory quality assessment and performance. Both practices are associated with examples of improved laboratory performance. The relationship between laboratory performance and improved patient safety is more difficult to assess because of the many variables that are involved with patient outcome. Despite this difficulty, the argument to continue external evaluation of laboratories is too compelling to consider the alternative.

  4. Assessment Report Sandia National Laboratories Fuel Cycle Technologies Quality Assurance Evaluation of FY15 SNL FCT M2 Milestone Deliverables

    International Nuclear Information System (INIS)

    Appel, Gordon John

    2016-01-01

    Sandia National Laboratories (SNL) Fuel Cycle Technologies (FCT) program activities are conducted in accordance with FCT Quality Assurance Program Document (FCT-QAPD) requirements. The FCT-QAPD interfaces with SNL approved Quality Assurance Program Description (SNL-QAPD) as explained in the Sandia National Laboratories QA Program Interface Document for FCT Activities (Interface Document). This plan describes SNL's FY16 assessment of SNL's FY15 FCT M2 milestone deliverable's compliance with program QA requirements, including SNL R&A requirements. The assessment is intended to confirm that SNL's FY15 milestone deliverables contain the appropriate authenticated review documentation and that there is a copy marked with SNL R&A numbers.

  5. Assessment Report Sandia National Laboratories Fuel Cycle Technologies Quality Assurance Evaluation of FY15 SNL FCT M2 Milestone Deliverables

    Energy Technology Data Exchange (ETDEWEB)

    Appel, Gordon John [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-05-01

    Sandia National Laboratories (SNL) Fuel Cycle Technologies (FCT) program activities are conducted in accordance with FCT Quality Assurance Program Document (FCT-QAPD) requirements. The FCT-QAPD interfaces with SNL approved Quality Assurance Program Description (SNL-QAPD) as explained in the Sandia National Laboratories QA Program Interface Document for FCT Activities (Interface Document). This plan describes SNL's FY16 assessment of SNL's FY15 FCT M2 milestone deliverable's compliance with program QA requirements, including SNL R&A requirements. The assessment is intended to confirm that SNL's FY15 milestone deliverables contain the appropriate authenticated review documentation and that there is a copy marked with SNL R&A numbers.

  6. Identifying shortcomings in the measurement of service quality.

    Science.gov (United States)

    Fogarty, G; Catts, R; Forlin, C

    2000-01-01

    SERVPEFR, the performance component of the Service Quality Scale (SERVQUAL), has been shown to measure five underlying dimensions corresponding to Tangibles, Reliability, Responsiveness, Assurance, and Empathy (Parasuraman, Zeithaml, & Berry, 1988). This paper describes three separate studies employing SERVPERF in an Australian context. In the first of these studies (N = 113), a shortened 15-item version of the SERVPERF scale (SERVPERF-R) was found to be suitable for use in an Australian small business setting. A five-factor structure was identifiable but the factors were highly correlated, suggesting that they were not clearly distinct. The tendency for marked negative skewness observed by other researchers was also noted here. A follow-up study involving three other small businesses (N = 212) used Rasch analysis to test assumptions about the spread of items on the underlying continuum. These analyses indicated that there is an even, though narrow, spread of items across the continuum. The Rasch analysis suggested that the items in both SERVPERF and SERVPERF-R are too easy to rate highly and that more "difficult" items need to be added to the scale. The third study (N = 122) was conducted using a version of SERVPERF-R that included seven new items intended to extend the range of the scale. The new items, however, did not achieve this desirable outcome. The implications for service quality assessment are discussed.

  7. Quality knowledge of science through virtual laboratory as an element of visualization

    Science.gov (United States)

    Rizman Herga, Natasa

    experiment, carried out over a period of two school years (2012/2013 and 2013/2014) in ten primary schools, the effectiveness of teaching carried out with the support of a virtual laboratory was analyzed. The obtained empirical findings reveal that the use of virtual laboratory has great impact on the pupils' knowledge and interest. At the end of the experiment, pupils in the experimental group had an advantage according to knowledge of chemical contents in science. Also, the use of virtual laboratory had an impact on the sustainability of the acquired knowledge of science contents and pupils' interest at the end of the experiment, because the pupils in the experimental group had a higher interest for learning science contents. The didactic experiment determined, that the use of virtual laboratory enables quality learning and teaching chemical contents of science, because it allows: (1) experimental work as an active learning method, (2) the visualization of abstract concepts and phenomena, (3) dynamic sub micro presentations (4) integration of all three levels of the chemical concept as a whole and (5) positively impacts pupils' interest, knowledge and sustainability of the acquired knowledge.

  8. The RCP Information Laboratory (iLab): breaking the cycle of poor data quality.

    Science.gov (United States)

    Croft, Giles P; Williams, John G

    2005-01-01

    A review of data quality in the NHS by the Audit Commission cited a lack of clinician involvement in the validation and use of centrally held activity data as one of the key issues to resolve. The perception that hospital episode statistics cannot support the needs of the individual clinician results in mistrust and disinterest. This in turn leads to under-development of such data from a clinical perspective, and the cycle continues. The RCP Information Laboratory (iLab) aims to address this problem by accessing, analysing and presenting information from these central repositories concerning the activity of visiting individual consultant physicians. With support from iLab staff--an information analyst and a clinician--local data quality issues are highlighted and local solutions sought. The information obtained can be used as an objective measure of activity to support the processes of appraisal and revalidation.

  9. Sandia National Laboratories

    Science.gov (United States)

    Gilliom, Laura R.

    1992-01-01

    Sandia National Laboratories has identified technology transfer to U.S. industry as a laboratory mission which complements our national security mission and as a key component of the Laboratory's future. A number of technology transfer mechanisms - such as CRADA's, licenses, work-for-others, and consortia - are identified and specific examples are given. Sandia's experience with the Specialty Metals Processing Consortium is highlighted with a focus on the elements which have made it successful. A brief discussion of Sandia's potential interactions with NASA under the Space Exploration Initiative was included as an example of laboratory-to-NASA technology transfer. Viewgraphs are provided.

  10. Underground Test Area Fiscal Year 2012 Annual Quality Assurance Report Nevada National Security Site, Nevada, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Farnham, Irene [Navarro-Intera, LLC (N-I), Las Vegas, NV (United States); Marutzky, Sam [Navarro-Intera, LLC (N-I), Las Vegas, NV (United States)

    2013-01-01

    This report is mandated by the Underground Test Area (UGTA) Quality Assurance Project Plan (QAPP) and identifies the UGTA quality assurance (QA) activities for fiscal year (FY) 2012. All UGTA organizations—U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO); Desert Research Institute (DRI); Lawrence Livermore National Laboratory (LLNL); Los Alamos National Laboratory (LANL); Navarro-Intera, LLC (N-I); National Security Technologies, LLC (NSTec); and the U.S. Geological Survey (USGS)—conducted QA activities in FY 2012. The activities included conducting assessments, identifying findings and completing corrective actions, evaluating laboratory performance, revising the QAPP, and publishing documents. In addition, processes and procedures were developed to address deficiencies identified in the FY 2011 QAPP gap analysis.

  11. The Case for Laboratory Developed Procedures

    Directory of Open Access Journals (Sweden)

    Karen L. Kaul MD, PhD

    2017-07-01

    Full Text Available An explosion of knowledge and technology is revolutionizing medicine and patient care. Novel testing must be brought to the clinic with safety and accuracy, but also in a timely and cost-effective manner, so that patients can benefit and laboratories can offer testing consistent with current guidelines. Under the oversight provided by the Clinical Laboratory Improvement Amendments, laboratories have been able to develop and optimize laboratory procedures for use in-house. Quality improvement programs, interlaboratory comparisons, and the ability of laboratories to adjust assays as needed to improve results, utilize new sample types, or incorporate new mutations, information, or technologies are positive aspects of Clinical Laboratory Improvement Amendments oversight of laboratory-developed procedures. Laboratories have a long history of successful service to patients operating under Clinical Laboratory Improvement Amendments. A series of detailed clinical examples illustrating the quality and positive impact of laboratory-developed procedures on patient care is provided. These examples also demonstrate how Clinical Laboratory Improvement Amendments oversight ensures accurate, reliable, and reproducible testing in clinical laboratories.

  12. Assessment of three medical and research laboratories using WHO ...

    African Journals Online (AJOL)

    AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING AJOL ... in all three laboratories, lack of quality audit schemes by two laboratories and only one laboratory enrolled into external quality assurance schemes.

  13. Isotopic power supplies for space and terrestrial systems: quality assurance by Sandia National Laboratories

    International Nuclear Information System (INIS)

    Hannigan, R.L.; Harnar, R.R.

    1981-09-01

    The Sandia National Laboratories participation in Quality Assurance (QA) programs for Radioisotopic Thermoelectric Generators which have been used in space and terrestrial systems over the past 15 years is summarized. Basic elements of the program are briefly described and recognition of assistance from other Sandia organizations is included. Descriptions of the various systems for which Sandia has had the QA responsibility are also presented. In addition, the outlook for Sandia participation in RTG programs for the next several years is noted

  14. [The experience of implementation of system of quality management in the Department of Laboratory Diagnostic of the N.V. Sklifosofskiy Research Institute of Emergency Care of Moscow Health Department: a lecture].

    Science.gov (United States)

    Zenina, L P; Godkov, M A

    2013-08-01

    The article presents the experience of implementation of system of quality management into the practice of multi-field laboratory of emergency medical care hospital. The analysis of laboratory errors is applied and the modes of their prevention are demonstrated. The ratings of department of laboratory diagnostic of the N. V. Sklifosofskiy research institute of emergency care in the program EQAS (USA) Monthly Clinical Chemistry from 2007 are presented. The implementation of the system of quality management of laboratory analysis into department of laboratory diagnostic made it possible to support physicians of clinical departments with reliable information. The confidence of clinicians to received results increased. The effectiveness of laboratory diagnostic increased due to lowering costs of analysis without negative impact to quality of curative process.

  15. Toward sustainable environmental quality: Identifying priority research questions for Latin America

    Science.gov (United States)

    Furley, Tatiana Heid; Brodeur, Julie; Silva de Assis, Helena C; Carriquiriborde, Pedro; Chagas, Katia R; Corrales, Jone; Denadai, Marina; Fuchs, Julio; Mascarenhas, Renata; Miglioranza, Karina SB; Miguez Caramés, Diana Margarita; Navas, José Maria; Nugegoda, Dayanthi; Planes, Estela; Rodriguez‐Jorquera, Ignacio Alejandro; Orozco‐Medina, Martha; Boxall, Alistair BA; Rudd, Murray A

    2018-01-01

    ABSTRACT The Global Horizon Scanning Project (GHSP) is an innovative initiative that aims to identify important global environmental quality research needs. Here we report 20 key research questions from Latin America (LA). Members of the Society of Environmental Toxicology and Chemistry (SETAC) LA and other scientists from LA were asked to submit research questions that would represent priority needs to address in the region. One hundred questions were received, then partitioned among categories, examined, and some rearranged during a workshop in Buenos Aires, Argentina. Twenty priority research questions were subsequently identified. These research questions included developing, improving, and harmonizing across LA countries methods for 1) identifying contaminants and degradation products in complex matrices (including biota); 2) advancing prediction of contaminant risks and effects in ecosystems, addressing lab‐to‐field extrapolation challenges, and understanding complexities of multiple stressors (including chemicals and climate change); and 3) improving management and regulatory tools toward achieving sustainable development. Whereas environmental contaminants frequently identified in these key questions were pesticides, pharmaceuticals, endocrine disruptors or modulators, plastics, and nanomaterials, commonly identified environmental challenges were related to agriculture, urban effluents, solid wastes, pulp and paper mills, and natural extraction activities. Several interesting research topics included assessing and preventing pollution impacts on conservation protected areas, integrating environment and health assessments, and developing strategies for identification, substitution, and design of less hazardous chemicals (e.g., green chemistry). Finally, a recurrent research need included developing an understanding of differential sensitivity of regional species and ecosystems to environmental contaminants and other stressors. Addressing these critical

  16. Toward sustainable environmental quality: Identifying priority research questions for Latin America.

    Science.gov (United States)

    Furley, Tatiana Heid; Brodeur, Julie; Silva de Assis, Helena C; Carriquiriborde, Pedro; Chagas, Katia R; Corrales, Jone; Denadai, Marina; Fuchs, Julio; Mascarenhas, Renata; Miglioranza, Karina Sb; Miguez Caramés, Diana Margarita; Navas, José Maria; Nugegoda, Dayanthi; Planes, Estela; Rodriguez-Jorquera, Ignacio Alejandro; Orozco-Medina, Martha; Boxall, Alistair Ba; Rudd, Murray A; Brooks, Bryan W

    2018-05-01

    The Global Horizon Scanning Project (GHSP) is an innovative initiative that aims to identify important global environmental quality research needs. Here we report 20 key research questions from Latin America (LA). Members of the Society of Environmental Toxicology and Chemistry (SETAC) LA and other scientists from LA were asked to submit research questions that would represent priority needs to address in the region. One hundred questions were received, then partitioned among categories, examined, and some rearranged during a workshop in Buenos Aires, Argentina. Twenty priority research questions were subsequently identified. These research questions included developing, improving, and harmonizing across LA countries methods for 1) identifying contaminants and degradation products in complex matrices (including biota); 2) advancing prediction of contaminant risks and effects in ecosystems, addressing lab-to-field extrapolation challenges, and understanding complexities of multiple stressors (including chemicals and climate change); and 3) improving management and regulatory tools toward achieving sustainable development. Whereas environmental contaminants frequently identified in these key questions were pesticides, pharmaceuticals, endocrine disruptors or modulators, plastics, and nanomaterials, commonly identified environmental challenges were related to agriculture, urban effluents, solid wastes, pulp and paper mills, and natural extraction activities. Several interesting research topics included assessing and preventing pollution impacts on conservation protected areas, integrating environment and health assessments, and developing strategies for identification, substitution, and design of less hazardous chemicals (e.g., green chemistry). Finally, a recurrent research need included developing an understanding of differential sensitivity of regional species and ecosystems to environmental contaminants and other stressors. Addressing these critical questions will

  17. Improving Histopathology Laboratory Productivity: Process Consultancy and A3 Problem Solving

    Directory of Open Access Journals (Sweden)

    Kutsal YÖRÜKOĞLU

    2017-01-01

    Full Text Available Objective: The ISO 17020 quality program has been run in our pathology laboratory for four years to establish an action plan for correction and prevention of identified errors. In this study, we aimed to evaluate the errors that we could not identify through ISO 17020 and/or solve by means of process consulting. Process consulting is carefully intervening in a group or team to help it to accomplish its goals. Material and Method: The A3 problem solving process was run under the leadership of a ‘workflow, IT and consultancy manager’. An action team was established consisting of technical staff. A root cause analysis was applied for target conditions, and the 6-S method was implemented for solution proposals. Applicable proposals were activated and the results were rated by six-sigma analysis. Non-applicable proposals were reported to the laboratory administrator. Results: A mislabelling error was the most complained issue triggering all pre-analytical errors. There were 21 non-value added steps grouped in 8 main targets on the fish bone graphic (transporting, recording, moving, individual, waiting, over-processing, over-transaction and errors. Unnecessary redundant requests, missing slides, archiving issues, redundant activities, and mislabelling errors were proposed to be solved by improving visibility and fixing spaghetti problems. Spatial re-organization, organizational marking, re-defining some operations, and labeling activities raised the six sigma score from 24% to 68% for all phases. Operational transactions such as implementation of a pathology laboratory system was suggested for long-term improvement. Conclusion: Laboratory management is a complex process. Quality control is an effective method to improve productivity. Systematic checking in a quality program may not always find and/or solve the problems. External observation may reveal crucial indicators about the system failures providing very simple solutions.

  18. Improving Histopathology Laboratory Productivity: Process Consultancy and A3 Problem Solving.

    Science.gov (United States)

    Yörükoğlu, Kutsal; Özer, Erdener; Alptekin, Birsen; Öcal, Cem

    2017-01-01

    The ISO 17020 quality program has been run in our pathology laboratory for four years to establish an action plan for correction and prevention of identified errors. In this study, we aimed to evaluate the errors that we could not identify through ISO 17020 and/or solve by means of process consulting. Process consulting is carefully intervening in a group or team to help it to accomplish its goals. The A3 problem solving process was run under the leadership of a 'workflow, IT and consultancy manager'. An action team was established consisting of technical staff. A root cause analysis was applied for target conditions, and the 6-S method was implemented for solution proposals. Applicable proposals were activated and the results were rated by six-sigma analysis. Non-applicable proposals were reported to the laboratory administrator. A mislabelling error was the most complained issue triggering all pre-analytical errors. There were 21 non-value added steps grouped in 8 main targets on the fish bone graphic (transporting, recording, moving, individual, waiting, over-processing, over-transaction and errors). Unnecessary redundant requests, missing slides, archiving issues, redundant activities, and mislabelling errors were proposed to be solved by improving visibility and fixing spaghetti problems. Spatial re-organization, organizational marking, re-defining some operations, and labeling activities raised the six sigma score from 24% to 68% for all phases. Operational transactions such as implementation of a pathology laboratory system was suggested for long-term improvement. Laboratory management is a complex process. Quality control is an effective method to improve productivity. Systematic checking in a quality program may not always find and/or solve the problems. External observation may reveal crucial indicators about the system failures providing very simple solutions.

