Volume 38 Number 5 | October 2024

April German, MLS(ASCP)CM, Westgard Sigma-QM, ASCLS Today Volunteer Contributor

Bill Donohue, CEO of CarePoint

April German and Bill DonohueAs you walk into an outpatient draw station to have your blood collected, have you ever thought about the chain of events that begins when you sit in that chair and culminates in the result showing up in your chart? During the blood collection process, the correct collection tubes, the correct processing, and the correct storage of your blood sample all ultimately impact the result. Then comes the testing portion of the process. Let’s assume your sample made it to the lab without any mishandling errors. An educated and certified medical laboratory professional will perform your testing. Many individuals in the medical field think this process is simple. The work required to verify the accuracy of the test results is an endless stream of checking, calculating, and checking again. Our system of checks and balances is lovingly referred to as quality control, or QC for short.

In today’s rapidly evolving healthcare landscape, the role of QC in laboratory settings cannot be overstated. Laboratories are entrusted with providing accurate and reliable test results, forming the cornerstone of clinical decision-making. To ensure the highest standards of quality and safety, laboratories are compelled to employ robust QC processes and embrace emerging new technologies.

“Strategies to overcoming burnout include the adoption of emerging digital technologies that can automate mundane tasks and optimize critical workflows.”

At the heart of every laboratory operation is an effective QC plan. These quality protocols establish baseline performance benchmarks, acceptable limits, and process improvements that safeguard test performance. For example, following the on-boarding of new shipments of reagents (chemicals used in the testing process), medical lab professionals conduct rigorous comparison analyses. By establishing appropriate statistical means, standard deviations, and acceptable limits, laboratories can trend daily performance to identify analytical issues before they impact patients’ outcomes.

In the event an error in the system is not detected, incorrect results will be inappropriately placed into the patient’s chart, contributing to incorrect diagnoses and ineffective (or even harmful) treatments and therapies.

For example, consider a loved one who has a diagnosis of hypothyroidism (underactive thyroid gland). They require regular medication adjustments to maintain normal thyroid functionality to stabilize their overall health. If the results of their thyroid tests are incorrect, this could lead to incorrect dosage of medicine like levothyroxine. The side effects of levothyroxine overdose are listed publicly and can be found in the link at the bottom of this article, and some can be very serious. This is one example of thousands of different laboratory tests performed in most hospital and clinical labs across the United States.

Based upon manufacturer’s guidelines, good laboratory practices, and the needs of their patient population, medical laboratory professionals develop tailored QC plans to meet the unique needs of each laboratory setting. QC performance is reviewed and assessed on a daily, weekly, and monthly basis by a supervisor to ensure the accuracy of laboratory test results and alignment with evolving standards and best practices.

To streamline operations and address potential performance issues, medical laboratory leaders create comprehensive policies, procedures, flowcharts, and worksheets for troubleshooting purposes. These resources serve as invaluable tools for laboratory staff, facilitating efficient problem-solving and ensuring seamless workflow continuity.

By prioritizing the implementation of robust QC practices, laboratories can uphold the highest standards of quality, accuracy, and patient safety. Through ongoing staff training, competency assessments, and process improvement, we can optimize positive patient outcomes.

However, given increased workloads due to the industry-wide shortage of certified medical laboratory professionals, and the high stakes associated with diagnostic errors, laboratory staff can experience significant burnout. Burnout is characterized by emotional exhaustion, de-personalization, and a diminished sense of personal accomplishment. In medical laboratories, burnout can have severe consequences, including reduced productivity, an increase in errors, and compromised clinical outcomes. High levels of stress and fatigue can impair judgment and concentration, increasing the likelihood of mistakes. In the context of QC, where meticulous attention to detail is crucial, sources of errors in the testing process can be overlooked leading to compromised patient outcomes.

Strategies to overcoming burnout include the adoption of emerging digital technologies that can automate mundane tasks and optimize critical workflows.

An example is Pro-QCP, from CarePoint Solutions, Inc., Beverly, MA. Pro-QCP is a SaaS (software-as-a-service) utility just coming to market that leverages machine learning and advanced risk mitigation strategies to improve diagnostic accuracy and reliability. At the same time, through workflow optimization, Pro-QCP saves laboratory staff hundreds of hours of time.

Digital solutions like Pro-QCP empower laboratory managers to streamline laboratory operations, increase billable productivity, and reduce the labor associated with manual tasks. Furthermore, by implementing proven process improvement controls, laboratories can more effectively mitigate human errors, reduce cognitive overload, and improve staff morale.

Even more importantly, because diagnostic results inform a majority of medical decisions, their accuracy literally drives the downstream efficiencies, economies, and outcomes of an entire healthcare system. One could argue that there’s no better investment a healthcare organization can make than to improve its diagnostic accuracy.

I (April) have had the privilege of building a collaborative working relationship with Bill Donohue, the founder of CarePoint Solutions and the creator of Pro-QCP. His dedication to quality aligns closely with my own. Bill and I can spend hours delving into the intricacies of ISO standards, risk management, and quality control strategies. This is where the journey towards a more efficient, effective, and compassionate health care system takes root.

Behind every accurate test result you will find a team of dedicated medical laboratory professionals that are committed to quality outcomes. As laboratory leaders, we need to seek ways to increase our staff’s efficiency, effectiveness, productivity, and motivation. It is exciting to see newly emerging technologies that can support us in this essential role.

References

April German is Principal Consultant at Lab Connections in Joplin, Missouri.

Bill Donohue is President/CEO and Founder of CarePoint Solutions, Inc., located in Westford, Massachusetts.