3.2. The benefits of improving laboratory data management on
the patient safety in care delivery
Qualitymeasurement inhealthcare is going to be focused on
accountability for patient care outcomes and not onlyon quality assurance
sinceevery step in the process of patient care carries a risk of harm.In
relation to the quality assurance within the clinical laboratory, recent
improvements have been done to significantly decrease the rates of errors, but
the procedures before and after the clinical test are more prone to the
introduction of errors.(Plebani, 2009) In the study conducted by Mario Plebani
in Italy, to assess quality indicator of laboratory test. The author mentioned
that event if a lot ofefforts have been donein the last decade to implement
quality indicators for laboratory tests focused on the analytical performance,
a systematic framework for laboratory quality measurement is still not
available. The evaluation is based on the laboratory capability to provide
service that is safe, timely, efficient, effective, equitable, and
patient-centered. This study demonstrates that pre and post-analytical steps of
the total testing process are more error-prone than the analytical phase inside
the laboratory since the diagnostic process, which consists of numerous
clinical steps, stretches across multiple care providersin the hospital. Some
of the identified error are:the inappropriate test request from clinician,
error in patient identification and specimen collection, lost to follow up the
lab test. (Plebani, 2009)
3.3. The importance of laboratory data for public health
monitoring of diseases and epidemics
The improvement of laboratory result management does not only
improve patient care but it is also essential for disease monitoring and
surveillance. The reports of disease notifiable conditions from laboratories
and health care providers to public health authorities, is fundamental to the
prevention and control of population health related problems.(Overhage,
Grannis, & McDonald, 2008)
In the study conducted by J.Marc Overhage and others in 2008
in Mario County in Indianapolis, the research team examines whether the
information produced by the automated electronic laboratory reporting of
notifiable-diseases are more complete, accurate and timely produced than those
produced by the paper based reporting procedure. Two source of data has been
compared: the first source is an automated electronic laboratory reporting
(ELR) system, the Indiana Network for Patient Care (INPC) notifiable condition
database that link laboratories, radiology centers, and public health
departments in central Indiana in a shared database, and he second source the
Marion County Health Department usespaper-based records. (Overhage et al.,
2008)
After 3month study period, the team found that the ELR
identified 4.4 times as many cases as traditional spontaneous reporting methods
which show that automated system more-timely report the notifiable diseases
conditions than does traditional spontaneous reporting. And the data produced
by the electronic reporting of notifiable conditions can be easily mapped and
scale with the Logical Observation Identifiers Names and Codes (LOINC) for
laboratory test result and the Systematized Nomenclature of Medicine-Clinical
Terms (SNOMED-CT) clinical condition according to the Centers for Disease
Control and Prevention (CDC). (Overhage et al., 2008)
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