  19. [Statistical approach to evaluate the occurrence of out-of acceptable ranges and accuracy for antimicrobial susceptibility tests in inter-laboratory quality control program].

    Science.gov (United States)

    Ueno, Tamio; Matuda, Junichi; Yamane, Nobuhisa

    2013-03-01

    To evaluate the occurrence of out-of acceptable ranges and accuracy of antimicrobial susceptibility tests, we applied a new statistical tool to the Inter-Laboratory Quality Control Program established by the Kyushu Quality Control Research Group. First, we defined acceptable ranges of minimum inhibitory concentration (MIC) for broth microdilution tests and inhibitory zone diameter for disk diffusion tests on the basis of Clinical and Laboratory Standards Institute (CLSI) M100-S21. In the analysis, more than two out-of acceptable range results in the 20 tests were considered as not allowable according to the CLSI document. Of the 90 participating laboratories, 46 (51%) experienced one or more occurrences of out-of acceptable range results. Then, a binomial test was applied to each participating laboratory. The results indicated that the occurrences of out-of acceptable range results in the 11 laboratories were significantly higher when compared to the CLSI recommendation (allowable rate laboratory was statistically compared with zero using a Student's t-test. The results revealed that 5 of the 11 above laboratories reported erroneous test results that systematically drifted to the side of resistance. In conclusion, our statistical approach has enabled us to detect significantly higher occurrences and source of interpretive errors in antimicrobial susceptibility tests; therefore, this approach can provide us with additional information that can improve the accuracy of the test results in clinical microbiology laboratories.

  20. Destructive analysis capabilities for plutonium and uranium characterization at Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    Tandon, Lav; Kuhn, Kevin J.; Drake, Lawrence R.; Decker, Diana L.; Walker, Laurie F.; Colletti, Lisa M.; Spencer, Khalil J.; Peterson, Dominic S.; Herrera, Jaclyn A.; Wong, Amy S.

    2010-01-01

    Los Alamos National Laboratory's (LANL) Actinide Analytical Chemistry (AAC) group has been in existence since the Manhattan Project. It maintains a complete set of analytical capabilities for performing complete characterization (elemental assay, isotopic, metallic and non metallic trace impurities) of uranium and plutonium samples in different forms. For a majority of the customers there are strong quality assurance (QA) and quality control (QC) objectives including highest accuracy and precision with well defined uncertainties associated with the analytical results. Los Alamos participates in various international and national programs such as the Plutonium Metal Exchange Program, New Brunswick Laboratory's (NBL' s) Safeguards Measurement Evaluation Program (SME) and several other inter-laboratory round robin exercises to monitor and evaluate the data quality generated by AAC. These programs also provide independent verification of analytical measurement capabilities, and allow any technical problems with analytical measurements to be identified and corrected. This presentation will focus on key analytical capabilities for destructive analysis in AAC and also comparative data between LANL and peer groups for Pu assay and isotopic analysis.

  1. Invertebrate-Based Water Quality Impairments and Associated Stressors Identified through the US Clean Water Act

    Science.gov (United States)

    Govenor, Heather; Krometis, Leigh Anne H.; Hession, W. Cully

    2017-10-01

    Macroinvertebrate community assessment is used in most US states to evaluate stream health under the Clean Water Act. While water quality assessment and impairment determinations are reported to the US Environmental Protection Agency, there is no national summary of biological assessment findings. The objective of this work was to determine the national extent of invertebrate-based impairments and to identify pollutants primarily responsible for those impairments. Evaluation of state data in the US Environmental Protection Agency's Assessment and Total Maximum Daily Load Tracking and Implementation System database revealed considerable differences in reporting approaches and terminologies including differences in if and how states report specific biological assessment findings. Only 15% of waters impaired for aquatic life could be identified as having impairments determined by biological assessments (e.g., invertebrates, fish, periphyton); approximately one-third of these were associated with macroinvertebrate bioassessment. Nearly 650 invertebrate-impaired waters were identified nationwide, and sediment was the most common pollutant in bedded (63%) and suspended (9%) forms. This finding is not unexpected, given previous work on the negative impacts of sediment on aquatic life, and highlights the need to more specifically identify the mechanisms driving sediment impairments in order to design effective remediation plans. It also reinforces the importance of efforts to derive sediment-specific biological indices and numerical sediment quality guidelines. Standardization of state reporting approaches and terminology would significantly increase the potential application of water quality assessment data, reveal national trends, and encourage sharing of best practices to facilitate the attainment of water quality goals.

  2. Pollution prevention for cleaner air: EPA's air and energy engineering research laboratory

    International Nuclear Information System (INIS)

    Shaver, E.M.

    1992-01-01

    The article discusses the role of EPA's Air and Energy Engineering Research Laboratory (AEERL) in pollution prevention research for cleaner air. For more than 20 years, AEERL has been conducting research to identify control approaches for the pollutants and sources which contribute to air quality problems. The Laboratory has successfully developed and demonstrated cost-effective sulfur dioxide, nitrogen oxides, and particulate control technologies for fossil fuel combustion sources. More recently, it has expanded its research activities to include indoor air quality, radon, organic control, stratospheric ozone depletion, and global warming. AEERL also develops inventories of air emissions of many types. Over the last several years, it has made substantial efforts to expand research on pollution prevention as the preferred choice for air emissions reduction

  3. Obtaining valid laboratory data in clinical trials conducted in resource diverse settings: lessons learned from a microbicide phase III clinical trial.

    Directory of Open Access Journals (Sweden)

    Tania Crucitti

    2010-10-01

    Full Text Available Over the last decade several phase III microbicides trials have been conducted in developing countries. However, laboratories in resource constrained settings do not always have the experience, infrastructure, and the capacity to deliver laboratory data meeting the high standards of clinical trials. This paper describes the design and outcomes of a laboratory quality assurance program which was implemented during a phase III clinical trial evaluating the efficacy of the candidate microbicide Cellulose Sulfate 6% (CS [1].In order to assess the effectiveness of CS for HIV and STI prevention, a phase III clinical trial was conducted in 5 sites: 3 in Africa and 2 in India. The trial sponsor identified an International Central Reference Laboratory (ICRL, responsible for the design and management of a quality assurance program, which would guarantee the reliability of laboratory data. The ICRL provided advice on the tests, assessed local laboratories, organized trainings, conducted supervision visits, performed re-tests, and prepared control panels. Local laboratories were provided with control panels for HIV rapid tests and Chlamydia trachomatis/Neisseria gonorrhoeae (CT/NG amplification technique. Aliquots from respective control panels were tested by local laboratories and were compared with results obtained at the ICRL.Overall, good results were observed. However, discordances between the ICRL and site laboratories were identified for HIV and CT/NG results. One particular site experienced difficulties with HIV rapid testing shortly after study initiation. At all sites, DNA contamination was identified as a cause of invalid CT/NG results. Both problems were timely detected and solved. Through immediate feedback, guidance and repeated training of laboratory staff, additional inaccuracies were prevented.Quality control guidelines when applied in field laboratories ensured the reliability and validity of final study data. It is essential that sponsors

  4. Defining a roadmap for harmonizing quality indicators in Laboratory Medicine: a consensus statement on behalf of the IFCC Working Group "Laboratory Error and Patient Safety" and EFLM Task and Finish Group "Performance specifications for the extra-analytical phases".

    Science.gov (United States)

    Sciacovelli, Laura; Panteghini, Mauro; Lippi, Giuseppe; Sumarac, Zorica; Cadamuro, Janne; Galoro, César Alex De Olivera; Pino Castro, Isabel Garcia Del; Shcolnik, Wilson; Plebani, Mario

    2017-08-28

    The improving quality of laboratory testing requires a deep understanding of the many vulnerable steps involved in the total examination process (TEP), along with the identification of a hierarchy of risks and challenges that need to be addressed. From this perspective, the Working Group "Laboratory Errors and Patient Safety" (WG-LEPS) of International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) is focusing its activity on implementation of an efficient tool for obtaining meaningful information on the risk of errors developing throughout the TEP, and for establishing reliable information about error frequencies and their distribution. More recently, the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) has created the Task and Finish Group "Performance specifications for the extra-analytical phases" (TFG-PSEP) for defining performance specifications for extra-analytical phases. Both the IFCC and EFLM groups are working to provide laboratories with a system to evaluate their performances and recognize the critical aspects where improvement actions are needed. A Consensus Conference was organized in Padova, Italy, in 2016 in order to bring together all the experts and interested parties to achieve a consensus for effective harmonization of quality indicators (QIs). A general agreement was achieved and the main outcomes have been the release of a new version of model of quality indicators (MQI), the approval of a criterion for establishing performance specifications and the definition of the type of information that should be provided within the report to the clinical laboratories participating to the QIs project.

  5. Quality system of the SDA laboratory to obtain the certification of Good BPLC-2009 (CECMED)

    International Nuclear Information System (INIS)

    Pizarro, L.; Acevedo, Y; Fernández, C; Cordoví, Y; Vázquez, L; Fraga, M; Salazar, Y; Benitez, M; Fernández, N; Lazo, I.

    2016-01-01

    Due to the financial limitations of hospitals in Cuba since the 1990s, and using CENTIS's coverage of a licensed laboratory for working with radioactive substances, an experienced staff made it possible a centralized analytical service (SDA) was considered by the RIA / IRMA method, which would help to alleviate the unmet demand for analysis, and in accordance with the requirements established by the Good Clinical Laboratory Practices (BPLC 03- 2009). An SDA Quality System was designed as a complement to the CENTIS Quality System, which would guarantee the reliability of the results. In order to ensure the traceability of the samples and their results through all stages of service execution, a computer system was designed as a reliable tool, in addition to the use of certified reference materials, reagent sets, periodic and constant calibration of the samples. Means of measurement (pipettes, metering equipment), training and evaluation of personnel in RIA // IRMA test techniques applied. The new potentialities of SDA are directed towards the introduction of tumor markers. Tumor markers are currently used primarily to evaluate the cancer reaction to treatment and to control relapse, although its role in the early detection and diagnosis of cancer is still being studied.

  6. Quality assurance in biomarker measurement.

    Science.gov (United States)

    Aitio, A; Apostoli, P

    1995-05-01

    Quality assurance (QA) concerns the validity of all the analytical processes (from collection of the samples to interpretation of the results). It is not an abstract concept but must be adapted to the different situations such as the different exposure levels, the different analytical methods, and the context of use (risk assessment procedures, research, routine determinations). The main requirements in QA programmes regard the control of all the known sources of preanalytical and analytical variations, while the instruments with which adequate QA can be implemented are the certified materials and the quality control programmes (quality manual, internal and external quality controls). Another important concept in QA is that measurements must be placed a different metrological levels: at the highest there are the methods (definitive, reference) to be used for assessing accuracy of routine methods. QA programmes should enable a grading of biomarkers (from experimental only to full evaluated) and of the laboratories in order to identify the significance of the test and to assess the level at which a laboratory could operate.

  7. The Laboratory-Based Intermountain Validated Exacerbation (LIVE Score Identifies Chronic Obstructive Pulmonary Disease Patients at High Mortality Risk

    Directory of Open Access Journals (Sweden)

    Denitza P. Blagev

    2018-06-01

    Full Text Available Background: Identifying COPD patients at high risk for mortality or healthcare utilization remains a challenge. A robust system for identifying high-risk COPD patients using Electronic Health Record (EHR data would empower targeting interventions aimed at ensuring guideline compliance and multimorbidity management. The purpose of this study was to empirically derive, validate, and characterize subgroups of COPD patients based on routinely collected clinical data widely available within the EHR.Methods: Cluster analysis was used in 5,006 patients with COPD at Intermountain to identify clusters based on a large collection of clinical variables. Recursive Partitioning (RP was then used to determine a preferred tree that assigned patients to clusters based on a parsimonious variable subset. The mortality, COPD exacerbations, and comorbidity profile of the identified groups were examined. The findings were validated in an independent Intermountain cohort and in external cohorts from the United States Veterans Affairs (VA and University of Chicago Medicine systems.Measurements and Main Results: The RP algorithm identified five LIVE Scores based on laboratory values: albumin, creatinine, chloride, potassium, and hemoglobin. The groups were characterized by increasing risk of mortality. The lowest risk, LIVE Score 5 had 8% 4-year mortality vs. 56% in the highest risk LIVE Score 1 (p < 0.001. These findings were validated in the VA cohort (n = 83,134, an expanded Intermountain cohort (n = 48,871 and in the University of Chicago system (n = 3,236. Higher mortality groups also had higher COPD exacerbation rates and comorbidity rates.Conclusions: In large clinical datasets across different organizations, the LIVE Score utilizes existing laboratory data for COPD patients, and may be used to stratify risk for mortality and COPD exacerbations.

  8. Analysis of ISO/IEC 17025 for establishment of KOLAS (Korea Laboratory Accreditation Scheme) quality assurance system

    International Nuclear Information System (INIS)

    Nam, Ji Hee

    2000-12-01

    Besides one existent accredited lab, radioactive material chemical analysis lab, five test laboratories and two calibration labs are under plan to acquire the accreditation from KOLAS. But the current Quality Manual was developed according to ISO Guide 25 that was superceded by ISO/IEC 17025. Since it is tailored to the radioactive material chemical analysis lab, a number of requirements of the Manual are not applicable to the labs other than radioactive material chemical analysis lab. Through the analysis of ISO/IEC 17025, a model of quality system was established which is not only consistent with ISO/IEC 17025 but reflective of the KAERI's situation

  9. Identifying continuous quality improvement publications: what makes an improvement intervention ‘CQI’?

    Science.gov (United States)

    Hempel, Susanne; Lim, Yee-Wei; Danz, Marjorie S; Foy, Robbie; Suttorp, Marika J; Shekelle, Paul G; Rubenstein, Lisa V

    2011-01-01

    Background The term continuous quality improvement (CQI) is often used to refer to a method for improving care, but no consensus statement exists on the definition of CQI. Evidence reviews are critical for advancing science, and depend on reliable definitions for article selection. Methods As a preliminary step towards improving CQI evidence reviews, this study aimed to use expert panel methods to identify key CQI definitional features and develop and test a screening instrument for reliably identifying articles with the key features. We used a previously published method to identify 106 articles meeting the general definition of a quality improvement intervention (QII) from 9427 electronically identified articles from PubMed. Two raters then applied a six-item CQI screen to the 106 articles. Results Per cent agreement ranged from 55.7% to 75.5% for the six items, and reviewer-adjusted intra-class correlation ranged from 0.43 to 0.62. ‘Feedback of systematically collected data’ was the most common feature (64%), followed by being at least ‘somewhat’ adapted to local conditions (61%), feedback at meetings involving participant leaders (46%), using an iterative development process (40%), being at least ‘somewhat’ data driven (34%), and using a recognised change method (28%). All six features were present in 14.2% of QII articles. Conclusions We conclude that CQI features can be extracted from QII articles with reasonable reliability, but only a small proportion of QII articles include all features. Further consensus development is needed to support meaningful use of the term CQI for scientific communication. PMID:21727199

  10. GLYCOHEMOGLOBIN - COMPARISON OF 12 ANALYTICAL METHODS, APPLIED TO LYOPHILIZED HEMOLYSATES BY 101 LABORATORIES IN AN EXTERNAL QUALITY ASSURANCE PROGRAM

    NARCIS (Netherlands)

    WEYKAMP, CW; PENDERS, TJ; MUSKIET, FAJ; VANDERSLIK, W

    Stable lyophilized ethylenediaminetetra-acetic acid (EDTA)-blood haemolysates were applied in an external quality assurance programme (SKZL, The Netherlands) for glycohaemoglobin assays in 101 laboratories using 12 methods. The mean intralaboratory day-to-day coefficient of variation (CV),

  11. Upscaling laboratory results for water quality prediction at underground collieries in South Africa's Highveld Coalfields

    Energy Technology Data Exchange (ETDEWEB)

    Usher, B.H. [University of Orange Free State, Bloemfontein (South Africa). Institute for Groundwater Studies

    2009-01-15

    The prediction of future acidity and water quality is a key aspect of water management in mining environments. In this paper, different prediction techniques tested in an isolated underground compartment at a colliery in the Highveld Coalfield of South Africa are discussed. Considerations for upscaling these results are explained, and a methodology for upscaling is tested at this facility. Over 30 samples were collected around the compartment and through cored boreholes. These samples were tested using acid-base accounting tests, humidity cells, and mineralogy. From this, an integrated interpretation of potential water quality evolution was made, supported by detailed water quality sampling with the use of surface boreholes, stratified sampling underground, and pumped qualities over a period of two years. The results show that analytical tests play an integral role in water quality predictions at underground collieries. The results also show that, despite the vast differences between laboratory test conditions and the situation in the field, by taking site conditions into account to properly contextualise the results, improved predictions of expected water quality can be obtained.

