Patient Safety Corner

Stacy E. Walz, PhD, MS, MT(ASCP), ASCLS Patient Safety Committee Chair

One of the many wonderful resources easily accessible by laboratory professionals, other healthcare professionals, and the general public, is the blog, Lab Testing Matters, sponsored and managed by COLA. For several years now, the ASCLS Patient Safety Committee has proudly been supplying articles for posting to this site.

The 2019-20 theme for articles supplied by the Patient Safety Committee is “Improving Diagnosis in Health Care,” based on the report published in 2015 by the National Academies of Sciences, Engineering and Medicine. In this report, clinical laboratory professionals were specifically identified as critical partners in addressing a specific type of medical error: diagnostic error. The working definition of diagnostic error is, “the failure to (a) establish an accurate and timely explanation for the patient’s health problem(s) or (b) communicate that explanation to the patient.”

The report acknowledges the complexity of the diagnostic process and that it occurs within the context of a work system, workplace culture, and physical environment. Multiple team members are involved, performing specific tasks within their scope of practice, using tools and technologies, all of which can impact the accuracy, timeliness, and communication of a diagnosis.

The authors of the 2015 report suggest eight goals to improve diagnosis in medicine:

  1. Facilitate more effective teamwork in the diagnostic process among healthcare professionals, patients, and their families;
  2. Enhance healthcare professionals’ education and training in the diagnostic process;
  3. Ensure health information technologies support patients and healthcare professionals in the diagnostic process;
  4. Develop and deploy approaches to identify, learn from, and reduce diagnostic errors and near misses in clinical practice;
  5. Establish a work system and culture that supports the diagnostic process and improvements in diagnostic performance;
  6. Develop a reporting environment and medical liability system that facilitates improved diagnosis by learning from diagnostic errors and near misses;
  7. Design a payment and care delivery environment that supports the diagnostic process, and
  8. Provide dedicated funding for research on the diagnostic process and diagnostic errors.

The Patient Safety Committee decided to devote an article to each of these goals, paying specific attention to how clinical laboratory professionals can play a role. We felt it was important to go beyond just educating our colleagues about these goals, because it can be challenging to see how best we “fit in” to some of these initiatives.

In my personal experiences presenting on the topic of patient safety, my laboratory colleagues are usually in agreement with the need to get involved in improving patient safety, but often ask, “What can I do?” We are lucky to have some very engaged members on the Patient Safety Committee who are involved in their workplaces or in the education of MLT/MLS students in some ground-breaking quality improvement activities that directly relate to improving diagnosis in healthcare. We invite you to access the Lab Testing Matters website frequently and learn from your ASCLS colleagues.

National Academies of Sciences, Engineering, and Medicine. (2015). Improving Diagnosis in Health Care. Washington, DC: The National Academies Press.

Stacy Walz is chair of the Clinical Laboratory Science Program and associate professor of clinical laboratory science at Arkansas State University in Jonesboro, Arkansas.