Posted by Sten Westgard, MS
We live in an era of diminished resources, particularly in healthcare, particularly in the laboratory, and particularly for education and training. The training budgets for labs have been shrinking and shrinking over the years, even as the need for skilled technologists has increased.
Educational institutions have not been able to provide enough (high quality, lost cost) training to fill the need. So the manufacturers and vendors have stepped into this gap, supporting the educational needs of their customers.
Westgard Workshops 2011 could not have been mounted without the generous educational help of our gold sponsors, Bio-Rad Laboratories and Abbott Diagnostics. Randox Laboratories also stepped up and provided a premier sponsorship, which helped us immensely.
Dr. James Westgard, pictured here with representatives of the Premier Workshop Sponsor, Randox Laboratories. At Left, Vinay Naik, National Account Manager, who introduced the workshops. Also pictured here is Lynsey Adams, Scientific Writer.
After the break, you can hear the Westgard Workshops Introduction from Randox...
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Posted by Sten Westgard, MS
Westgard QC is proud to announce 2 new public workshops to be held this year:
Both workshops will be held at the DoubleTree Hotel in Madison, Wisconsin.
For more than a decade, the Westgard Workshops have provided in-depth training that can't be found at other conferences. If you want to be more than an anonymous seat in a cavernous hall... If you want to learn whether or not the latest management fad has any real applications in laboratories... If you want honest assessments instead of equivocal statements... If you care more about practical tools than precious theory... You need to attend the Westgard Workshops.
More details on the workshops after the jump...
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Posted by Sten Westgard, MS
In the iconic western film, The Magnificent Seven, there is a famous scene about marksmanship. [Quick set up: The Magnificent Seven are - you guessed it, seven - gunmen hired to protect a peasant village from a much larger group of bandits] Early in the film, the heroic gunmen detect three bandit scouts and want to capture them. In an abrupt exchange of gunfire, two bandits are killed, but the third bandit mounts his horse and attempts to escape. As the bandit flees, one of the gunmen, Britt, steadies his pistol and takes aim. The escaping bandit gallops farther and farther away. But just as he is about to disappear behind a hill, Britt shoots, hitting the bandit square in the back, killing him. The youngest of the gunmen, Chico, shouts:
Chico: (in awe) That was the greatest shot I've ever seen!
Britt: (sternly) The worst! I was aiming at the horse.
This scene reminds us that even when what one person thinks is great performance may not be acceptable by another person's standards. Indeed, what appears like an accomplishment may actually be an error.
And what, you may ask, does this have to do with Six Sigma?
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Sten Westgard, MS
Posted by Sten Westgard, MS
What's in a Sigma-metric of 3, 6, or even 11?
Sigma-metrics provide a useful way of classifying method performance and relating that performance to the QC that is necessary to “verify the attainment of the intended quality of test results,” which is a requirement of ISO 15189. But, Sigma-metrics are not foolproof. Does that bother you?
Maybe it's better if we frame this by referencing the 1984 cult film, This is Spinal Tap.
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Posted by Sten Westgard, MS
A recent abstract from the 2009 IFCC/EFCC (Euromedlab) caught my eye:
Quality Indicators for Laboratory Process; assessment in the Trento Department of Laboratory Medicine.
I Caola, C Pellegrini, N Bergamo, E Saurini, P Caciagli.
CCLM 2009
Examining the quality records of five laboratories, they applied a set of Quality Indicators from the IFCC. Errors were tracked and tabulated. The results are quite interesting.
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Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
A recent op-ed in the New York Times by Dr. Robert Wachter as well as an interview with Don Berwick in HealthLeaders Media broached a taboo topic: is healthcare measuring too much?
'[T]he measurement fad has spun out of control. There are so many different hospital ratings that more than 1,600 medical centers can now lay claim to being included on a “top 100,” “honor roll,” grade “A” or “best” hospitals list. Burnout rates for doctors top 50 percent, far higher than other professions. A 2013 study found that the electronic health record was a dominant culprit. Another 2013 study found that emergency room doctors clicked a mouse 4,000 times during a 10-hour shift. The computer systems have become the dark force behind quality measures.'
How Measurement Fails Doctors and Teachers, New York Times, January 16, 2016
As the global debate over establishing the best error models and performance specifications rages, laboratories are probably asking themselves the same questions that the doctors are asking: how many metrics are too much?
A possible answer, or at least some more questions, after the jump...
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Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
An interesting abstract was published at the Paris IFCC meeting. It detailed the EQA performance of a set of 12 public laboratories in Catalonia. Can you guess what the failure rate for these labs for biochemistry EQA?
- 14.5%
- 14%
- 3%
- none of the above
The answer, after the jump...
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Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Posted by Sten Westgard, MS
Last month, Advance for the Laboratory published a three part series on Six Sigma in the Clinical Laboratory, written by David Plaut, Nathalie Lepage, and Kim Przekop:
While it's great that Advance has invested in in-depth coverage of the Six Sigma topic, unfortunately one of their examples in part 2 demonstrates a misunderstanding of the application.
See the mistake, after the jump...
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Posted by Sten Westgard, MS
A recent question came in from a technical support consultant for a major diagnostic manufacturer:
"It is for Free T4 analyte. Customer [has] establihed a QC range after 20 QC runs. Mean and SD were derived from 20 runs and %CV achieved from 20 runs is 1.2%. Allowable interassay precision criteria according to CLIA is 6%.
"Now when customer [applies] Mean and SD according to the established range many...times they face QC rules violations of 41s and 10x.
"So can you please suggest, when the SD is too narrow is it necessary to apply these two rules to immunoassays?"
What's your guess? I'll take a stab at an answer, after the jump.
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Posted by Sten Westgard, MS
I came across a very valuable paper in Clinica Chimica Acta on the stability of hematology controls for MCV. (Some of you are already guessing what this is going to be about...)
If you take a hematology control, how many SDs should you expect to see it shift at week 5 of use versus the first week of use? In other words, what is the SDI you should expect?
- 1 SDI
- 2 SDI
- 3 SDI
- 4 SDI
- 5 SDI
- higher than 5 SDI
The answer, after the jump...
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