  12. Education and Research Laboratories as a Means of Enhancing the Quality of Professional Engineering Education in Design and Production of Composite Parts

    Science.gov (United States)

    Khaliulin, Valentin I.; Gershtein, Elena M.

    2016-01-01

    Relevance of this research is determined by quality improvement of professional engineering education. The purpose of this paper is to offer practical recommendations for those interested in establishment of education and research laboratories as a means of enhancing the quality of professional engineering education in design and production of…

  13. Institute of Laboratory Animal Research

    National Research Council Canada - National Science Library

    Dell, Ralph

    2000-01-01

    ...; and reports on specific issues of humane care and use of laboratory animals. ILAR's mission is to help improve the availability, quality, care, and humane and scientifically valid use of laboratory animals...

  14. Current quality assurance concepts and considerations for quality control of in-clinic biochemistry testing.

    Science.gov (United States)

    Lester, Sally; Harr, K E; Rishniw, Mark; Pion, Paul

    2013-01-15

    Quality assurance is an implied concept inherent in every consumer's purchase of a product or service. In laboratory testing, quality assurance encompasses preanalytic (sampling, transport, and handling prior to testing), analytic (measurement), and postanalytic (reporting and interpretation) factors. Quality-assurance programs require that procedures are in place to detect errors in all 3 components and that the procedures are characterized by both documentation and correction of errors. There are regulatory bodies that provide mandatory standards for and regulation of human medical laboratories. No such regulations exist for veterinary laboratory testing. The American Society for Veterinary Clinical Pathology (ASVCP) Quality Assurance and Laboratory Standards Committee was formed in 1996 in response to concerns of ASVCP members about quality assurance and quality control in laboratories performing veterinary testing. Guidelines for veterinary laboratory testing have been developed by the ASVCP. The purpose of this report was to provide an overview of selected quality-assurance concepts and to provide recommendations for quality control for in-clinic biochemistry testing in general veterinary practice.

  15. Strengthening laboratory systems in resource-limited settings.

    Science.gov (United States)

    Olmsted, Stuart S; Moore, Melinda; Meili, Robin C; Duber, Herbert C; Wasserman, Jeffrey; Sama, Preethi; Mundell, Ben; Hilborne, Lee H

    2010-09-01

    Considerable resources have been invested in recent years to improve laboratory systems in resource-limited settings. We reviewed published reports, interviewed major donor organizations, and conducted case studies of laboratory systems in 3 countries to assess how countries and donors have worked together to improve laboratory services. While infrastructure and the provision of services have seen improvement, important opportunities remain for further advancement. Implementation of national laboratory plans is inconsistent, human resources are limited, and quality laboratory services rarely extend to lower tier laboratories (eg, health clinics, district hospitals). Coordination within, between, and among governments and donor organizations is also frequently problematic. Laboratory standardization and quality control are improving but remain challenging, making accreditation a difficult goal. Host country governments and their external funding partners should coordinate their efforts effectively around a host country's own national laboratory plan to advance sustainable capacity development throughout a country's laboratory system.

  16. Impact of Educational Activities in Reducing Pre-Analytical Laboratory Errors: A quality initiative.

    Science.gov (United States)

    Al-Ghaithi, Hamed; Pathare, Anil; Al-Mamari, Sahimah; Villacrucis, Rodrigo; Fawaz, Naglaa; Alkindi, Salam

    2017-08-01

    Pre-analytic errors during diagnostic laboratory investigations can lead to increased patient morbidity and mortality. This study aimed to ascertain the effect of educational nursing activities on the incidence of pre-analytical errors resulting in non-conforming blood samples. This study was conducted between January 2008 and December 2015. All specimens received at the Haematology Laboratory of the Sultan Qaboos University Hospital, Muscat, Oman, during this period were prospectively collected and analysed. Similar data from 2007 were collected retrospectively and used as a baseline for comparison. Non-conforming samples were defined as either clotted samples, haemolysed samples, use of the wrong anticoagulant, insufficient quantities of blood collected, incorrect/lack of labelling on a sample or lack of delivery of a sample in spite of a sample request. From 2008 onwards, multiple educational training activities directed at the hospital nursing staff and nursing students primarily responsible for blood collection were implemented on a regular basis. After initiating corrective measures in 2008, a progressive reduction in the percentage of non-conforming samples was observed from 2009 onwards. Despite a 127.84% increase in the total number of specimens received, there was a significant reduction in non-conforming samples from 0.29% in 2007 to 0.07% in 2015, resulting in an improvement of 75.86% ( P educational activities directed primarily towards hospital nursing staff had a positive impact on the quality of laboratory specimens by significantly reducing pre-analytical errors.

  17. Underground Test Area Fiscal Year 2013 Annual Quality Assurance Report Nevada National Security Site, Nevada, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Krenzien, Susan [Navarro-Intera, LLC (N-I), Las Vegas, NV (United States); Marutzky, Sam [Navarro-Intera, LLC (N-I), Las Vegas, NV (United States)

    2014-01-01

    This report is required by the Underground Test Area (UGTA) Quality Assurance Plan (QAP) and identifies the UGTA quality assurance (QA) activities for fiscal year (FY) 2013. All UGTA organizations—U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Field Office (NNSA/NFO); Desert Research Institute (DRI); Lawrence Livermore National Laboratory (LLNL); Los Alamos National Laboratory (LANL); Navarro-Intera, LLC (N-I); National Security Technologies, LLC (NSTec); and the U.S. Geological Survey (USGS)—conducted QA activities in FY 2013. The activities included conducting assessments, identifying findings and completing corrective actions, evaluating laboratory performance, and publishing documents. In addition, integrated UGTA required reading and corrective action tracking was instituted.

  18. Quality specifications for the extra-analytical phase of laboratory testing: Reference intervals and decision limits.

    Science.gov (United States)

    Ceriotti, Ferruccio

    2017-07-01

    Reference intervals and decision limits are a critical part of the clinical laboratory report. The evaluation of their correct use represents a tool to verify the post analytical quality. Four elements are identified as indicators. 1. The use of decision limits for lipids and glycated hemoglobin. 2. The use, whenever possible, of common reference values. 3. The presence of gender-related reference intervals for at least the following common serum measurands (besides obviously the fertility relate hormones): alkaline phosphatase (ALP), alanine aminotransferase (ALT), creatine kinase (CK), creatinine, gamma-glutamyl transferase (GGT), IgM, ferritin, iron, transferrin, urate, red blood cells (RBC), hemoglobin (Hb) and hematocrit (Hct). 4. The presence of age-related reference intervals. The problem of specific reference intervals for elderly people is discussed, but their use is not recommended; on the contrary it is necessary the presence of pediatric age-related reference intervals at least for the following common serum measurands: ALP, amylase, creatinine, inorganic phosphate, lactate dehydrogenase, aspartate aminotransferase, urate, insulin like growth factor 1, white blood cells, RBC, Hb, Hct, alfa-fetoprotein and fertility related hormones. The lack of such reference intervals may imply significant risks for the patients. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  19. Impact of improved laboratory compliance on notification of genital Chlamydia trachomatis infection in Victoria.

    Science.gov (United States)

    Thompson, S C; MacEachern, A; Stevenson, E

    1997-02-01

    Although regulations in Victoria require notification of chlamydia infection by both clinician and laboratory, review found many reports that were notified only by one source (i.e., were unmatched). To identify problems with the notification system and to improve the quality of surveillance for this disease. All notified cases of chlamydia diagnosed in January or February 1995 were followed up by contacting diagnosing doctors. Identified noncompliant laboratories were asked to provide a list of all diagnoses for the period and institute ongoing reporting. Notification data were reviewed for timeliness and completeness. Clinicians never notified without laboratory confirmation. Soliciting laboratory reports increased total notifications by 30%, and there was a highly significant improvement in reporting by both clinicians and laboratories. Reasons for failure to notify by clinicians included an assumption by some clinicians that laboratories would notify and ignorance that notification was required. Notified cases generally are now accompanied by a laboratory report, and although nonnotification by clinicians continues, notification has improved. Further improvements in clinician notification may depend on doctors knowing that public health action results from reporting. An alternative to requiring doctors' time to be spent in duplicate notification would be to strengthen laboratory reporting and then check that adequate treatment and partner notification has occurred through contact with the diagnosing doctor.

  20. Aquatic macroinvertebrates and water quality of Sandia Canyon, Los Alamos National Laboratory, November 1993--October 1994

    Energy Technology Data Exchange (ETDEWEB)

    Cross, S.

    1995-08-01

    The Ecological Studies Team (EST) of ESH-20 at Los Alamos National Laboratory (LANL) has collected samples from the stream within Sandia Canyon since the summer of 1990. These field studies gather water quality measurements and collect aquatic macroinvertebrates from permanent sampling sites. Reports by Bennett (1994) and Cross (1994) discuss previous EST aquatic studies in Sandia Canyon. This report updates and expands those findings. EST collected water quality data and aquatic macroinvertebrates at five permanent stations within the canyon from November 1993 through October 1994. The two upstream stations are located below outfalls that discharge industrial and sanitary waste effluent into the stream, thereby maintaining year-round flow. Some water quality parameters are different at the first three stations from those expected of natural streams in the area, indicating degraded water quality due to effluent discharges. The aquatic habitat at the upper stations has also been degraded by sedimentation and channelization. The macroinvertebrate communities at these stations are characterized by low diversities and unstable communities. In contrast, the two downstream stations appear to be in a zone of recovery, where water quality parameters more closely resemble those found in natural streams of the area. The two lower stations have increased macroinvertebrate diversity and stable communities, further indications of downstream water quality improvement.

  1. Data Quality Objectives Supporting Radiological Air Emissions Monitoring for the Marine Sciences Laboratory, Sequim Site

    Energy Technology Data Exchange (ETDEWEB)

    Barnett, J. Matthew; Meier, Kirsten M.; Snyder, Sandra F.; Antonio, Ernest J.; Fritz, Brad G.; Poston, Theodore M.

    2012-12-27

    This document of Data Quality Objectives (DQOs) was prepared based on the U.S. Environmental Protection Agency (EPA) Guidance on Systematic Planning Using the Data Quality Objectives Process, EPA, QA/G4, 2/2006 (EPA 2006), as well as several other published DQOs. The intent of this report is to determine the necessary steps required to ensure that radioactive emissions to the air from the Marine Sciences Laboratory (MSL) headquartered at the Pacific Northwest National Laboratory’s Sequim Marine Research Operations (Sequim Site) on Washington State’s Olympic Peninsula are managed in accordance with regulatory requirements and best practices. The Sequim Site was transitioned in October 2012 from private operation under Battelle Memorial Institute to an exclusive use contract with the U.S. Department of Energy, Office of Science, Pacific Northwest Site Office.

  2. Critical appraisal of the Vienna consensus: performance indicators for assisted reproductive technology laboratories.

    Science.gov (United States)

    Lopez-Regalado, María Luisa; Martínez-Granados, Luis; González-Utor, Antonio; Ortiz, Nereyda; Iglesias, Miriam; Ardoy, Manuel; Castilla, Jose A

    2018-05-24

    The Vienna consensus, based on the recommendations of an expert panel, has identified 19 performance indicators for assisted reproductive technology (ART) laboratories. Two levels of reference values are established for these performance indicators: competence and benchmark. For over 10 years, the Spanish embryology association (ASEBIR) has participated in the definition and design of ART performance indicators, seeking to establish specific guidelines for ART laboratories to enhance quality, safety and patient welfare. Four years ago, ASEBIR took part in an initiative by AENOR, the Spanish Association for Standardization and Certification, to develop a national standard in this field (UNE 17900:2013 System of quality management for assisted reproduction laboratories), extending the former requirements, based on ISO 9001, to include performance indicators. Considering the experience acquired, we discuss various aspects of the Vienna consensus and consider certain discrepancies in performance indicators between the consensus and UNE 179007:2013, and analyse the definitions, methodology and reference values used. Copyright © 2018. Published by Elsevier Ltd.

  3. Aviation Information Systems Development Laboratory (AISDL)

    Data.gov (United States)

    Federal Laboratory Consortium — Purpose:The Aviation Information Systems Development Laboratory (AISDL) provides the tools, reconfigurability and support to ensure the quality and integrity of new...

  4. Helping air quality managers identify vulnerable communities

    CSIR Research Space (South Africa)

    Wright, C

    2008-10-01

    Full Text Available population exposure and vulnerability risk prioritisation model is proposed for potential use by air quality managers in conjunction with their air quality management plans. The model includes factors such as vulnerability caused by poverty, respiratory...

  5. Development of the Global Measles Laboratory Network.

    Science.gov (United States)

    Featherstone, David; Brown, David; Sanders, Ray

    2003-05-15

    The routine reporting of suspected measles cases and laboratory testing of samples from these cases is the backbone of measles surveillance. The Global Measles Laboratory Network (GMLN) has developed standards for laboratory confirmation of measles and provides training resources for staff of network laboratories, reference materials and expertise for the development and quality control of testing procedures, and accurate information for the Measles Mortality Reduction and Regional Elimination Initiative. The GMLN was developed along the lines of the successful Global Polio Laboratory Network, and much of the polio laboratory infrastructure was utilized for measles. The GMLN has developed as countries focus on measles control activities following successful eradication of polio. Currently more than 100 laboratories are part of the global network and follow standardized testing and reporting procedures. A comprehensive laboratory accreditation process will be introduced in 2002 with six quality assurance and performance indicators.

  6. Air quality investigations of the Sandia National Laboratories Sol se Mete Aerial Cable Facility

    International Nuclear Information System (INIS)

    Gutman, W.M.; Silver, R.J.

    1994-12-01

    The air quality implications of the test and evaluation activities at the Sandia National Laboratories Sol se Mete Aerial Cable Facility are examined. All facets of the activity that affect air quality are considered. Air contaminants produced directly include exhaust products of rocket motors used to accelerate test articles, dust and gas from chemical explosives, and exhaust gases from electricity generators in the test arenas. Air contaminants produced indirectly include fugitive dust and exhaust contaminants from vehicles used to transport personnel and material to the test area, and effluents produced by equipment used to heat the project buildings. Both the ongoing program and the proposed changes in the program are considered. Using a reliable estimate of th maximum annual testing level, the quantities of contaminants released by project activities ar computed either from known characteristics of test items or from EPA-approved emission factors Atmospheric concentrations of air contaminants are predicted using EPA dispersion models. The predicted quantities and concentrations are evaluated in relation to Federal, New Mexico, an Bernalillo County air quality regulations and the human health and safety standards of the American Conference of Governmental Industrial Hygienists

  7. Procedure for implementing the system of quality management in the testing laboratory of the Center for Genetic Engineering and Biotechnology in Sancti Spiritus.

    Directory of Open Access Journals (Sweden)

    Lídice Peraza Cruz

    2014-03-01

    Full Text Available Implementation of Quality Management System in testing laboratories offers the possibility of its accreditation and a frame for cooperation with other organizations, supporting information and experience exchange, as well as standards and procedures harmonization. To improve the performance of the Center for Genetic Engineering and Biotechnology of Sancti Spíritus testing laboratory, assuring technically valid data and results which promote technical competence and credibility of in vitro diagnostics and biological reagents products, a procedure was designed to implement a Quality Management System. This procedure applies Deming´s Quality Cycle and considers all relevant requirements in NC ISO/IEC 17025:2006 “General requirements for the competence of testing and calibration laboratories” and Regulation No. 20 2004 “Good Manufacturing Practices for in vitro Diagnostics” of Center for State Control of Drugs, Equipment and Medical Devices. We recommend an auto evaluation method, designed by authors, to verify quality management system accomplishment.

  8. The quality of clinical maternal and neonatal healthcare - a strategy for identifying 'routine care signal functions'.

    Directory of Open Access Journals (Sweden)

    Stephan Brenner

    Full Text Available A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs, a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC, the 'EmOC signal functions', a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example.We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi.Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants' adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks.The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes will contribute to streamlining

  9. The quality of clinical maternal and neonatal healthcare - a strategy for identifying 'routine care signal functions'.

