quality essentials

Question 1

what is accuracy + phleb example

Answer 1

• clopse to actual result
• is true restul for pt is 125 mg/dL accurate is close to that

Question 2

what is precision + phleb example

Answer 2

• ability to give nearly sa e result when preformed repeatedly
• if glucose range consistently fall in 120-130 mg/dL it is precise
• can be precise but not accurate

Question 3

what does clinical and lab standards instituve (CLSI) recognize for achievement of quality

Answer 3

• hiearchy of processes ( step by step events including procedure )
• documentation in EHR
• total quality management (TQM)
• quality cost management (QCM), Quality management system (QMS), wuality assurance (QA), and quality control (QC) (quality assurance and quality control are used interchangeable in lab), quality assessment and process improvement (QAPI) and continour quality improvement (CQI)

Question 4

• what is total quality management

Answer 4

• highest level of quality oversight (manage at organizational or institutional level)
• govern behavior of healthcare workers
• ## identify organizations internal and external customers and designs operations to produce higest custoemr satisfaction

Question 5

what are other ways to show quality of care other than lab results

Answer 5

● How long they had to wait for the procedure
● The presence or absence of bruising to the site
● How many needlesticks or attempts were required
● Their perception of the phlebotomist (e.g., dress, communication skills)

Question 6

what is quality cost management

Answer 6

• measure and manage cost of quality
• in the lab that is cost of repeating tests when quewstionable tests and errors

Question 7

what is quality management system

Answer 7

• set of quality objectives to achive goals identified by TQM and methods to monitor achievement of those objectives
• includes organizatonal structure of lab and procedures, processes, and resources to develop and meet quality objevctives
• QMS includes functions that most directyl involve lab personell (quality assourance and conro)

Question 8

what is qwuality assurance?

Answer 8

• Joint commision defined as system of planned activites that assess operational processes for delivery of serivces or the quality of products provided to consumers, customers, and dpatients
• guarantee quality pt care by continued reassessment of all prcoesses
• refers to examining performace of a process to ensure testing is carried out correctly, accurate results

Question 9

what does qualirt ssurance include?

Answer 9

Quality assurance focuses on the overall process used to measure patient

outcomes (condition and length of hospital stay), which includes error detec-
tion activities (double-checking information) as well as corrective and preven-
tive activities (documentation and training). In the medical laboratory setting,

QA is applied to everything involved in producing a quality laboratory test
result, including
● the ordering and requisitioning of tests
● positive patient identification
● collection processes
● the integrity of the specimen
● test analysis processes
● the reporting of results
● turnaround time (the time between placing the order and receiving the
results)
● the training of lab personnel
● performance on proficiency testing
● performance on laboratory inspections
● documentation and follow-up on corrective action

Question 10

what is quality control?

Answer 10

activities that ensure that specific steps in a process meet acceptable standards or parameters (limitations).
- ensure reliable results and mandated by accrediting agencies
- periodically review QC doc
- verifying pt identify, expiration dates, testing contorl material, review data for error r included
- focus on detecting defects that r indicated by variances

Question 11

what is standard operating procuedre (SOP)

Answer 11

• explains each procuedres purpose, specimen requirements, step by step instructions, limitations, mornal and critical value and interpretation
• devloped by The Joint Commission, Clinical and Laboratory Standards
  Institute (CLSI), Food and Drug Administration (FDA),

Question 12

what are controls?

Answer 12

• liquid, a serum, or freeze-dried material that has been
  prepared and tested by the manufacturer and that has a known value, such as
  a serum with a known glucose value of 125 mg/dL.
• if control out of range then double check with expiration date

Question 13

what is calibration

Answer 13

• procuedre to ensure equipment provides accurate results
• run standard sample
• if inaccurate adjust manually or newer system calibrate automatically

Question 14

what is qualitry control is done before the exam

Answer 14

= pt identification
- specimen labeling
- specimen collection
- refrigeratiors and freezers
- centriguge

Question 15

what quality control is done during exam?

Answer 15

• inclubator and water baths
• analytic instruments

Question 16

what quality contorl is post exam

Answer 16

• pt results

Question 17

what is a delta check

Answer 17

• check of current result aginst previous result for pt

Question 18

what is levey jennings chart

Answer 18

• graph showing acceptable limits
• used to visualize whether results fall within acceptable paramter or shoft
• trends and shifts are known as systemic errors and may be bc aging reagents or control material deterioration of light sources or changes in temp

Question 19

what Quality assessment and process improvement (QAPI)

Answer 19

• review of documentation to discover weakness in process
• aka continuous quality improvement (CQI)

Question 20

what is an assessment/ audit

Answer 20

t (review of
records), is performed to discover any weaknesses in a process

Question 21

what are incident ofrms?

Answer 21

documents recording procedural or process errors

Question 22

what is corrective action

Answer 22

activity that helps eliminate the cause of an error
or undesirable situation

Question 23

what is perventive action

Answer 23

activity that helps ensure that a problem does not
occur or does not occur again

Question 24

what is competnency assessment?

Answer 24

method of documenting an employee’s ability
to perform assigned tasks correctly

Question 25

what is proficiency testing (PT)

Answer 25

means of evaluating the performance of a laboratory and its personnel in comparison with that of other, similar laboratorie

Question 26

what are Health Resources and Services Administration quality improvement tools

Answer 26

A toolbox of clinical quality and performance measures provided by the U.S. Department of Health and Human Services, including tools for data collection and performance measurement webinars.

Question 27

what are The Joint Commission quality improvement tools

Answer 27

A suite of tools and resources for healthcare organizations to help them meet TJC standards and National Patient Safety Goals. These tools are available only to TJCaccredited organizations.

Question 28

what is Root Cause Analysis (Six Sigma)

Answer 28

A commercial quality improvement program that provides methodologies for improving quality and reducing variation in any new or existing process. The steps of analysis for new processes include define, measure, analyze, design, and verify. The steps of analysis for existing processes include define, measure, analyze, improve, and control - root cause is required by TJC in response to all SEs

Question 29

what is Failure Mode Effects Analysis (FMEA)

Answer 29

Step-by-step method to identify all of the possible causes of failure in a process or service. These causes are then prioritized according to their seriousness and frequency. Each problem is then analyzed and corrective actions are taken. As each corrective action is completed, the date and results are recorded.

Question 30

what is lean methodology

Answer 30

aims to improvde pt safety and quality by eliminiateing waste in form of unecessary processes

Question 31

what is threshold balue

Answer 31

level of acceptavble practice beyond whcih quality pt care cant be assured

Question 32

what is corrective action preventative action (CAPA)

Answer 32

- establish if data idnetifys a probelm or opportunity for improvment

Question 33

whos responsability is QA vs QC

Answer 33

QA is everyone on clinical lab team QC is phleb or lab person performing activity

Question 34

what is procedure manual?

Answer 34

states policies and procuedres for each test in lab - purpose, plocy, specimen type and collection method, equipment and supplied, step by step, limitations and variables of method, corrective actions, method validation, normal values and referneces, reviews and revision dates, approval signatures and dates

Question 35

what is risk management

Answer 35

- identify and minimizing sutations that pose risk to pt and employees

Question 36

what is individualized qualirty control plan (IQCP)

Answer 36

- lab have option of devleoping risk based objecive approach to QC tailied based on testing, pt pop and lab