Read by QxMD icon Read

Six sigma for clinical lab

Ronda F Greaves, Lisa Jolly, Michaela F Hartmann, Chung Shun Ho, Richard K T Kam, John Joseph, Conchita Boyder, Stefan A Wudy
BACKGROUND: Serum dihydrotestosterone (DHT) is an important analyte for the clinical assessment of disorders of sex development. It is also reportedly a difficult analyte to measure. Currently, there are significant gaps in the standardisation of this analyte, including no external quality assurance (EQA) program available worldwide to allow for peer review performance of DHT. We therefore proposed to establish a pilot EQA program for serum DHT. METHODS: DHT was assessed in the 2015 Royal College of Pathologists of Australasia Quality Assurance Programs' Endocrine program material...
October 4, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
Remona E David, Minodora Dobreanu
BACKGROUND: Development of quality measurement principles is a strategic point for each clinical laboratory. Preexamination process is the most critical and the most difficult to be managed. The aim of this study is to identify, quantify, and monitor the nonconformities of the pre-analytical process using quality indicators that can affect the patient's health safety in four different locations of a Romanian private clinical laboratory. METHODS: The study group consisted of all the analysis requests received by the departments of biochemistry, hematology, and coagulation from January through March 2015...
2016: Clinical Laboratory
Cristiano Ialongo, Sergio Bernardini
Almost thirty years of systematic analysis have proven the turnaround time to be a fundamental dimension for the clinical laboratory. Several indicators are to date available to assess and report quality with respect to timeliness, but they sometimes lack the communicative immediacy and accuracy. The six sigma is a paradigm developed within the industrial domain for assessing quality and addressing goal and issues. The sigma level computed through the Z-score method is a simple and straightforward tool which delivers quality by a universal dimensionless scale and allows to handle non-normal data...
2016: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
M S Shaikh, B Moiz
INTRODUCTION: 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...
April 2016: International Journal of Laboratory Hematology
Elizabeta Topic, Nora Nikolac, Mauro Panteghini, Elvar Theodorsson, Gian Luca Salvagno, Marijana Miler, Ana-Maria Simundic, Ilenia Infusino, Gunnar Nordin, Sten Westgard
Laboratory medicine is amongst the fastest growing fields in medicine, crucial in diagnosis, support of prevention and in the monitoring of disease for individual patients and for the evaluation of treatment for populations of patients. Therefore, high quality and safety in laboratory testing has a prominent role in high-quality healthcare. Applied knowledge and competencies of professionals in laboratory medicine increases the clinical value of laboratory results by decreasing laboratory errors, increasing appropriate utilization of tests, and increasing cost effectiveness...
October 2015: Clinical Chemistry and Laboratory Medicine: CCLM
Yang Fei, Wei Wang, Falin He, Kun Zhong, Zhiguo Wang
BACKGROUND: The aim of this study was to use Six Sigma(SM) (Motorola Trademark Holdings, Libertyville, IL) techniques to analyze the quality of point-of-care (POC) glucose testing measurements quantitatively and to provide suggestions for improvement. MATERIALS AND METHODS: In total, 151 laboratories in China were included in this investigation in 2014. Bias and coefficient of variation were collected from an external quality assessment and an internal quality control program, respectively, for POC glucose testing organized by the National Center for Clinical Laboratories...
October 2015: Diabetes Technology & Therapeutics
Chuanbao Zhang, Haijian Zhao, Jing Wang, Jie Zeng, Zhiguo Wang
BACKGROUND: Recently, Six Sigma techniques have been adopted by clinical laboratories to evaluate laboratory performance. Measurement procedures in laboratories can be categorized as "excellent", "good", and "improvement needed" based on sigma (σ) metrics of σ ≥ 6, 3 ≤ σ < 6, and σ < 3, respectively. The quality goal index (QGI) was further investigated for measurement procedures with σ ≤ 3. Improvements of the procedures were recommended based on QGI: QGI < 0.8 indicates that the precision of the procedure needs to be improved; QGI > 1...
2015: Clinical Laboratory
Lena Jafri, Aysha Habib Khan, Farooq Ghani, Shahid Shakeel, Ahmed Raheem, Imran Siddiqui
INTRODUCTION: Quality indicators for assessing the performance of a laboratory require a systematic and continuous approach in collecting and analyzing data. The aim of this study was to determine the frequency of errors utilizing the quality indicators in a clinical chemistry laboratory and to convert errors to the Sigma scale. MATERIALS AND METHODS: Five-year quality indicator data of a clinical chemistry laboratory was evaluated to describe the frequency of errors...
July 2015: Scandinavian Journal of Clinical and Laboratory Investigation
James O Westgard, Sten A Westgard
BACKGROUND: There is a need to assess the quality being achieved for laboratory examinations that are being utilized to support evidence-based clinical guidelines. Application of Six Sigma concepts and metrics can provide an objective assessment of the current analytical quality of different examination procedures. METHODS: A "Sigma Proficiency Assessment Chart" can be constructed for data obtained from proficiency testing and external quality assessment surveys to evaluate the observed imprecision and bias of method subgroups and determine quality on the Sigma scale...
September 1, 2015: Clinical Chemistry and Laboratory Medicine: CCLM
Justice Afrifa, Seth A Gyekye, William K B A Owiredu, Richard K D Ephraim, Samuel Essien-Baidoo, Samuel Amoah, David L Simpong, Aaron R Arthur
BACKGROUND: 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. MATERIALS AND METHODS: 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...