    Science.gov (United States)

    Brenner, Stephan; De Allegri, Manuela; Gabrysch, Sabine; Chinkhumba, Jobiba; Sarker, Malabika; Muula, Adamson S

    2015-01-01

    A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH) programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs), a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC), the 'EmOC signal functions', a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example. We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi. Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants' adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks. The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes will contribute to streamlining MNH program

  10. Critical evaluation of quality assurance in laboratory diagnosis of tuberculosis in selected nearby microscopic centers under RNTCP

    Directory of Open Access Journals (Sweden)

    Anuradha

    2013-01-01

    Full Text Available Objective: RNTCP relies on sputum smear microscopy for diagnosis, categorization of patients for treatment and assessment of their program. Therefore, it is crucial that the smear microscopy services provided are of highest quality possible. The current study is undertaken to do on site evaluation and Random blinded rechecking (RBRC of slides at selected microscopic centers. Material & Methods: Five microscopic centers were selected for onsite evaluation and Random Blinded rechecking. Slides were collected monthly from the respective DMCs. A questionnaire was developed to assess the overall operational conditions at the DMCs and a checklist was prepared to record the observation during the visit. RBRC slides were read by two microbiologists independently and results were compared with RNTCP results. Slides were read before and after restaining the slides. Results: After the evaluation of checklist and questionnaire, it was found that 100% centers were following the charts for smear preparation, staining and grading with adequate stock supply. One out of 5 centers had maximum number of slides with poor quality of smear (16.7%, 8% uneven smear and 14% slides with improper thickness. There was 100% concordance when reading five positive and five negative smears. The mean time spent on microscopic examination was 4.4 minutes, compared with recommended time of 10 minutes. Out of 828 slides rechecked under RBRC one low false negative error was found. Conclusion: The evaluation of quality control practices was found satisfactory. The laboratory staff was able to incorporate simple quality control procedures for AFB microscopy into their routine practice, resulting in reliable service. Onsite evaluation and RBRC are viable measures of laboratory performance and both should be continued.

  11. Transuranic waste examination quality assurance at the Idaho National Engineering Laboratory

    International Nuclear Information System (INIS)

    Bower, J.M.

    1987-01-01

    Since 1954, defense-generated transuranic (TRU) waste has been received at the Radioactive Waste Management Complex (RWMC) at the Idaho National Engineering Laboratory (INEL). A major objective of the Department of Energy (DOE) Nuclear Waste Management Programs is the proper management of the defense-generated TRU waste. The Stored Waste Examination Pilot Plant (SWEPP) is providing nondestructive examination and assay of retrievably stored contact handled TRU waste in order to certify it to the Waste Isolation Pilot Plant Waste Acceptance Crtieria (WIPP-WAC). SWEPP's capabilities for certifying contact handled waste containers include weighing, real-time radiographic examination, fissile material assay examination, container integrity examination, radiological surveys and labeling of waste containers. These processes involve not only instrument accuracy but also a wide range of technician interpretation from moderate on the assay to 100% on the radiograph. This, therefore, requires a variety of quality assurance techniques to ensure that the examinations and certifications are being performed correctly. The purpose of this paper is to discuss the methods utilized by SWEPP for checking on the examination process and to ensure that waste certifications are being properly performed. Included is the application of the quality assurance techniques to each examination system, the management of the data generated by the examination, and the verifications to ensure accurate certification. 1 ref

  12. Guidelines for quality assurance and quality control of fish taxonomic data collected as part of the National Water-Quality Assessment Program

    Science.gov (United States)

    Walsh, Stephen Joseph; Meador, Michael R.

    1998-01-01

    Fish community structure is characterized by the U.S. Geological Survey's National Water-Quality Assessment (NAWQA) Program as part of a perennial, multidisciplinary approach to evaluating the physical, chemical, and biological conditions of the Nation's water resources. The objective of quality assurance and quality control of fish taxonomic data that are collected as part of the NAWQA Program is to establish uniform guidelines and protocols for the identification, processing, and archiving of fish specimens to ensure that accurate and reliable data are collected. Study unit biologists, collaborating with regional biologists and fish taxonomic specialists, prepare a pre-sampling study plan that includes a preliminary faunal list and identification of an ichthyological curation center for receiving preserved fish specimens. Problematic taxonomic issues and protected taxa also are identified in the study plan, and collecting permits are obtained in advance of sampling activities. Taxonomic specialists are selected to identify fish specimens in the field and to assist in determining what fish specimens should be sacrificed, fixed, and preserved for laboratory identification, independent taxonomic verification, and long-term storage in reference or voucher collections. Quantitative and qualitative sampling of fishes follows standard methods previously established for the NAWQA Program. Common ichthyological techniques are used to process samples in the field and prepare fish specimens to be returned to the laboratory or sent to an institutional repository. Taxonomic identifications are reported by using a standardized list of scientific names that provides nomenclatural consistency and uniformity across study units.

  13. Methods of Estimation the Reliability and Increasing the Informativeness of the Laboratory Results (Analysis of the Laboratory Case of Measurement the Indicators of Thyroid Function

    Directory of Open Access Journals (Sweden)

    N A Kovyazina

    2014-06-01

    Full Text Available The goal of the study was to demonstrate the multilevel laboratory quality management system and point at the methods of estimating the reliability and increasing the amount of information content of the laboratory results (on the example of the laboratory case. Results. The article examines the stages of laboratory quality management which has helped to estimate the reliability of the results of determining Free T3, Free T4 and TSH. The measurement results are presented by the expanded uncertainty and the evaluation of the dynamics. Conclusion. Compliance with mandatory measures for laboratory quality management system enables laboratories to obtain reliable results and calculate the parameters that are able to increase the amount of information content of laboratory tests in clinical decision making.

  14. Key performance indicators score (KPIs-score) based on clinical and laboratorial parameters can establish benchmarks for internal quality control in an ART program.

    Science.gov (United States)

    Franco, José G; Petersen, Claudia G; Mauri, Ana L; Vagnini, Laura D; Renzi, Adriana; Petersen, Bruna; Mattila, M C; Comar, Vanessa A; Ricci, Juliana; Dieamant, Felipe; Oliveira, João Batista A; Baruffi, Ricardo L R

    2017-06-01

    KPIs have been employed for internal quality control (IQC) in ART. However, clinical KPIs (C-KPIs) such as age, AMH and number of oocytes collected are never added to laboratory KPIs (L-KPIs), such as fertilization rate and morphological quality of the embryos for analysis, even though the final endpoint is the evaluation of clinical pregnancy rates. This paper analyzed if a KPIs-score strategy with clinical and laboratorial parameters could be used to establish benchmarks for IQC in ART cycles. In this prospective cohort study, 280 patients (36.4±4.3years) underwent ART. The total KPIs-score was obtained by the analysis of age, AMH (AMH Gen II ELISA/pre-mixing modified, Beckman Coulter Inc.), number of metaphase-II oocytes, fertilization rates and morphological quality of the embryonic lot. The total KPIs-score (C-KPIs+L-KPIs) was correlated with the presence or absence of clinical pregnancy. The relationship between the C-KPIs and L-KPIs scores was analyzed to establish quality standards, to increase the performance of clinical and laboratorial processes in ART. The logistic regression model (LRM), with respect to pregnancy and total KPIs-score (280 patients/102 clinical pregnancies), yielded an odds ratio of 1.24 (95%CI = 1.16-1.32). There was also a significant difference (pclinical pregnancies (total KPIs-score=20.4±3.7) and the group without clinical pregnancies (total KPIs-score=15.9±5). Clinical pregnancy probabilities (CPP) can be obtained using the LRM (prediction key) with the total KPIs-score as a predictor variable. The mean C-KPIs and L-KPIs scores obtained in the pregnancy group were 11.9±2.9 and 8.5±1.7, respectively. Routinely, in all cases where the C-KPIs score was ≥9, after the procedure, the L-KPIs score obtained was ≤6, a revision of the laboratory procedure was performed to assess quality standards. This total KPIs-score could set up benchmarks for clinical pregnancy. Moreover, IQC can use C-KPIs and L-KPIs scores to detect problems

  15. Potential external contamination with bisphenol A and other ubiquitous organic environmental chemicals during biomonitoring analysis: an elusive laboratory challenge.

    Science.gov (United States)

    Ye, Xiaoyun; Zhou, Xiaoliu; Hennings, Ryan; Kramer, Joshua; Calafat, Antonia M

    2013-03-01

    Biomonitoring studies are conducted to assess internal dose (i.e., body burden) to environmental chemicals. However, because of the ubiquitous presence in the environment of some of these chemicals, such as bisphenol A (BPA), external contamination during handling and analysis of the biospecimens collected for biomonitoring evaluations could compromise the reported concentrations of such chemicals. We examined the contamination with the target analytes during analysis of biological specimens in biomonitoring laboratories equipped with state-of-the-art analytical instrumentation. We present several case studies using the quantitative determination of BPA and other organic chemicals (i.e., benzophenone-3, triclosan, parabens) in human urine, milk, and serum to identify potential contamination sources when the biomarkers measured are ubiquitous environmental contaminants. Contamination with target analytes during biomonitoring analysis could result from solvents and reagents, the experimental apparatus used, the laboratory environment, and/or even the analyst. For biomonotoring data to be valid-even when obtained from high-quality analytical methods and good laboratory practices-the following practices must be followed to identify and track unintended contamination with the target analytes during analysis of the biological specimens: strict quality control measures including use of laboratory blanks; replicate analyses; engineering controls (e.g., clean rooms, biosafety cabinets) as needed; and homogeneous matrix-based quality control materials within the expected concentration ranges of the study samples.

  16. A web-based laboratory information system to improve quality of care of tuberculosis patients in Peru: functional requirements, implementation and usage statistics.

    Science.gov (United States)

    Blaya, Joaquin A; Shin, Sonya S; Yagui, Martin J A; Yale, Gloria; Suarez, Carmen Z; Asencios, Luis L; Cegielski, J Peter; Fraser, Hamish S F

    2007-10-28

    Multi-drug resistant tuberculosis patients in resource-poor settings experience large delays in starting appropriate treatment and may not be monitored appropriately due to an overburdened laboratory system, delays in communication of results, and missing or error-prone laboratory data. The objective of this paper is to describe an electronic laboratory information system implemented to alleviate these problems and its expanding use by the Peruvian public sector, as well as examine the broader issues of implementing such systems in resource-poor settings. A web-based laboratory information system "e-Chasqui" has been designed and implemented in Peru to improve the timeliness and quality of laboratory data. It was deployed in the national TB laboratory, two regional laboratories and twelve pilot health centres. Using needs assessment and workflow analysis tools, e-Chasqui was designed to provide for improved patient care, increased quality control, and more efficient laboratory monitoring and reporting. Since its full implementation in March 2006, 29,944 smear microscopy, 31,797 culture and 7,675 drug susceptibility test results have been entered. Over 99% of these results have been viewed online by the health centres. High user satisfaction and heavy use have led to the expansion of e-Chasqui to additional institutions. In total, e-Chasqui will serve a network of institutions providing medical care for over 3.1 million people. The cost to maintain this system is approximately US$0.53 per sample or 1% of the National Peruvian TB program's 2006 budget. Electronic laboratory information systems have a large potential to improve patient care and public health monitoring in resource-poor settings. Some of the challenges faced in these settings, such as lack of trained personnel, limited transportation, and large coverage areas, are obstacles that a well-designed system can overcome. e-Chasqui has the potential to provide a national TB laboratory network in Peru

  17. Improving patient safety through quality assurance.

    Science.gov (United States)

    Raab, Stephen S

    2006-05-01

    Anatomic pathology laboratories use several quality assurance tools to detect errors and to improve patient safety. To review some of the anatomic pathology laboratory patient safety quality assurance practices. Different standards and measures in anatomic pathology quality assurance and patient safety were reviewed. Frequency of anatomic pathology laboratory error, variability in the use of specific quality assurance practices, and use of data for error reduction initiatives. Anatomic pathology error frequencies vary according to the detection method used. Based on secondary review, a College of American Pathologists Q-Probes study showed that the mean laboratory error frequency was 6.7%. A College of American Pathologists Q-Tracks study measuring frozen section discrepancy found that laboratories improved the longer they monitored and shared data. There is a lack of standardization across laboratories even for governmentally mandated quality assurance practices, such as cytologic-histologic correlation. The National Institutes of Health funded a consortium of laboratories to benchmark laboratory error frequencies, perform root cause analysis, and design error reduction initiatives, using quality assurance data. Based on the cytologic-histologic correlation process, these laboratories found an aggregate nongynecologic error frequency of 10.8%. Based on gynecologic error data, the laboratory at my institution used Toyota production system processes to lower gynecologic error frequencies and to improve Papanicolaou test metrics. Laboratory quality assurance practices have been used to track error rates, and laboratories are starting to use these data for error reduction initiatives.

  18. Quality control for laboratory diagnosis for hand, foot and mouth ...

    African Journals Online (AJOL)

    McRoy

    the system for laboratory diagnosis in HFMD. Despite using molecular based technique, some laboratories can still not possibly detect the pathogen.[11] For sure, this can cause the problem in disease control during the outbreak. It is noted that using internal control help improve diagnostic property of laboratory test.[12].

  19. Socioemotional characteristics of elementary school children identified as exhibiting social leadership qualities.

    Science.gov (United States)

    Scharf, Miri; Mayseless, Ofra

    2009-03-01

    Elementary school teachers identified characteristics in 4 major socioemotional domains associated with children's social leadership: self-perception, social anxiety, attachment orientation with peers, and interpersonal goals and skills in close friendships. Participants were 260 4th- and 5th-grade students (126 boys, 134 girls) from 10 classes in a school in northern Israel. Social leadership skills were associated with positive self-perceptions in various domains, low social anxiety, secure orientation to peers, higher levels of relationship-maintenance goal, lower levels of revenge goal in close friendships, and-unexpectedly-lower levels of accommodation as a strategy to solve conflicts with a friend. Positive self-concept and attachment security were indirectly associated with leadership qualities through their significant association with prosocial orientation skills. The authors discuss these findings as reflecting an internalization of positive model of self and positive model of others in children who exhibit social leadership qualities. The authors also discuss implications of these qualities for school and class ecology, as well as the importance of culture.

  20. Identifying and assessing highly hazardous drugs within quality risk management programs.

    Science.gov (United States)

    Sussman, Robert G; Schatz, Anthony R; Kimmel, Tracy A; Ader, Allan; Naumann, Bruce D; Weideman, Patricia A

    2016-08-01

    Historically, pharmaceutical industry regulatory guidelines have assigned certain active pharmaceutical ingredients (APIs) to various categories of concern, such as "cytotoxic", "hormones", and "steroids". These categories have been used to identify APIs requiring segregation or dedication in order to prevent cross-contamination and protect the quality and safety of drug products. Since these terms were never defined by regulatory authorities, and many novel pharmacological mechanisms challenge these categories, there is a recognized need to modify the historical use of these terms. The application of a risk-based approach using a health-based limit, such as an acceptable daily exposure (ADE), is more appropriate for the development of a Quality Risk Management Program (QRMP) than the use of categories of concern. The toxicological and pharmacological characteristics of these categories are discussed to help identify and prioritize compounds requiring special attention. Controlling airborne concentrations and the contamination of product contact surfaces in accordance with values derived from quantitative risk assessments can prevent adverse effects in workers and patients, regardless of specific categorical designations to which these APIs have been assigned. The authors acknowledge the movement away from placing compounds into categories and, while not yet universal, the importance of basing QRMPs on compound-specific ADEs and risk assessments. Based on the results of a risk assessment, segregation and dedication may also be required for some compounds to prevent cross contamination during manufacture of APIs. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Professor Created On-line Biology Laboratory Course

    Science.gov (United States)

    Bowman, Arthur W.

    2010-01-01

    This paper will share the creation, implementation, and modification of an online college level general biology laboratory course offered for non-science majors as a part of a General Education Curriculum. The ability of professors to develop quality online laboratories will address a growing need in Higher Education as more institutions combine course sections and look for suitable alternative course delivery formats due to declining departmental budgets requiring reductions in staffing, equipment, and supplies. Also, there is an equal or greater need for more professors to develop the ability to create online laboratory experiences because many of the currently available online laboratory course packages from publishers do not always adequately parallel on-campus laboratory courses, or are not as aligned with the companion lecture sections. From a variety of scientific simulation and animation web sites, professors can easily identify material that closely fit the specific needs of their courses, instructional environment, and students that they serve. All too often, on-campus laboratory courses in the sciences provide what are termed confirmation experiences that do NOT allow students to experience science as would be carried out by scientists. Creatively developed online laboratory experiences can often provide the type of authentic investigative experiences that are not possible on-campus due to the time constraints of a typical two-hour, once-per-week-meeting laboratory course. In addition, online laboratory courses can address issues related to the need for students to more easily complete missing laboratory assignments, and to have opportunities to extend introductory exercises into more advanced undertakings where a greater sense of scientific discovery can be experienced. Professors are strongly encourages to begin creating online laboratory exercises for their courses, and to consider issues regarding assessment, copyrights, and Intellectual Property

  2. Secondary calibration laboratory for ionizing radiation laboratory accreitation program National Institute of Standards and Technology National Voluntary Laboratory Accreditation Program

    Energy Technology Data Exchange (ETDEWEB)

    Martin, P.R.

    1993-12-31

    This paper presents an overview of the procedures and requirements for accreditation under the Secondary Calibration Laboratory for Ionizing Radiation Program (SCLIR LAP). The requirements for a quality system, proficiency testing and the onsite assessment are discussed. The purpose of the accreditation program is to establish a network of secondary calibration laboratories that can provide calibrations traceable to the primary national standards.

