2021_Book_TextbookOfPatientSafetyAndClin

24 Patient Safety in Laboratory Medicine
cedures. Some authors have reported on their
experience applying Failure Mode and Effect
Analysis (FMEA) to critical activities using QI
data. The reported findings demonstrate that the
use of QIs to monitor errors and implement risk
management procedures reduces the error rate,
maximizes performance quality, and improves
patient safety and health system outcomes [42].
The promotion of continued improvement centers
about the commitment of laboratory professionals
to the management of QIs. The last few
years have confirmed that the utility of QIs is
closely linked to the recognition by all personnel
involved of their importance and of the need to
guarantee appropriate data collection as well as
effective data analysis. To raise awareness in professionals,
there has been a diffusion of consensually
approved MQI and results that highlight
achieved improvement, and professionals have
been encouraged to assume responsibility. The
continuous exchange of experiences among laboratory
professional aim therefore to improve both
the quality of the project and of laboratory services
[41].
24.2.3 Professional Competence:
Education and Skill
333
In order to make the role of laboratory medicine
in the context of patient care more visible, laboratory
professionals must accept that they are members
of a multidisciplinary team. Greater visibility
in the form of rounds, committees, consultation,
demonstration of knowledge, and self-promotion
will be judged chiefly in relation to the clinical
value they bring. Laboratory professionals must
develop new competencies to highlight the contribution
of laboratory information to patient
management. Even knowledge of less traditional
areas is required; this will bring new insights and
approaches from other disciplines. Moreover,
laboratory professionals must realize that the
level of recognition achieved will be profoundly
affected by continuous advancements in areas
such as computerization, technology, clinical
decision tools, informative media, and artificial
neural networks. Laboratory medicine is a continuously
evolving clinical discipline and emerging
challenges require a revision and improvement
of operational flows to enhance quality and safety
in patients care. Laboratory professionals must
maintain a high level of skills for achieving efficiency
and effectiveness when delivering laboratory
services [43]. To reduce diagnostic errors,
the first-line intervention consists of education
and training designed to improve knowledge and
skills to guarantee relevant competency [23].
Given the data reported above, it might be necessary
to act on graduate education and training by
rescheduling national programs, enhancing the
duration and contents of courses given in laboratory
medicine. Currently, however, only postgraduate
initiatives are underway. The EFLM
published the fifth edition of a syllabus for laboratory
medicine outlining requirements for the
postgraduate skills, knowledge, and competency
needed to direct laboratory medicine services.
The syllabus would not replace existing postgraduate
programs, the aim being to harmonize
the common principles of education and training
of professionals working Europe in order to guarantee
high standards of quality and safety. This
initiative paves the way for the free migration of
professionals and patients across EU national
borders. While the fourth version of the syllabus
was built with the specialist’s generic skills,
knowledge, and competencies in mind, the fifth
version details individual discipline requirements
(such as those in clinical chemistry, immunology,
hematology, blood transfusion, microbiology/
virology, genetics, and in vitro fertilization) and
includes new analytical techniques and statistics.
Laboratory organization, quality, safety, and clinical
governance have also been included as fundamental
aspects of training, thus enabling the
specialist in Laboratory Medicine to operate as a
clinical leader who can support and transform
healthcare services [44]. Given the recent changes
in the nature of laboratory service and its role in
the healthcare process, the new generation of
laboratory professionals and leaders are then
called upon to incorporate specific technical
skills into a broader vision of healthcare and of
patients’ needs. As shown in Table 24.1, the
recently published “Manifesto for the future of