January 2015: Nigerian Medical Journal: Journal of the Nigeria Medical Association
Angeles Giménez-Marín, Francisco Rivas-Ruiz, Maria Del Mar Pérez-Hidalgo, Pedro Molina-Mendoza
INTRODUCTION: This study describes quality indicators for the pre-analytical process, grouping errors according to patient risk as critical or major, and assesses their evaluation over a five-year period. MATERIALS AND METHODS: A descriptive study was made of the temporal evolution of quality indicators, with a study population of 751,441 analytical requests made during the period 2007-2011. The Runs Test for randomness was calculated to assess changes in the trend of the series, and the degree of control over the process was estimated by the Six Sigma scale...
2014: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
Yash Pal Agrawal, Maria Cid, Sten Westgard, Thomas S Parker, Ryan Jaikaran, Daniel M Levine
BACKGROUND: A global tacrolimus proficiency study recently showed clinically significant variability between laboratories, the inability of a common calibrator to harmonize methods, and differences in patient classification depending on the test method. The authors evaluated (1) the effect of a change in methodology on patient classification based on tacrolimus blood concentration and (2) the ability of 2 methods to position the concentration in a given specimen within the correct range...
December 2014: Therapeutic Drug Monitoring
Francesco Cian, Elisabeth Villiers, Joy Archer, Francesca Pitorri, Kathleen Freeman
BACKGROUND: Quality control (QC) validation is an essential tool in total quality management of a veterinary clinical pathology laboratory. Cost-analysis can be a valuable technique to help identify an appropriate QC procedure for the laboratory, although this has never been reported in veterinary medicine. OBJECTIVE: The aim of this study was to determine the applicability of the Six Sigma Quality Cost Worksheets in the evaluation of possible candidate QC rules identified by QC validation...
June 2014: Veterinary Clinical Pathology
Bruce H Matt, Heather K Woodward-Hagg, Christopher L Wade, Penny D Butler, Mimi S Kokoska
OBJECTIVES: (1) Confirm the positive value stream of office-based ultrasound using Lean Six Sigma; (2) demonstrate how ultrasound reduces time to diagnosis, costs, patient inconvenience and travel, exposure to ionizing radiation, intravenous contrast, and laboratory tests. STUDY DESIGN: Case series with historical controls using chart review. SETTING: Tertiary Veterans Administration Hospital (university-affiliated). SUBJECTS AND METHODS: Patients with a consult request or decision for ultrasound guided fine needle aspiration (USFNA) from 2006 to 2012...
July 2014: Otolaryngology—Head and Neck Surgery
Koen Hens, Mario Berth, Dave Armbruster, Sten Westgard
BACKGROUND: Six Sigma metrics were used to assess the analytical quality of automated clinical chemistry and immunoassay tests in a large Belgian clinical laboratory and to explore the importance of the source used for estimation of the allowable total error. Clinical laboratories are continually challenged to maintain analytical quality. However, it is difficult to measure assay quality objectively and quantitatively. METHODS: The Sigma metric is a single number that estimates quality based on the traditional parameters used in the clinical laboratory: allowable total error (TEa), precision and bias...
July 2014: Clinical Chemistry and Laboratory Medicine: CCLM
Sunil Kumar Nanda, Lopamudra Ray
INTRODUCTION: Laboratory errors are result of a poorly designed quality system in the laboratory. Six Sigma is an error reduction methodology that has been successfully applied at Motorola and General Electric. Sigma (σ) is the mathematical symbol for standard deviation (SD). Sigma methodology can be applied wherever an outcome of a process has to be measured. A poor outcome is counted as an error or defect. This is quantified as defects per million (DPM). A six sigma process is one in which 99...
December 2013: Journal of Clinical and Diagnostic Research: JCDR
Ali Elbireer, Julie Le Chasseur, Brooks Jackson
PURPOSE: 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. DESIGN/METHODOLOGY/APPROACH: 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...
2013: International Journal of Health Care Quality Assurance
Lisa Shipley
Lisa Shipley is Vice President of Pharmacokinetics, Pharmacodynamics and Drug Metabolism at Merck Research Laboratories. She is responsible for preclinical and clinical ADME activities and molecular biomarker assay development activities at all Merck research sites and support of all programs from discovery through to post-product launch. Prior to joining Merck in 2008, Shipley spent over 20 years at Eli Lilly and Company in roles of increasing responsibility, including the positions of executive director at Lean Six Sigma and vice president of Drug Disposition, PK/PD and Trial Simulations...
August 2013: Bioanalysis
Sean Egan, Philip G Murphy, Jerome P Fennell, Sinead Kelly, Mary Hickey, Carolyn McLean, Muriel Pate, Ciara Kirke, Annette Whiriskey, Niall Wall, Eddie McCullagh, Joan Murphy, Tim Delaney
BACKGROUND: Safe, effective therapy with the antimicrobial gentamicin requires good practice in dose selection and monitoring of serum levels. Suboptimal therapy occurs with breakdown in the process of drug dosing, serum blood sampling, laboratory processing and level interpretation. Unintentional underdosing may result. This improvement effort aimed to optimise this process in an academic teaching hospital using Six Sigma process improvement methodology. METHODS: A multidisciplinary project team was formed...
December 2012: BMJ Quality & Safety
Bhawna Singh, Binita Goswami, Vinod Kumar Gupta, Ranjna Chawla, Venkatesan Mallika
Ensuring quality of laboratory services is the need of the hour in the field of health care. Keeping in mind the revolution ushered by six sigma concept in corporate world, health care sector may reap the benefits of the same. Six sigma provides a general methodology to describe performance on sigma scale. We aimed to gauge our laboratory performance by sigma metrics. Internal quality control (QC) data was analyzed retrospectively over a period of 6 months from July 2009 to December 2009. Laboratory mean, standard deviation and coefficient of variation were calculated for all the parameters...
April 2011: Indian Journal of Clinical Biochemistry: IJCB
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"