  3. Secondary calibration laboratory for ionizing radiation laboratory accreitation program National Institute of Standards and Technology National Voluntary Laboratory Accreditation Program

    International Nuclear Information System (INIS)

    Martin, P.R.

    1993-01-01

    This paper presents an overview of the procedures and requirements for accreditation under the Secondary Calibration Laboratory for Ionizing Radiation Program (SCLIR LAP). The requirements for a quality system, proficiency testing and the onsite assessment are discussed. The purpose of the accreditation program is to establish a network of secondary calibration laboratories that can provide calibrations traceable to the primary national standards

  4. Analytical performance evaluation of a high-volume hematology laboratory utilizing sigma metrics as standard of excellence.

    Science.gov (United States)

    Shaikh, M S; Moiz, B

    2016-04-01

    Around two-thirds of important clinical decisions about the management of patients are based on laboratory test results. Clinical laboratories are required to adopt quality control (QC) measures to ensure provision of accurate and precise results. Six sigma is a statistical tool, which provides opportunity to assess performance at the highest level of excellence. The purpose of this study was to assess performance of our hematological parameters on sigma scale in order to identify gaps and hence areas of improvement in patient care. Twelve analytes included in the study were hemoglobin (Hb), hematocrit (Hct), red blood cell count (RBC), mean corpuscular volume (MCV), red cell distribution width (RDW), total leukocyte count (TLC) with percentages of neutrophils (Neutr%) and lymphocytes (Lymph %), platelet count (Plt), mean platelet volume (MPV), prothrombin time (PT), and fibrinogen (Fbg). Internal quality control data and external quality assurance survey results were utilized for the calculation of sigma metrics for each analyte. Acceptable sigma value of ≥3 was obtained for the majority of the analytes included in the analysis. MCV, Plt, and Fbg achieved value of performed poorly on both level 1 and 2 controls with sigma value of <3. Despite acceptable conventional QC tools, application of sigma metrics can identify analytical deficits and hence prospects for the improvement in clinical laboratories. © 2016 John Wiley & Sons Ltd.

  5. Clinical pharmacology quality assurance program: models for longitudinal analysis of antiretroviral proficiency testing for international laboratories.

    Science.gov (United States)

    DiFrancesco, Robin; Rosenkranz, Susan L; Taylor, Charlene R; Pande, Poonam G; Siminski, Suzanne M; Jenny, Richard W; Morse, Gene D

    2013-10-01

    Among National Institutes of Health HIV Research Networks conducting multicenter trials, samples from protocols that span several years are analyzed at multiple clinical pharmacology laboratories (CPLs) for multiple antiretrovirals. Drug assay data are, in turn, entered into study-specific data sets that are used for pharmacokinetic analyses, merged to conduct cross-protocol pharmacokinetic analysis, and integrated with pharmacogenomics research to investigate pharmacokinetic-pharmacogenetic associations. The CPLs participate in a semiannual proficiency testing (PT) program implemented by the Clinical Pharmacology Quality Assurance program. Using results from multiple PT rounds, longitudinal analyses of recovery are reflective of accuracy and precision within/across laboratories. The objectives of this longitudinal analysis of PT across multiple CPLs were to develop and test statistical models that longitudinally: (1) assess the precision and accuracy of concentrations reported by individual CPLs and (2) determine factors associated with round-specific and long-term assay accuracy, precision, and bias using a new regression model. A measure of absolute recovery is explored as a simultaneous measure of accuracy and precision. Overall, the analysis outcomes assured 97% accuracy (±20% of the final target concentration of all (21) drug concentration results reported for clinical trial samples by multiple CPLs). Using the Clinical Laboratory Improvement Act acceptance of meeting criteria for ≥2/3 consecutive rounds, all 10 laboratories that participated in 3 or more rounds per analyte maintained Clinical Laboratory Improvement Act proficiency. Significant associations were present between magnitude of error and CPL (Kruskal-Wallis P Kruskal-Wallis P < 0.001).

  6. LEGO plot for simultaneous application of multiple quality requirements during trueness verification of quantitative laboratory tests.

    Science.gov (United States)

    Park, Hae-il; Chae, Hyojin; Kim, Myungshin; Lee, Jehoon; Kim, Yonggoo

    2014-03-01

    We developed a two-dimensional plot for viewing trueness that takes into account potential shift and variable quality requirements to verify trueness using certified reference material (CRM). Glucose, total cholesterol (TC), and creatinine levels were determined by two kinds of assay in two levels of a CRM. Available quality requirements were collected, codified, and sorted in an ascending order in the plot's header row. Centering on the mean of measured values from CRM, the "mean ± US CLIA '88 allowable total error" was located in the header of the leftmost and rightmost columns. Twenty points were created in intervening columns as potential shifts. Uncertainties were calculated according to regression between certified values and uncertainties of CRM, and positioned in the corresponding columns. Cells were assigned different colors where column and row intersected based on comparison of the 95% confidence interval of the percentage bias with each quality requirement. A glucose assay failed to meet the highest quality criteria, for which shift of +0.13-0.14 mmol/l was required. A TC assay met the quality requirement and a shift of ±0.03 mmol/l was tolerable. A creatinine assay also met the quality requirement but any shift was not tolerable. The plot provides a systematic view of the trueness of quantitative laboratory tests. © 2014 Wiley Periodicals, Inc.

  7. [Accreditation of medical laboratories].

    Science.gov (United States)

    Horváth, Andrea Rita; Ring, Rózsa; Fehér, Miklós; Mikó, Tivadar

    2003-07-27

    official acceptance of ISO 15189 the clauses of this harmonized guideline fulfill the requirements of the new international standard as well. Accreditation of medical laboratories in Hungary may not only facilitate quality improvement of laboratory services, but also the development of a quality-based purchasing and reimbursement policy of the health insurance fund.

  8. Crystal quality analysis and improvement using x-ray topography

    International Nuclear Information System (INIS)

    Maj, J.; Goetze, K.; Macrander, A.; Zhong, Y.; Huang, X.; Maj, L.

    2008-01-01

    The Topography X-ray Laboratory of the Advanced Photon Source (APS) at Argonne National Laboratory operates as a collaborative effort with APS users to produce high performance crystals for APS X-ray beamline experiments. For many years the topography laboratory has worked closely with an on-site optics shop to help ensure the production of crystals with the highest quality, most stress-free surface finish possible. It has been instrumental in evaluating and refining methods used to produce high quality crystals. Topographical analysis has shown to be an effective method to quantify and determine the distribution of stresses, to help identify methods that would mitigate the stresses and improve the Rocking curve, and to create CCD images of the crystal. This paper describes the topography process and offers methods for reducing crystal stresses in order to substantially improve the crystal optics.

  9. Model for selecting quality standards for a salad bar through identifying elements of customer satisfaction.

    Science.gov (United States)

    Ouellet, D; Norback, J P

    1993-11-01

    Continuous quality improvement is the new requirement of the Joint Commission on Accreditation of Healthcare Organizations. This means that meeting quality standards will not be enough. Dietitians will need to improve those standards and the way they are selected. Because quality is defined in terms of the customers, all quality improvement projects must start by defining what customers want. Using a salad bar as an example, this article presents and illustrates a technique developed in Japan to identify which elements in a product or service will satisfy or dissatisfy consumers. Using a model and a questionnaire format developed by Kano and coworkers, 273 students were surveyed to classify six quality elements of a salad bar. Four elements showed a dominant "must-be" characteristic: food freshness, labeling of the dressings, no spills in the food, and no spills on the salad bar. The two other elements (food easy to reach and food variety) showed a dominant one-dimensional characteristic. By better understanding consumer perceptions of quality elements, foodservice managers can select quality standards that focus on what really matters to their consumers.

  10. Technical baseline description for in situ vitrification laboratory test equipment

    International Nuclear Information System (INIS)

    Beard, K.V.; Bonnenberg, R.W.; Watson, L.R.

    1991-09-01

    IN situ vitrification (ISV) has been identified as possible waste treatment technology. ISV was developed by Pacific Northwest Laboratory (PNL), Richland, Washington, as a thermal treatment process to treat contaminated soils in place. The process, which electrically melts and dissolves soils and associated inorganic materials, simultaneously destroys and/or removes organic contaminants while incorporating inorganic contaminants into a stable, glass-like residual product. This Technical Baseline Description has been prepared to provide high level descriptions of the design of the Laboratory Test model, including all design modifications and safety improvements made to data. Furthermore, the Technical Baseline Description provides a basic overview of the interface documents for configuration management, program management interfaces, safety, quality, and security requirements. 8 figs

  11. Laboratory procedures for waste form testing

    International Nuclear Information System (INIS)

    Mast, E.S.

    1994-01-01

    The 100 and 300 areas of the Hanford Site are included on the US Environmental Protection Agencies (EPA) National Priorities List under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). Soil washing is a treatment process that is being considered for the remediation of the soil in these areas. Contaminated soil washing fines can be mixed or blended with cementations materials to produce stable waste forms that can be used for beneficial purposes in mixed or low-level waste landfills, burial trenches, environmental restoration sites, and other applications. This process has been termed co-disposal. The Co-Disposal Treatability Study Test Plan is designed to identify a range of cement-based formulations that could be used in disposal efforts in Hanford in co-disposal applications. The purpose of this document is to provide explicit procedural information for the testing of co-disposal formulations. This plan also provides a discussion of laboratory safety and quality assurance necessary to ensure safe, reproducible testing in the laboratory

  12. Laboratory procedures for waste form testing

    Energy Technology Data Exchange (ETDEWEB)

    Mast, E.S.

    1994-09-19

    The 100 and 300 areas of the Hanford Site are included on the US Environmental Protection Agencies (EPA) National Priorities List under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). Soil washing is a treatment process that is being considered for the remediation of the soil in these areas. Contaminated soil washing fines can be mixed or blended with cementations materials to produce stable waste forms that can be used for beneficial purposes in mixed or low-level waste landfills, burial trenches, environmental restoration sites, and other applications. This process has been termed co-disposal. The Co-Disposal Treatability Study Test Plan is designed to identify a range of cement-based formulations that could be used in disposal efforts in Hanford in co-disposal applications. The purpose of this document is to provide explicit procedural information for the testing of co-disposal formulations. This plan also provides a discussion of laboratory safety and quality assurance necessary to ensure safe, reproducible testing in the laboratory.

  13. Nonanalytic Laboratory Automation: A Quarter Century of Progress.

    Science.gov (United States)

    Hawker, Charles D

    2017-06-01

    Clinical laboratory automation has blossomed since the 1989 AACC meeting, at which Dr. Masahide Sasaki first showed a western audience what his laboratory had implemented. Many diagnostics and other vendors are now offering a variety of automated options for laboratories of all sizes. Replacing manual processing and handling procedures with automation was embraced by the laboratory community because of the obvious benefits of labor savings and improvement in turnaround time and quality. Automation was also embraced by the diagnostics vendors who saw automation as a means of incorporating the analyzers purchased by their customers into larger systems in which the benefits of automation were integrated to the analyzers.This report reviews the options that are available to laboratory customers. These options include so called task-targeted automation-modules that range from single function devices that automate single tasks (e.g., decapping or aliquoting) to multifunction workstations that incorporate several of the functions of a laboratory sample processing department. The options also include total laboratory automation systems that use conveyors to link sample processing functions to analyzers and often include postanalytical features such as refrigerated storage and sample retrieval.Most importantly, this report reviews a recommended process for evaluating the need for new automation and for identifying the specific requirements of a laboratory and developing solutions that can meet those requirements. The report also discusses some of the practical considerations facing a laboratory in a new implementation and reviews the concept of machine vision to replace human inspections. © 2017 American Association for Clinical Chemistry.

  14. Environmental analytical laboratory setup operation and QA/QC

    International Nuclear Information System (INIS)

    Hsu, J.P.; Boyd, J.A.; DeViney, S.

    1991-01-01

    Environmental analysis requires precise and timely measurements. The required precise measurement is ensured with quality control and timeliness through an efficient operation. The efficiency of the operation also ensures cost-competitiveness. Environmental analysis plays a very important role in the environmental protection program. Due to the possible litigation involvement, most environmental analyses follow stringent criteria, such as the U.S. EPA Contract Laboratory Program procedures with analytical results documented in an orderly manner. The documentation demonstrates that all quality control steps are followed and facilitates data evaluation to determine the quality and usefulness of the data. Furthermore, the tedious documents concerning sample checking, chain-of-custody, standard or surrogate preparation, daily refrigerator and oven temperature monitoring, analytical and extraction logbooks, standard operation procedures, etc., also are an important part of the laboratory documentation. Quality control for environmental analysis is becoming more stringent, required documentation is becoming more detailed and turnaround time is shorter. However, the business is becoming more cost-competitive and it appears that this trend will continue. In this paper, we discuss what should be done to deal this high quality, fast-paced and tedious environmental analysis process at a competitive cost. The success of environmental analysis is people. The knowledge and experience of the staff are the key to a successful environmental analysis program. In order to be successful in this new area, the ability to develop new methods is crucial. In addition, the laboratory information system, laboratory automation and quality assurance/quality control (QA/QC) are major factors for laboratory success. This paper concentrates on these areas

  15. Strengthening public health laboratory capacity in Thailand for International Health Regulations (IHR) (2005).

    Science.gov (United States)

    Peruski, Anne Harwood; Birmingham, Maureen; Tantinimitkul, Chawalit; Chungsamanukool, Ladawan; Chungsamanukool, Preecha; Guntapong, Ratigorn; Pulsrikarn, Chaiwat; Saengklai, Ladapan; Supawat, Krongkaew; Thattiyaphong, Aree; Wongsommart, Duangdao; Wootta, Wattanapong; Nikiema, Abdoulaye; Pierson, Antoine; Peruski, Leonard F; Liu, Xin; Rayfield, Mark A

    2014-07-01

    Thailand conducted a national laboratory assessment of core capacities related to the International Health Regulations (IHR) (2005), and thereby established a baseline to measure future progress. The assessment was limited to public laboratories found within the Thai Bureau of Quality and Safety of Food, National Institute of Health and regional medical science centres. The World Health Organization (WHO) laboratory assessment tool was adapted to Thailand through a participatory approach. This adapted version employed a specific scoring matrix and comprised 16 modules with a quantitative output. Two teams jointly performed the on-site assessments in December 2010 over a two-week period, in 17 public health laboratories in Thailand. The assessment focused on the capacity to identify and accurately detect pathogens mentioned in Annex 2 of the IHR (2005) in a timely manner, as well as other public health priority pathogens for Thailand. Performance of quality management, budget and finance, data management and communications was considered strong (>90%); premises quality, specimen collection, biosafety, public health functions, supplies management and equipment availability were judged as very good (>70% but ≤90%); while microbiological capacity, staffing, training and supervision, and information technology needed improvement (>60% but ≤70%). This assessment is a major step in Thailand towards development of an optimized and standardized national laboratory network for the detection and reporting of infectious disease that would be compliant with IHR (2005). The participatory strategy employed to adapt an international tool to the Thai context can also serve as a model for use by other countries in the Region. The participatory approach probably ensured better quality and ownership of the results, while providing critical information to help decision-makers determine where best to invest finite resources.

  16. Application of sigma metrics for the assessment of quality control in clinical chemistry laboratory in Ghana: A pilot study.

    Science.gov (United States)

    Afrifa, Justice; Gyekye, Seth A; Owiredu, William K B A; Ephraim, Richard K D; Essien-Baidoo, Samuel; Amoah, Samuel; Simpong, David L; Arthur, Aaron R

    2015-01-01

    Sigma metrics provide a uniquely defined scale with which we can assess the performance of a laboratory. The objective of this study was to assess the internal quality control (QC) in the clinical chemistry laboratory of the University of Cape Cost Hospital (UCC) using the six sigma metrics application. We used commercial control serum [normal (L1) and pathological (L2)] for validation of quality control. Metabolites (glucose, urea, and creatinine), lipids [triglycerides (TG), total cholesterol, high-density lipoprotein cholesterol (HDL-C)], enzymes [alkaline phosphatase (ALP), alanine aminotransferase (AST)], electrolytes (sodium, potassium, chloride) and total protein were assessed. Between-day imprecision (CVs), inaccuracy (Bias) and sigma values were calculated for each control level. Apart from sodium (2.40%, 3.83%), chloride (2.52% and 2.51%) for both L1 and L2 respectively, and glucose (4.82%), cholesterol (4.86%) for L2, CVs for all other parameters (both L1 and L2) were >5%. Four parameters (HDL-C, urea, creatinine and potassium) achieved sigma levels >1 for both controls. Chloride and sodium achieved sigma levels >1 for L1 but sigma levels 1 for L2. Glucose and ALP achieved a sigma level >1 for both control levels whereas TG achieved a sigma level >2 for both control levels. Unsatisfactory sigma levels (six sigma levels for the laboratory.

