Scope Of Practice Review - Health Professions Regulatory Advisory ...

College of AmericanPathologists. LaboratoryTest Ordering &Documentation. Undated.Howantis, P. Errors inLaboratory Medicine:Practical Lessons toImprove Patient Safety.Archives of Pathologyand LaboratoryMedicine. Vol 129. 2005.Joint Commission onAccreditation ofHealthcareOrganizations. 2005National Patient SafetyGoals: Laboratory. 2005.Guidelines for laboratory testingand documentation.Patient safety is influenced by thefrequency and seriousness oferrors that occur in the health caresystem. Error rates in laboratorypractices are collected routinelyfor a variety of performancemeasures in all clinical pathologylaboratories in the United States,but a list of critical performancemeasures has not yet beenrecommended. The mostextensive databases describingerror rates in pathology weredeveloped and are maintained bythe College of AmericanPathologists (CAP). Thesedatabases include the CAP’s Q-Probes and Q-Tracks programs,which provide information onerror rates from more than130 inter-laboratory studies.This study defines criticalperformance measures inlaboratory medicine, describeserror rates of these measures, andprovides suggestions to decreasethese errors. Includes a list ofrecommended performancemeasures, the frequency of errorswhen these performance measureswere studied, and suggestions toimprove patient safety byreducing these errors.The Joint Commission establishesNational Patient Safety Goals(NPSGs) each year to evaluate thesafety and the quality of careprovided at accredited health careorganizations. These goals havespecific requirements forprotecting patients.Provides guidelines for:• Test Ordering• Recording Results• Resolving Problems• Reporting Test Results• Supplemental or Confirmatory Reporting• Disease Reporting• Record Keeping• Confidentiality, HIPPA Regulations.Error rates for pre-analytic and post-analyticperformance measures were higher than for analyticmeasures. Eight performance measures wereidentified, including customer satisfaction, testturnaround times, patient identification, specimenacceptability, proficiency testing, critical valuereporting, blood product wastage, and blood culturecontamination. Error rate benchmarks for theseperformance measures were cited andrecommendations for improving patient safetypresented.Not only has each of the 8 performance measuresproven practical, useful, and important for patientcare, taken together, they also fulfill regulatoryrequirements. All laboratories should considerimplementing these performance measures andstandardizing their own scientific designs, dataanalysis, and error reduction strategies according tofindings from these published studies.Goals:Improve the accuracy of patient identification.• Use at least two patient identifiers (neither to bethe patient's location) whenever collectinglaboratory samples or administeringmedications or blood products, and use twoidentifiers to label sample collection containersin the presence of the patient. Processes areestablished to maintain samples' identitythroughout the pre-analytical, analytical andpost-analytical processes.• Immediately prior to the start of any invasiveprocedure, conduct a final verification processto confirm the correct patient, procedure, site,and availability of appropriate documents. Thisverification process uses active—not passive—23