Originally posted July 12, 2006
The GAO developed thirteen recommendations based on their investigation
of CMS, CAP, JCAHO, COLA and the other state agencies. The
recommendations are aimed at CMS and what it should do and how it
should change. Here's a quick list in plain English:
Standardize survey findings
Ensure consistent advance notice by state survey agencies
Ensure identifying deficiences comes before education
Impose sanctions on labs with consecutive failures
Require all survey organizations to require whistle-blower posters
Require quarterly proficiency testing
Ensure timely evaluation of survey organizations
Ensure that new survey rules are reviewed in a timely manner
Hire more staff
Perform more validation inspections of state survey organizations
Require more independent validation of survey organizations
Collect and review more survey data
Establish an enforcement database
Some of these recommendations are common sense. Some of them are
bizarre. Most of them will do nothing to address the real problem with
the quality of laboratory testing.
To read in detail - and see the recommendations in the original bureaucratese - read the essay we've posted.
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Originally posted June 30, 2008
Remember the Maryland General laboratory scandal
of two years ago? Part of the outcome of the media circus and the
Congressional Hearings on Maryland General was a request by Congress
for an investigation of CMS by the GAO (Government Accountability
Office). The GAO was asked to examine (1) the quality of lab testing;
(2) the effectiveness of surveys, complaint investigations, and
enforcement actions in detecting and addressing lab problems; and (3)
the adequacy of CMS's CLIA oversight.
Well, that report is finally out - and it's not kind to CMS.
The titles say it all:
Testimony to Congress: CMS and Survey Organization Oversight Is Not Sufficient to Ensure Lab Quality
Full Report: CMS and Survey Organization Oversight Should Be Strengthened
Westgard Web will provide some detailed analysis of the reports (both
what is in the reports and what got left out) in the coming days, but
the first thing we want to do is encourage you to read the reports directly.
Go straight to the source and see what they found, and see if their
conclusions match your own. In July, we'll tell you what we think of
the reports - and you can judge us as well.
Let me pull a few highlights just from the one page summary:
Originally posted June 16, 2008
You've probably noticed that new JCAHO National Patient Safety
Goals
are out. Some new goals have been added this year. These goals are some
of the most prominent new measures, metrics, and indcators that are
being introduced to healthcare. At the Westgard Workshops, Teresa
Darcy, MD, MMM, gave a
presentation on this recent proliferation of Quality Indicators.
Do you know how many Indicators are out there? Here's just a short list
of what Dr. Darcy discussed:
Originally posted on June 12, 2006
First of all, we want to thank all of our participants who came
from all directions to learn and share. The most rewarding part of this
continuing series is that some of our speakers this year were the
participants only a few years ago. Clearly, we have seen people absorb
the material, put it into action, and go even further with it.
Lookingat the "class of 2006", it's going to be very interesting to see
who emerges as the new leaders and teachers.
Originally posted on May 3rd, 2006
I’ve been intrigued by some of the reasoning that is guiding laboratory priorities and directions, particularly the emphasis on pre-analytic and post-analytic processes along with a disregard for the quality of analytic processes. You can see this emphasis in the IQLM recommendations for laboratory quality indicators.
Originally posted April 21st, 2006
To: Those who will influence the future quality of laboratory testingCLSI Area Committee on Evaluation ProtocolsCLSI Subcommittee on Establishment of Manufacturer’s QC RecommendationsCLSI Subcommitee on Laboratory Quality Control Procedures
I
want to call your attention to an article on “The Quality of Laboratory
Testing Today” that was published in the American Journal of Clinical
Pathology in March 2006 (v125:pp343-354). This article was prepared for
the “QC for the Future” workshop, which was held in March 2005 in
Baltimore. Because you attended this conference and/or are involved in
the ongoing project work to develop QC for the Future, I hope you will
have some interest in the results of this study.