  17. Qualification of testing laboratories of Comision Nacional de Energia Atomica - CNEA

    International Nuclear Information System (INIS)

    Casa, Adriana; Palacios, Tulio; Peretti, Matilde; Pucci, Gladys; Resnizki, Sara

    1996-01-01

    Testing and calibration laboratories of the Argentine Atomic Energy Commission which made services for the nuclear and conventional industries must prove the reliability of their results. It is achieved implanting at the laboratories, a management quality system, to proof the capacity and technical aptitude, with the establish minimal requirements. When the requirement are fulfilled, the laboratory would be in conditions for a national level accreditation within the National System of Standards, Quality and Certification, recently created for our national government. The Laboratories Calibration Board of CNEA had made some assessments of a group of laboratories in order to determine their quality level. (author)

  18. Risk assessment and quality improvement of liquid waste management in Taiwan University chemical laboratories.

    Science.gov (United States)

    Ho, Chao-Chung; Chen, Ming-Shu

    2018-01-01

    The policy of establishing new universities across Taiwan has led to an increase in the number of universities, and many schools have constructed new laboratories to meet students' academic needs. In recent years, there has been an increase in the number of laboratory accidents from the liquid waste in universities. Therefore, how to build a safety system for laboratory liquid waste disposal has become an important issue in the environmental protection, safety, and hygiene of all universities. This study identifies the risk factors of liquid waste disposal and presents an agenda for practices to laboratory managers. An expert questionnaire is adopted to probe into the risk priority procedures of liquid waste disposal; then, the fuzzy theory-based FMEA method and the traditional FMEA method are employed to analyze and improve the procedures for liquid waste disposal. According to the research results, the fuzzy FMEA method is the most effective, and the top 10 potential disabling factors are prioritized for improvement according to the risk priority number (RNP), including "Unclear classification", "Gathering liquid waste without a funnel or a drain pan", "Lack of a clearance and transport contract", "Liquid waste spill during delivery", "Spill over", "Decentralized storage", "Calculating weight in the wrong way", "Compatibility between the container material and the liquid waste", "Lack of dumping and disposal tools", and "Lack of a clear labels for liquid waste containers". After tracking improvements, the overall improvement rate rose to 60.2%. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Concrete laying laboratory

    International Nuclear Information System (INIS)

    Bastlova, K.

    1986-01-01

    The task of the concrete laying laboratory established within a special department for quality control and assurance at the Dukovany nuclear power plant, is to check the composition of concrete mixes produced by the central concrete production plant on the site, and the shipment, laying and processing of concrete. The composition is given of special barite and serpentinite concretes designed for biological shields. The system of checks and of filing the results is briefly described. Esperience is summed up from the operation of the concrete laying laboratory, and conclusions are formulated which should be observed on similar large construction sites. They include the precise definition of the designer's requirements for the quality of concrete, the surface finish of concrete surfaces, the method of concreting specific structures around bushings, increased density reinforcements and various technological elements, and requirements for shipment to poorly accessible or remote places. As for the equipment of the laboratory, it should be completed with an instrument for the analysis of fresh concrete mixes, a large capacity drying kiln, etc. (Z.M.)

  20. Report on the analysis of the quality assurance and quality control data for the petroleum refining sector

    International Nuclear Information System (INIS)

    Thorton, N.; Michajluk, S.; Powell, T.; Lee, G.

    1992-07-01

    The Ontario Municipal-Industrial Strategy for Abatement (MISA) program has the ultimate goal of virtual elimination of persistent toxic contaminants from all discharges to provincial waterways. MISA effluent monitoring regulations, first promulgated for the petroleum refining sector, require direct dischargers to monitor their effluents for a specified number of contaminants and a specified frequency over a one-year period. The refineries were also required to carry out a quality control program on all process effluent streams and for specified analytical test groups. Two types of quality assurance/quality control (QA/QC) data were required: field QA/QC, which would indicate problems with field contamination or sampling, and laboratory QA/QC, which would indicate problems with the laboratory. The objectives of QA/QC analysis are to identify the significance of biases, chronic contamination, data variability, and false results, to assess data validity, and to allow data comparability among companies and laboratories. Of the 149 parameters monitored in the petroleum refining sector, 34 qualified as candidates for setting effluent limits. The QA/QC evaluation of monitoring data for the 34 parameters confirmed the presence of 18 parameters at such levels that they could be used to set statistically valid quantitative limits. 50 tabs

  1. Implementation of a new 'community' laboratory CD4 service in a rural health district in South Africa extends laboratory services and substantially improves local reporting turnaround time.

    Science.gov (United States)

    Coetzee, L M; Cassim, N; Glencross, D K

    2015-12-16

    The CD4 integrated service delivery model (ITSDM) provides for reasonable access to pathology services across South Africa (SA) by offering three new service tiers that extend services into remote, under-serviced areas. ITSDM identified Pixley ka Seme as such an under-serviced district. To address the poor service delivery in this area, a new ITSDM community (tier 3) laboratory was established in De Aar, SA. Laboratory performance and turnaround time (TAT) were monitored post implementation to assess the impact on local service delivery. Using the National Health Laboratory Service Corporate Data Warehouse, CD4 data were extracted for the period April 2012-July 2013 (n=11,964). Total mean TAT (in hours) was calculated and pre-analytical and analytical components assessed. Ongoing testing volumes, as well as external quality assessment performance across ten trials, were used to indicate post-implementation success. Data were analysed using Stata 12. Prior to the implementation of CD4 testing at De Aar, the total mean TAT was 20.5 hours. This fell to 8.2 hours post implementation, predominantly as a result of a lower pre-analytical mean TAT reducing from a mean of 18.9 to 1.8 hours. The analytical testing TAT remained unchanged after implementation and monthly test volumes increased by up to 20%. External quality assessment indicated adequate performance. Although subjective, questionnaires sent to facilities reported improved service delivery. Establishing CD4 testing in a remote community laboratory substantially reduces overall TAT. Additional community CD4 laboratories should be established in under-serviced areas, especially where laboratory infrastructure is already in place.

  2. Up-to-date laboratory methods for assessing the safety of perfumery and cosmetic products in the quality assurance system of the Russian Federation

    Directory of Open Access Journals (Sweden)

    A. V. Rezaykina

    2016-01-01

    Full Text Available Most of the developed countries as well as Russian Federation have a dynamically developing quality assurance system for testing the quality of laboratory tests and safety of perfumery and cosmetic products entering the market comprising a regulatory and legal framework, physical infrastructure and appropriate methodical basis and staff. At the same time, it is necessary to develop alternative test methods adjusted to perfumery and cosmetic products on a regular basis. In addition, it is necessary to optimize methods for ensuring standard sample preparation conditions in response to new forms of cosmetic products when determining microbiological, physical, chemical and toxicological characteristics, and more accurate observation methods for clinical and laboratory indices to be approved by supervising authorities.

  3. Quality Assurance in Nuclear Fuel Research at the Laboratory of High- and Medium-level Activity at SCK-CEN

    Energy Technology Data Exchange (ETDEWEB)

    Sannen, L.; Gys, A.; Verwerft, M

    1999-10-01

    Quality assurance in nuclear fuel research demands specific calibration and validation methodologies. Indeed the analytical experiments in hot-cells on highly radioactive objects are non-standard and many times unique. The standards and validation methods developed for and applied to the main nuclear fuel research experiments in the hot laboratories of the Belgian Nuclear Research Centre SCK-CEN are outlined.

  4. Quality Assurance in Nuclear Fuel Research at the Laboratory of High- and Medium-level Activity at SCK-CEN

    International Nuclear Information System (INIS)

    Sannen, L.; Gys, A.; Verwerft, M.

    1999-10-01

    Quality assurance in nuclear fuel research demands specific calibration and validation methodologies. Indeed the analytical experiments in hot-cells on highly radioactive objects are non-standard and many times unique. The standards and validation methods developed for and applied to the main nuclear fuel research experiments in the hot laboratories of the Belgian Nuclear Research Centre SCK-CEN are outlined

  5. Identifying and classifying quality-of-life tools for assessing pressure ulcers after spinal cord injury

    Science.gov (United States)

    Hitzig, Sander L.; Balioussis, Christina; Nussbaum, Ethne; McGillivray, Colleen F.; Catharine Craven, B.; Noreau, Luc

    2013-01-01

    Context Although pressure ulcers may negatively influence quality of life (QoL) post-spinal cord injury (SCI), our understanding of how to assess their impact is confounded by conceptual and measurement issues. To ensure that descriptions of pressure ulcer impact are appropriately characterized, measures should be selected according to the domains that they evaluate and the population and pathologies for which they are designed. Objective To conduct a systematic literature review to identify and classify outcome measures used to assess the impact of pressure ulcers on QoL after SCI. Methods Electronic databases (Medline/PubMed, CINAHL, and PsycInfo) were searched for studies published between 1975 and 2011. Identified outcome measures were classified as being either subjective or objective using a QoL model. Results Fourteen studies were identified. The majority of tools identified in these studies did not have psychometric evidence supporting their use in the SCI population with the exception of two objective measures, the Short-Form 36 and the Craig Handicap Assessment and Reporting Technique, and two subjective measures, the Life Situation Questionnaire-Revised and the Ferrans and Powers Quality of Life Index SCI-Version. Conclusion Many QoL outcome tools showed promise in being sensitive to the presence of pressure ulcers, but few of them have been validated for use with SCI. Prospective studies should employ more rigorous methods for collecting data on pressure ulcer severity and location to improve the quality of findings with regard to their impact on QoL. The Cardiff Wound Impact Schedule is a potential tool for assessing impact of pressure ulcers-post SCI. PMID:24090238

  6. An inter-laboratory comparison of arsenic analysis in Bangladesh. Draft report

    International Nuclear Information System (INIS)

    Aggarwal, P.K.; Dargie, M.; Groening, M.; Kulkarni, K.M.; Gibson, J.J.

    2001-03-01

    The International Atomic Energy Agency (IAEA) conducted an evaluation of the quality of arsenic analysis in Bangladesh through an inter-laboratory comparison of the analysis of synthetic standards and field samples. A set of 8 synthetic standards with arsenic concentrations ranging from 0 to about 500 μg/kg, traceable to an internationally recognized standard solution of arsenic, were prepared by the IAEA and provided to the participating laboratories. In addition, two samples of drinking water were collected from near Dhaka by the local office of the World Health Organization (WHO) and provided to all participating laboratories and the IAEA for analysis. Out of the 25 laboratories who received the synthetic standards and field samples, 17 laboratories submitted results to the IAEA for comparison. The reported arsenic concentrations have a wide range with values much higher or much lower than the expected value. Analysis of field samples shows a range of values from 0 to 396 μg/kg. Less than one third of the participating laboratories obtained results that were within about 20% of the expected values (about 60 μg/kg) obtained by a laboratory cooperating with the IAEA (University of Rochester). Results of this inter-laboratory comparison point to a lack of consistency in the analytical results that have been and are being obtained in Bangladesh. More importantly, drinking water wells where elevated arsenic concentrations have been found may in fact have low concentrations. Similarly, wells that have been found to be free of arsenic may in fact have substantially higher arsenic concentrations. The quality and reliability of arsenic analysis needs to be established and continually evaluated in order to identify all affected areas and to provide appropriate mitigation

  7. Performance audits and laboratory comparisons for SCOS97-NARSTO measurements of speciated volatile organic compounds

    Science.gov (United States)

    Fujita, Eric M.; Harshfield, Gregory; Sheetz, Laurence

    Performance audits and laboratory comparisons were conducted as part of the quality assurance program for the 1997 Southern California Ozone Study (SCOS97-NARSTO) to document potential measurement biases among laboratories measuring speciated nonmethane hydrocarbons (NMHC), carbonyl compounds, halogenated compounds, and biogenic hydrocarbons. The results show that measurements of volatile organic compounds (VOC) made during SCOS97-NARSTO are generally consistent with specified data quality objectives. The hydrocarbon comparison involved nine laboratories and consisted of two sets of collocated ambient samples. The coefficients of variation among laboratories for the sum of the 55 PAM target compounds and total NMHC ranged from ±5 to 15 percent for ambient samples from Los Angeles and Azusa. Abundant hydrocarbons are consistently identified by all laboratories, but discrepancies occur for olefins greater than C 4 and for hydrocarbons greater than C 8. Laboratory comparisons for halogenated compounds and biogenic hydrocarbons consisted of both concurrent ambient sampling by different laboratories and round-robin analysis of ambient samples. The coefficients of variation among participating laboratories were about 10-20 percent. Performance audits were conducted for measurement of carbonyl compounds involving sampling from a standard mixture of carbonyl compounds. The values reported by most of the laboratories were within 10-20 percent of those of the reference laboratory. Results of field measurement comparisons showed larger variations among the laboratories ranging from 20 to 40 percent for C 1-C 3 carbonyl compounds. The greater variations observed in the field measurement comparison may reflect potential sampling artifacts, which the performance audits did not address.

  8. Routine internal- and external-quality control data in clinical laboratories for estimating measurement and diagnostic uncertainty using GUM principles.

    Science.gov (United States)

    Magnusson, Bertil; Ossowicki, Haakan; Rienitz, Olaf; Theodorsson, Elvar

    2012-05-01

    Healthcare laboratories are increasingly joining into larger laboratory organizations encompassing several physical laboratories. This caters for important new opportunities for re-defining the concept of a 'laboratory' to encompass all laboratories and measurement methods measuring the same measurand for a population of patients. In order to make measurement results, comparable bias should be minimized or eliminated and measurement uncertainty properly evaluated for all methods used for a particular patient population. The measurement as well as diagnostic uncertainty can be evaluated from internal and external quality control results using GUM principles. In this paper the uncertainty evaluations are described in detail using only two main components, within-laboratory reproducibility and uncertainty of the bias component according to a Nordtest guideline. The evaluation is exemplified for the determination of creatinine in serum for a conglomerate of laboratories both expressed in absolute units (μmol/L) and relative (%). An expanded measurement uncertainty of 12 μmol/L associated with concentrations of creatinine below 120 μmol/L and of 10% associated with concentrations above 120 μmol/L was estimated. The diagnostic uncertainty encompasses both measurement uncertainty and biological variation, and can be estimated for a single value and for a difference. This diagnostic uncertainty for the difference for two samples from the same patient was determined to be 14 μmol/L associated with concentrations of creatinine below 100 μmol/L and 14 % associated with concentrations above 100 μmol/L.

  9. Building laboratory capacity to support HIV care in Nigeria: Harvard/APIN PEPFAR, 2004-2012.

    Science.gov (United States)

    Hamel, Donald J; Sankalé, Jean-Louis; Samuels, Jay Osi; Sarr, Abdoulaye D; Chaplin, Beth; Ofuche, Eke; Meloni, Seema T; Okonkwo, Prosper; Kanki, Phyllis J

    From 2004-2012, the Harvard/AIDS Prevention Initiative in Nigeria, funded through the US President's Emergency Plan for AIDS Relief programme, scaled up HIV care and treatment services in Nigeria. We describe the methodologies and collaborative processes developed to improve laboratory capacity significantly in a resource-limited setting. These methods were implemented at 35 clinic and laboratory locations. Systems were established and modified to optimise numerous laboratory processes. These included strategies for clinic selection and management, equipment and reagent procurement, supply chains, laboratory renovations, equipment maintenance, electronic data management, quality development programmes and trainings. Over the eight-year programme, laboratories supported 160 000 patients receiving HIV care in Nigeria, delivering over 2.5 million test results, including regular viral load quantitation. External quality assurance systems were established for CD4+ cell count enumeration, blood chemistries and viral load monitoring. Laboratory equipment platforms were improved and standardised and use of point-of-care analysers was expanded. Laboratory training workshops supported laboratories toward increasing staff skills and improving overall quality. Participation in a World Health Organisation-led African laboratory quality improvement system resulted in significant gains in quality measures at five laboratories. Targeted implementation of laboratory development processes, during simultaneous scale-up of HIV treatment programmes in a resource-limited setting, can elicit meaningful gains in laboratory quality and capacity. Systems to improve the physical laboratory environment, develop laboratory staff, create improvements to reduce costs and increase quality are available for future health and laboratory strengthening programmes. We hope that the strategies employed may inform and encourage the development of other laboratories in resource-limited settings.

  10. Identifying Assets Associated with Quality Extension Programming at the Local Level

    Directory of Open Access Journals (Sweden)

    Amy Harder

    2017-10-01

    Full Text Available County Extension offices are responsible for the majority of programming delivered in the United States. The purpose of this study was to identify and explore assets influencing the quality of county Extension programs. A basic qualitative research design was followed to conduct constant comparative analysis of five Extension county program review reports. Using the appreciative inquiry process as the lens through which to view the county program review reports revealed multiple assets leading to quality programming. Assets of the reviewed county Extension programs were found to cluster within the following themes: competent and enthusiastic Extension faculty, community partnerships, engaged and supportive stakeholders, effective resource management, sufficient and stable workforce, meeting stakeholder needs, positive reputation, access to facilities, positive relationships between county and state faculty, and innovative practices. The use of both needs-based and assets-based paradigms will provide Extension organizations with a more holistic understanding of its assets and a research-based foundation from which to make decisions about strengthening the organization at all levels.

