Tuesday 2 November 2010

Reducing errors at the point of care

Clinical and Laboratory Standards Institute (CLSI) recently published a new document, Quality Management: Approaches to Reducing Errors at the Point of Care; Approved Guideline (POCT07-A). This document describes a core infrastructure for a standardized error tracking system targeted to reduce risk and increase quality of point-of-care testing (POCT), while accumulating standardized data for benchmarking use.
Lou Ann Wyer, MS, MT(ASCP), Sentara Laboratory Services, and chairholder of the subcommittee that developed the guideline, says: "The goal of POCT07-A is to improve the performance of POCT by using different indicators, many listed in the document, that are applicable to different aspects of preexamination, examination, and postexamination phases of testing. Also, it highlights critical components of a quality management program and how a central laboratory can play into the coordination of the POCT quality program."

Wyer states the key highlights of the document include tables that provide excellent information about potential sources of error, analytes that may be affected, as well as practical suggestions to mitigate the potential error; appendices with templates and examples that can be easily modified and interpreted; and a case study that readers can follow through to see the whole process of error identification, documentation, and corrective action.

Valerie Ng, PhD, MD, Alameda County Medical Center/Highland General Hospital, and advisor to the subcommittee that developed the guideline, says: "The aim of POCT07-A is to raise awareness of all the steps in the testing process where things can go wrong. The reader will hopefully use this document to assess his or her own practice, identify areas of weakness, and put in place corrective systems. In doing so, he or she will ensure test results will truly be accurate. Most importantly, patients will be correctly treated and not harmed."

The guideline is intended for use by laboratory directors, managers, supervisors, quality managers, point-of-care coordinators, and other testing personnel responsible for implementing the policies, processes, procedures, activities, and records that support the quality management activities.

CLSI is a volunteer-driven, membership-supported, non-profit organization dedicated to developing standards and guidelines for the health care and medical testing community.