  11. Assembly and evaluation of an inventory of guidelines that are available to support clinical hematology laboratory practice.

    Science.gov (United States)

    Hayward, C P M; Moffat, K A; George, T I; Proytcheva, M

    2015-05-01

    Practice guidelines provide helpful support for clinical laboratories. Our goal was to assemble an inventory of publically listed guidelines on hematology laboratory topics, to create a resource for laboratories and for assessing gaps in practice-focused guidelines. PubMed and website searches were conducted to assemble an inventory of hematology laboratory-focused guidelines. Exclusions included annual, technical, or collaborative study reports, clinically focused guidelines, position papers, nomenclature, and calibration documents. Sixty-eight guidelines were identified on hematology laboratory practice topics from 12 organizations, some as joint guidelines. The median year of publication was 2010 and 15% were >10 years old. Coagulation topics had the largest numbers of guidelines, whereas some areas of practice had few guidelines. A minority of guidelines showed evidence of periodic updates, as some organizations did not remove or identify outdated guidelines. This inventory of current practice guidelines will encourage awareness and uptake of guideline recommendations by the worldwide hematology laboratory community, with the International Society for Laboratory Hematology facilitating ongoing updates. There is a need to encourage best guideline development practices, to ensure that hematology laboratory community has current, high-quality, and evidence-based practice guidelines that cover the full scope of hematology laboratory practice. © 2015 John Wiley & Sons Ltd.

  12. Design of a Quality Control Program for the Measurement of Gross Alpha and Gross Beta Activities (LMPR-CIEMAT)

    International Nuclear Information System (INIS)

    Alvarez, A.; Yague, L.; Gasco, C.; Navarro, N.; Higueras, E.; Noguerales, C.

    2010-01-01

    In accordance with international standards, general requirements for testing laboratories have to include a quality system for planning, implementing, and assessing the work performed by the organization and for carrying out required quality assurance and quality control. The purpose of internal laboratory quality control is to monitor performance, identify problems, and initiate corrective actions. This report describes the internal quality control to monitor the gross alpha and beta activities determination. Identification of specific performance indicators, the principles that govern their use and statistical means of evaluation are explained. Finally, calculation of alpha and beta specific activities, uncertainties and detection limits are performed. (Author) 10 refs.

  13. SALE, Quality Control of Analytical Chemical Measurements

    International Nuclear Information System (INIS)

    Bush, W.J.; Gentillon, C.D.

    1985-01-01

    1 - Description of problem or function: The Safeguards Analytical Laboratory Evaluation (SALE) program is a statistical analysis program written to analyze the data received from laboratories participating in the SALE quality control and evaluation program. The system is aimed at identifying and reducing analytical chemical measurement errors. Samples of well-characterized materials are distributed to laboratory participants at periodic intervals for determination of uranium or plutonium concentration and isotopic distributions. The results of these determinations are statistically evaluated and participants are informed of the accuracy and precision of their results. 2 - Method of solution: Various statistical techniques produce the SALE output. Assuming an unbalanced nested design, an analysis of variance is performed, resulting in a test of significance for time and analyst effects. A trend test is performed. Both within- laboratory and between-laboratory standard deviations are calculated. 3 - Restrictions on the complexity of the problem: Up to 1500 pieces of data for each nuclear material sampled by a maximum of 75 laboratories may be analyzed

  14. Internal Quality Control Practices in Coagulation Laboratories: recommendations based on a patterns-of-practice survey.

    Science.gov (United States)

    McFarlane, A; Aslan, B; Raby, A; Moffat, K A; Selby, R; Padmore, R

    2015-12-01

    Internal quality control (IQC) procedures are crucial for ensuring accurate patient test results. The IQMH Centre for Proficiency Testing conducted a web-based survey to gather information on the current IQC practices in coagulation testing. A questionnaire was distributed to 174 Ontario laboratories licensed to perform prothrombin time (PT) and activated partial thromboplastin time (APTT). All laboratories reported using two levels of commercial QC (CQC); 12% incorporate pooled patient plasma into their IQC program; >68% run CQC at the beginning of each shift; 56% following maintenance, with reagent changes, during a shift, or with every repeat sample; 6% only run CQC at the beginning of the day and 25% when the instruments have been idle for a defined period of time. IQC run frequency was determined by manufacturer recommendations (71%) but also influenced by the stability of test (27%), clinical impact of an incorrect test result (25%), and sample's batch number (10%). IQC was monitored using preset limits based on standard deviation (66%), precision goals (46%), or allowable performance limits (36%). 95% use multirules. Failure actions include repeating the IQC (90%) and reporting patient results; if repeat passes, 42% perform repeat analysis of all patient samples from last acceptable IQC. Variability exists in coagulation IQC practices among Ontario clinical laboratories. The recommendations presented here would be useful in encouraging standardized IQC practices. © 2015 John Wiley & Sons Ltd.

  15. [Quality management in cardiovascular echography].

    Science.gov (United States)

    Gullace, Giuseppe

    2002-12-01

    The quality management of an organization can be defined as the ability to identify, plan and implement programs of measure, analysis, verification and control that allow to monitor management, resources, activities, processes and output/outcome of the same organization, including the satisfaction of the customers. Whatever the model used, it is demonstrated that the management-quality system, either for professional quality or for organization, turns out to be effective even in the health organizations within and to any level of organizational-structural complexity. The present paper concerns the experience of the Italian Society of Cardiovascular Echography (SIEC) on quality certification, both as a scientific society compared to other health organizations and to cardiovascular echo laboratories, and the definition of minimum requirements for the accreditation of the same laboratories. The model most frequently used for quality management is represented by the ISO 9000: Vision 2000, that is a management model with specific reference to the organization and the customer satisfaction. The model applied to the health structure needs a rapid change in mentality that addresses the operators to define, share and achieve objectives to be brought on by means of an active collaboration, group activity and deep sense of belonging necessary to the attainment of expected objectives. When the model is applied by a scientific society, it is necessary to take into account the different structural and functional organization, the constitution and the operators differing on the point of view of origin, experiences, mentality, and roles. The ISO 9000: Vision 2000 model can be applied also to the cardiovascular echo laboratory which may be compared to a simple organization; for its corrected functioning, SIEC has defined minimal requirements for the accreditation, realization and modalities to carry out and manage quality. The quality system represents a new way of operating of an

  16. Identifying organisational principles and management practices important to the quality of health care services for chronic conditions

    DEFF Research Database (Denmark)

    Frølich, Anne

    2012-01-01

    are limited, it is necessary to identify efficient methods to improve the quality of care. Comparing health care systems is a well-known method for identifying new knowledge regarding, for instance, organisational methods and principles. Kaiser Permanente (KP), an integrated health care delivery system...... in the U.S., is recognized as providing high-quality chronic care; to some extent, this is due to KP's implementation of the chronic care model (CCM). This model recommends a range of evidence-based management practices that support the implementation of evidence-based medicine. However, it is not clear...... which management practices in the CCM are most efficient and in what combinations. In addition, financial incentives and public reporting of performance are often considered effective at improving the quality of health care services, but this has not yet been definitively proved....

  17. Laboratory medicine in the European Union.

    Science.gov (United States)

    Oosterhuis, Wytze P; Zerah, Simone

    2015-01-01

    The profession of laboratory medicine differs between countries within the European Union (EU) in many respects. The objective of professional organizations of the promotion of mutual recognition of specialists within the EU is closely related to the free movement of people. This policy translates to equivalence of standards and harmonization of the training curriculum. The aim of the present study is the description of the organization and practice of laboratory medicine within the countries that constitute the EU. A questionnaire covering many aspects of the profession was sent to delegates of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and Union Européenne de Médecins Spécialistes (UEMS) of the 28 EU countries. Results were sent to the delegates for confirmation. Many differences between countries were identified: predominantly medical or scientific professionals; a broad or limited professional field of interest; inclusion of patient treatment; formal or absent recognition; a regulated or absent formal training program; general or minor application of a quality system based on ISO Norms. The harmonization of the postgraduate training of both clinical chemists and of laboratory physicians has been a goal for many years. Differences in the organization of the laboratory professions still exist in the respective countries which all have a long historical development with their own rationality. It is an important challenge to harmonize our profession, and difficult choices will need to be made. Recent developments with respect to the directive on Recognition of Professional Qualifications call for new initiatives to harmonize laboratory medicine both across national borders, and across the borders of scientific and medical professions.

  18. Strengthening systems for communicable disease surveillance: creating a laboratory network in Rwanda

    Directory of Open Access Journals (Sweden)

    Ndihokubwayo Jean B

    2011-06-01

    Full Text Available Abstract Background The recent emergence of a novel strain of influenza virus with pandemic potential underscores the need for quality surveillance and laboratory services to contribute to the timely detection and confirmation of public health threats. To provide a framework for strengthening disease surveillance and response capacities in African countries, the World Health Organization Regional Headquarters for Africa (AFRO developed Integrated Disease Surveillance and Response (IDSR aimed at improving national surveillance and laboratory systems. IDSR emphasizes the linkage of information provided by public health laboratories to the selection of relevant, appropriate and effective public health responses to disease outbreaks. Methods We reviewed the development of Rwanda's National Reference Laboratory (NRL to understand essential structures involved in creating a national public health laboratory network. We reviewed documents describing the NRL's organization and record of test results, conducted site visits, and interviewed health staff in the Ministry of Health and in partner agencies. Findings were developed by organizing thematic categories and grouping examples within them. We purposefully sought to identify success factors as well as challenges inherent in developing a national public health laboratory system. Results Among the identified success factors were: a structured governing framework for public health surveillance; political commitment to promote leadership for stronger laboratory capacities in Rwanda; defined roles and responsibilities for each level; coordinated approaches between technical and funding partners; collaboration with external laboratories; and use of performance results in advocacy with national stakeholders. Major challenges involved general infrastructure, human resources, and budgetary constraints. Conclusions Rwanda's experience with collaborative partnerships contributed to creation of a functional

  19. The Tanzania experience: clinical laboratory testing harmonization and equipment standardization at different levels of a tiered health laboratory system.

    Science.gov (United States)

    Massambu, Charles; Mwangi, Christina

    2009-06-01

    The rapid scale-up of the care and treatment programs in Tanzania during the preceding 4 years has greatly increased the demand for quality laboratory services for diagnosis of HIV and monitoring patients during antiretroviral therapy. Laboratory services were not in a position to cope with this demand owing to poor infrastructure, lack of human resources, erratic and/or lack of reagent supply and commodities, and slow manual technologies. With the limited human resources in the laboratory and the need for scaling up the care and treatment program, it became necessary to install automated equipment and train personnel for the increased volume of testing and new tests across all laboratory levels. With the numerous partners procuring equipment, the possibility of a multitude of equipment platforms with attendant challenges for procurement of reagents, maintenance of equipment, and quality assurance arose. Tanzania, therefore, had to harmonize laboratory tests and standardize laboratory equipment at different levels of the laboratory network. The process of harmonization of tests and standardization of equipment included assessment of laboratories, review of guidelines, development of a national laboratory operational plan, and stakeholder advocacy. This document outlines this process.

  20. [Our experience with outside laboratory quality control].

    Science.gov (United States)

    Dochev, D; Arakasheva, V; Nashkov, A; Tsachev, K

    1979-01-01

    The results from the national outside laboratory qualitative control of the clinical diagnostic laboratory investigations for the period September 1975 -- May 1977 were described. The following interlaboratory discrepancy was found on base of a systematic analysis of the data from the last two ring-like check-ups, November 1976 and May 1977, exressed by the variation coefficient (V.C. %); total protein, sodium, potassium and chlorides -- under 10%; cholesterol, urea and total fats -- between 10 and 20%; calcium, phosphorus, iron and creatinine -- over 20%. The highest per cent of admissible results are found with total protein -- to 85%; cholesterol -- to 70.38%; glucosa -- to 73.17%, urea -- to 69.23%, potassium -- to 59.46%, chlorides -- to 57.9%. With sodium, phosphorus, calcium, iron creatinine and uric acid the "admissibility" fluctuates about or under 50 per cent. The values of the qualitative-control indices discussed are comparable with the values obtained from them in the interlaboratory comparisons of other countries.

  1. Gargalos e recomendações para a incorporação de novas tecnologias na rede pública laboratorial de tuberculose no Brasil Bottlenecks and recommendations for the incorporation of new technologies in the tuberculosis laboratory network in Brazil

    Directory of Open Access Journals (Sweden)

    Maria Alice da Silva Telles

    2012-12-01

    Full Text Available Novas tecnologias para o diagnóstico da tuberculose foram recentemente recomendadas pela Organização Mundial da Saúde (OMS. Algumas recomendações da OMS incluem a elaboração de um plano estratégico para a adequação da rede, investimentos em supervisão e controle de qualidade, implementação de um sistema de gerenciamento de ambiente laboratorial, sem o que nenhuma nova tecnologia poderá ser eficazmente incorporada. Realizamos um levantamento da rede laboratorial de tuberculose no Brasil para identificar possíveis gargalos para a incorporação dessas tecnologias. Identificamos escassez de recursos para supervisão e controle de qualidade, baixa solicitação de culturas, ausência de sistemas eficazes de informação laboratorial e o desconhecimento da rede periférica municipal quanto às necessidades futuras na infraestrutura.The World Health Organization (WHO has recently recommended new technologies for the diagnosis of tuberculosis. The WHO recommendations include the development of a strategic plan for bringing the network up to grade; investment in supervision and quality control; and implementation of a system of laboratory environmental management. Without those measures having been taken, no new technology can be effectively incorporated. We surveyed the tuberculosis laboratory network in Brazil in order to identify possible bottlenecks for the incorporation of new technologies. We identified a lack of resources allocated to supervision and quality control; a low number of requests for cultures; a lack of effective laboratory information systems; and a lack of awareness regarding the future infrastructure needs of the laboratory network at the municipal level.

  2. Underground Test Area Fiscal Year 2014 Annual Quality Assurance Report Nevada National Security Site, Nevada, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Krenzien, Susan

    2015-01-01

    This report is required by the Underground Test Area (UGTA) Quality Assurance Plan (QAP) and identifies the UGTA quality assurance (QA) activities from October 1, 2013, through September 30, 2014 (fiscal year [FY] 2014). All UGTA organizations—U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Field Office (NNSA/NFO); Desert Research Institute (DRI); Lawrence Livermore National Laboratory (LLNL); Los Alamos National Laboratory (LANL); National Security Technologies, LLC (NSTec); Navarro-Intera, LLC (N-I); and the U.S. Geological Survey (USGS)—conducted QA activities in FY 2014. The activities included conducting oversight assessments for QAP compliance, identifying findings and completing corrective actions, evaluating laboratory performance, and publishing documents. UGTA Activity participants conducted 25 assessments on topics including safe operations, QAP compliance, activity planning, and sampling. These assessments are summarized in Section 2.0. Corrective actions tracked in FY 2014 are presented in Appendix A. Laboratory performance was evaluated based on three approaches: (1) established performance evaluation programs (PEPs), (2) interlaboratory comparisons, or (3) data review. The results of the laboratory performance evaluations, and interlaboratory comparison results are summarized in Section 4.0. The UGTA Activity published three public documents and a variety of other publications in FY 2014. The titles, dates, and main authors are identified in Section 5.0. The Contract Managers, Corrective Action Unit (CAU) Leads, Preemptive Review (PER) Committee members, and Topical Committee members are listed by name and organization in Section 6.0. Other activities that affected UGTA quality are discussed in Section 7.0. Section 8.0 provides the FY 2014 UGTA QA program conclusions, and Section 9.0 lists the references not identified in Section 5.0.

  3. Materials Capability Review Los Alamos National Laboratory May 4-7, 2009

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Antoniette J [Los Alamos National Laboratory

    2009-01-01

    Los Alamos National Laboratory (LANL) uses external peer review to measure and continuously improve the quality of its science, technology and engineering (STE). LANL uses capability reviews to assess the STE quality and institutional integration and to advise Laboratory Management on the current and future health of the STE. Capability reviews address the STE integration that LANL uses to meet mission requirements. STE capabilities are define to cut across directorates providing a more holistic view of the STE quality, integration to achieve mission requirements, and mission relevance. The scope of these capabilities necessitate that there will be significant overlap in technical areas covered by capability reviews (e.g ., materials research and weapons science and engineering). In addition, LANL staff may be reviewed in different capability reviews because of their varied assignments and expertise. LANL plans to perform a complete review of the Laboratory's STE capabilities (hence staff) in a three-year cycle. The principal product of an external review is a report that includes the review committee's assessments, commendations, and recommendations for STE. The Capability Review Committees serve a dual role of providing assessment of the Laboratory's technical contributions and integration towards its missions and providing advice to Laboratory Management. The assessments and advice are documented in reports prepared by the Capability Review Committees that are delivered to the Director and to the Principal Associate Director for Science, Technology and Engineering (PADSTE). This report will be used by Laboratory Management for STE assessment and planning. The report is also provided to the Department of Energy (DOE) as part of LANL's Annual Performance Plan and to the Los Alamos National Security (LANS) LLC's Science and Technology Committee (STC) as part of its responsibilities to the LANS Board of Governors. LANL has defined fourteen

  4. Defense Waste Processing Facility prototypic analytical laboratory

    International Nuclear Information System (INIS)

    Policke, T.A.; Bryant, M.F.; Spencer, R.B.

    1991-01-01

    The Defense Waste Processing Technology (DWPT) Analytical Laboratory is a relatively new laboratory facility at the Savannah River Site (SRS). It is a non-regulated, non-radioactive laboratory whose mission is to support research and development (R ampersand D) and waste treatment operations by providing analytical and experimental services in a way that is safe, efficient, and produces quality results in a timely manner so that R ampersand D personnel can provide quality technical data and operations personnel can efficiently operate waste treatment facilities. The modules are sample receiving, chromatography I, chromatography II, wet chemistry and carbon, sample preparation, and spectroscopy

  5. Development of a laboratory prototype water quality monitoring system suitable for use in zero gravity

    Science.gov (United States)

    Misselhorn, J. E.; Witz, S.; Hartung, W. H.

    1973-01-01

    The development of a laboratory prototype water quality monitoring system for use in the evaluation of candidate water recovery systems and for study of techniques for measuring potability parameters is reported. Sensing techniques for monitoring of the most desirable parameters are reviewed in terms of their sensitivities and complexities, and their recommendations for sensing techniques are presented. Rationale for selection of those parameters to be monitored (pH, specific conductivity, Cr(+6), I2, total carbon, and bacteria) in a next generation water monitor is presented along with an estimate of flight system specifications. A master water monitor development schedule is included.

  6. CRCPD`S laboratory accrediation program

    Energy Technology Data Exchange (ETDEWEB)

    Dukes, P.M. [South Carolina Department of Health and Environmental Control, Columbia, SC (United States)

    1993-12-31

    The Conference of Radiation Control Program Directors, or CRCPD, first became involved in a calibration laboratory accreditation program about 17 years ago. Since that time, the CRCPD has formed a Committee on Ionizing Measurements which writes criteria for the accreditation of laboratories, and performs the accreditation review process. To become accredited, a laboratory must agree to an administrative review, and an onsite review, and participate in measurement quality assurance (MQA) testing with the National Institute of Standards and Technology (NIST). The CRCPD currently has four accredited laboratories. All the laboratories are working with the Conference in promoting the improvement of MQA in radiation control programs.

  7. Construction quality assurance closure report, Lawrence Livermore National Laboratory Site 300, Pits 1 and 7

    International Nuclear Information System (INIS)

    1993-02-01

    This document presents the Final Construction Quality Assurance (CQA) report for the closure cover system of two mixed, low-level radioactive and hazardous waste landfills (pits) at Site 300. Site 300, operated by the Lawrence Livermore National Laboratory (LLNL), is located in the Altamont Hills, approximately 15 miles southeast of Livermore, California. The purpose of this report is to document the CQA program established to assure that construction is completed in accordance with the design intent and the approved Closure and Post Closure Plans dated May 1989 and revised January 1990 (EPA ID Number: CA 2890090002). Inclusive within the Closure and Post Closure Plan were the CQA Plan and the Technical Specifications for the final cover system. This report contains a complete narrative with photographic documentation of the construction activities and progress, problems encountered and solutions utilized, and third party testing and monitoring results, thus establishing the verification of compliance with the Quality Assurance Plan for the project

  8. Clinical protein science developments for patient monitoring in hospital central laboratories.

    Science.gov (United States)

    Malm, Johan; Marko-Varga, György

    2016-12-01

    Patient care relies heavily on standardized tests performed in hospital laboratories, typically including clinical chemistry, pathology and microbiology. With the introduction of personalized medicine tremendous efforts have been made to identify new biomarkers of disease with various omics technologies, often including mass spectrometry. In order to validate new biomarkers and perform clinical studies high quality biobank samples are of key importance. In this editorial different aspects of mass spectrometry in future personalized medicine are discussed.

  9. Quantifying sources of bias in National Healthcare Safety Network laboratory-identified Clostridium difficile infection rates.

    Science.gov (United States)

    Haley, Valerie B; DiRienzo, A Gregory; Lutterloh, Emily C; Stricof, Rachel L

    2014-01-01

    To assess the effect of multiple sources of bias on state- and hospital-specific National Healthcare Safety Network (NHSN) laboratory-identified Clostridium difficile infection (CDI) rates. Sensitivity analysis. A total of 124 New York hospitals in 2010. New York NHSN CDI events from audited hospitals were matched to New York hospital discharge billing records to obtain additional information on patient age, length of stay, and previous hospital discharges. "Corrected" hospital-onset (HO) CDI rates were calculated after (1) correcting inaccurate case reporting found during audits, (2) incorporating knowledge of laboratory results from outside hospitals, (3) excluding days when patients were not at risk from the denominator of the rates, and (4) adjusting for patient age. Data sets were simulated with each of these sources of bias reintroduced individually and combined. The simulated rates were compared with the corrected rates. Performance (ie, better, worse, or average compared with the state average) was categorized, and misclassification compared with the corrected data set was measured. Counting days patients were not at risk in the denominator reduced the state HO rate by 45% and resulted in 8% misclassification. Age adjustment and reporting errors also shifted rates (7% and 6% misclassification, respectively). Changing the NHSN protocol to require reporting of age-stratified patient-days and adjusting for patient-days at risk would improve comparability of rates across hospitals. Further research is needed to validate the risk-adjustment model before these data should be used as hospital performance measures.

  10. Valid methods: the quality assurance of test method development, validation, approval, and transfer for veterinary testing laboratories.

    Science.gov (United States)

    Wiegers, Ann L

    2003-07-01

    Third-party accreditation is a valuable tool to demonstrate a laboratory's competence to conduct testing. Accreditation, internationally and in the United States, has been discussed previously. However, accreditation is only I part of establishing data credibility. A validated test method is the first component of a valid measurement system. Validation is defined as confirmation by examination and the provision of objective evidence that the particular requirements for a specific intended use are fulfilled. The international and national standard ISO/IEC 17025 recognizes the importance of validated methods and requires that laboratory-developed methods or methods adopted by the laboratory be appropriate for the intended use. Validated methods are therefore required and their use agreed to by the client (i.e., end users of the test results such as veterinarians, animal health programs, and owners). ISO/IEC 17025 also requires that the introduction of methods developed by the laboratory for its own use be a planned activity conducted by qualified personnel with adequate resources. This article discusses considerations and recommendations for the conduct of veterinary diagnostic test method development, validation, evaluation, approval, and transfer to the user laboratory in the ISO/IEC 17025 environment. These recommendations are based on those of nationally and internationally accepted standards and guidelines, as well as those of reputable and experienced technical bodies. They are also based on the author's experience in the evaluation of method development and transfer projects, validation data, and the implementation of quality management systems in the area of method development.

  11. Benchmarking and the laboratory

    Science.gov (United States)

    Galloway, M; Nadin, L

    2001-01-01

    This article describes how benchmarking can be used to assess laboratory performance. Two benchmarking schemes are reviewed, the Clinical Benchmarking Company's Pathology Report and the College of American Pathologists' Q-Probes scheme. The Clinical Benchmarking Company's Pathology Report is undertaken by staff based in the clinical management unit, Keele University with appropriate input from the professional organisations within pathology. Five annual reports have now been completed. Each report is a detailed analysis of 10 areas of laboratory performance. In this review, particular attention is focused on the areas of quality, productivity, variation in clinical practice, skill mix, and working hours. The Q-Probes scheme is part of the College of American Pathologists programme in studies of quality assurance. The Q-Probes scheme and its applicability to pathology in the UK is illustrated by reviewing two recent Q-Probe studies: routine outpatient test turnaround time and outpatient test order accuracy. The Q-Probes scheme is somewhat limited by the small number of UK laboratories that have participated. In conclusion, as a result of the government's policy in the UK, benchmarking is here to stay. Benchmarking schemes described in this article are one way in which pathologists can demonstrate that they are providing a cost effective and high quality service. Key Words: benchmarking • pathology PMID:11477112

  12. [Contribution to the establishment of quality assurance in five medical microbiology departments in Togo].

    Science.gov (United States)

    Katawa, G; Kpotsra, A; Karou, D S; Eklou, M; Tayi, K E; de Souza, C

    2011-02-01

    In Togo, as in many other developing countries, there is a lack of data on quality control and assurance of laboratories. The present study aimed to access for the quality management system in five medical bacteriology laboratories in Togo. The study was conducted from May to August 2006. Data were recorded by an audit on the reliability of results and the technical organization of laboratories. The standard ISO 15189:2003, the Togolese guide of good laboratory practices (GBEA-Togo) and the WHO medical bacteriology standards were used as references. The results of the audit showed a lack of culture media in laboratories, inappropriate choice of culture media, partial identification of some microorganisms, variability of identification procedures, a lack of diagnostic reagents and an inability to identify some potentially pathogenic bacteria. Concerning the technical organization of laboratories, compliance average ranging from 25.8 to 54.8 % was recorded. This indicates a limited organization of such laboratories. The issue of this study showed that laboratories must be equipped, their technical organization should be improved and they must establish a program of equipment maintenance.

  13. Accreditation of Medical Laboratories – System, Process, Benefits for Labs

    Directory of Open Access Journals (Sweden)

    Zima Tomáš

    2017-09-01

    Full Text Available One and key of the priorities in laboratory medicine is improvement of quality management system for patient safety. Quality in the health care is tightly connected to the level of excellence of the health care provided in relation to the current level of knowledge and technical development. Accreditation is an effective way to demonstrate competence of the laboratory, a tool to recognize laboratories world-wide, is linked to periodical audits, to stimulate the maintenance and improvement of the quality, which leads to high standard of services for clients (patients, health care providers, etc.. The strategic plans of IFCC and EFLM include focusing on accreditation of labs based on ISO standards and cooperation with European Accreditation and national accreditation bodies. IFCC and EFLM recognised that ISO 15189:2012 Medical laboratories – Requirements for quality and competence, encompasses all the assessment criteria specified in the policy of quality. The last version is oriented to process approach with detailed division and clearly defined requirements. The accreditation of labs improves facilitation of accurate and rapid diagnostics, efficiency of treatment and reduction of errors in the laboratory process. Accreditation is not about who the best is, but who has a system of standard procedures with aim to improve the quality and patient safety. Quality system is about people, with people and for people.

  14. 77 FR 41188 - Clinical Laboratory Improvement Advisory Committee (CLIAC)

    Science.gov (United States)

    2012-07-12

    ... to general issues related to improvement in clinical laboratory quality and laboratory medicine... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Clinical... patient-centeredness of laboratory services; revisions to the standards under which clinical laboratories...

  15. Quality Assurance Program Plan for the Waste Sampling and Characterization Facility

    International Nuclear Information System (INIS)

    Grabbe, R.R.

    1995-01-01

    The objective of this Quality Assurance Plan is to provide quality assurance (QA) guidance, implementation of regulatory QA requirements, and quality control (QC) specifications for analytical service. This document follows the Department of Energy (DOE)-issued Hanford Analytical Services Quality Assurance Plan (HASQAP) and additional federal [10 US Code of Federal Regulations (CFR) 830.120] QA requirements that HASQAP does not cover. This document describes how the laboratory implements QA requirements to meet the federal or state requirements, provides what are the default QC specifications, and/or identifies the procedural information that governs how the laboratory operates. In addition, this document meets the objectives of the Quality Assurance Program provided in the WHC-CM-4-2, Section 2.1. This document also covers QA elements that are required in the Guidelines and Specifications for Preparing Quality Assurance Program Plans (QAPPs), (QAMS-004), and Interim Guidelines and Specifications for Preparing Quality Assurance Product Plans (QAMS-005) from the Environmental Protection Agency (EPA). A QA Index is provided in the Appendix A

  16. Quality control of the translation of the laboratory research into clinical practice

    International Nuclear Information System (INIS)

    Denekamp, J.

    1997-01-01

    This paper discusses the biological basis of new treatment strategies that are being introduced into the clinic in the form of controlled clinical trials. There is an increasing awareness of the need for quality assurance in the design, execution and analysis of these trials. However there is little awareness of the need to critically assess the biological basis of the trial design, to ensure that no other biological principles have been contravened in the attempt to optimise just one of the many parameters that determine the differential in sensitivity between tumours and normal tissues. Some examples are given of the changes that have recently occurred in the laboratory interpretation of both the mechanism of action and the therapeutic gain of several novel approaches. If these are not considered, the carefully controlled clinical trials may be wasted, because of being based on an incomplete consideration of all the interconnected biological factors. (author)

  17. Managing laboratory automation

    OpenAIRE

    Saboe, Thomas J.

    1995-01-01

    This paper discusses the process of managing automated systems through their life cycles within the quality-control (QC) laboratory environment. The focus is on the process of directing and managing the evolving automation of a laboratory; system examples are given. The author shows how both task and data systems have evolved, and how they interrelate. A BIG picture, or continuum view, is presented and some of the reasons for success or failure of the various examples cited are explored. Fina...

  18. Study on the internal quality control of TGAb and TMAb RIA in clinical laboratory

    International Nuclear Information System (INIS)

    Huang Jianrong

    2005-01-01

    To investigate the possible causes of the occasional instability of thyroglobulin anti- body(TGAb) and thyroid microsome antibody (TMAb) detection in the laboratory, the control serums of low, middle, and high value of different batches were measured and the stability of the labeled antigens stored at 2-8 degree C and below zero was observed. The results showed that the maximal variances of high value control serums for TGAb and TMAb between different batches were 33.0% and 32.5%, respectively. This was caused by the changes of titer of second anti- bodies. The labeled antigens stored below zero showed better stability. The strict internal quality control is an efficient measure to improve the measurement precision. (authors)

  19. Implementation of quality management for clinical bacteriology in low-resource settings.

    Science.gov (United States)

    Barbé, B; Yansouni, C P; Affolabi, D; Jacobs, J

    2017-07-01

    The declining trend of malaria and the recent prioritization of containment of antimicrobial resistance have created a momentum to implement clinical bacteriology in low-resource settings. Successful implementation relies on guidance by a quality management system (QMS). Over the past decade international initiatives were launched towards implementation of QMS in HIV/AIDS, tuberculosis and malaria. To describe the progress towards accreditation of medical laboratories and to identify the challenges and best practices for implementation of QMS in clinical bacteriology in low-resource settings. Published literature, online reports and websites related to the implementation of laboratory QMS, accreditation of medical laboratories and initiatives for containment of antimicrobial resistance. Apart from the limitations of infrastructure, equipment, consumables and staff, QMS are challenged with the complexity of clinical bacteriology and the healthcare context in low-resource settings (small-scale laboratories, attitudes and perception of staff, absence of laboratory information systems). Likewise, most international initiatives addressing laboratory health strengthening have focused on public health and outbreak management rather than on hospital based patient care. Best practices to implement quality-assured clinical bacteriology in low-resource settings include alignment with national regulations and public health reference laboratories, participating in external quality assurance programmes, support from the hospital's management, starting with attainable projects, conducting error review and daily bench-side supervision, looking for locally adapted solutions, stimulating ownership and extending existing training programmes to clinical bacteriology. The implementation of QMS in clinical bacteriology in hospital settings will ultimately boost a culture of quality to all sectors of healthcare in low-resource settings. Copyright © 2017 The Authors. Published by

  20. The Laboratory Diagnosis of HIV Infections

    Directory of Open Access Journals (Sweden)

    Margaret Fearon

    2005-01-01

    Full Text Available HIV diagnostic testing has come a long way since its inception in the early 1980s. Current enzyme immunoassays are sensitive enough to detect antibody as early as one to two weeks after infection. A variety of other assays are essential to confirm positive antibody screens (Western blot, polymerase chain reaction [PCR], provide an adjunct to antibody testing (p24 antigen, PCR, or provide additional information for the clinician treating HIV-positive patients (qualitative and quantitative PCR, and genotyping. Most diagnostic laboratories have complex testing algorithms to ensure accuracy of results and optimal use of laboratory resources. The choice of assays is guided by the initial screening results and the clinical information provided by the physician; both are integral to the laboratory's ability to provide an accurate laboratory diagnosis. Laboratories should also provide specific information on specimen collection, storage and transport so that specimen integrity is not compromised, thereby preserving the accuracy of laboratory results. Point of Care tests have become increasingly popular in the United States and some places in Canada over the past several years. These tests provide rapid, on-site HIV results in a format that is relatively easy for clinic staff to perform. However, the performance of these tests requires adherence to good laboratory quality control practices, as well as the backup of a licensed diagnostic laboratory to provide confirmation and resolution of positive or indeterminate results. Laboratory quality assurance programs and the participation in HIV proficiency testing programs are essential to ensure that diagnostic laboratories provide accurate, timely and clinically relevant laboratory results.