QUALITY MANAGEMENT Flashcards

1
Q

Coordinated activities to direct and
control an organization with regard
to quality (ISO,CLSI).
- All aspects of the laboratory
operation need to be addressed to
assure quality; this constitutes a
quality management system.

A

QUALITY MANAGEMENT SYSTEM

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2
Q

The result should be correct

A

Quality

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3
Q

even 1% error is unaaceptable. It
should be 100%accurate.

A

Error-free

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4
Q

result is grossly abnormal and the
decision to communicate the result
urgently is made not by the attending
doctor who requested the test, but by
laboratory staff, based on preset
critical limits.

A

Alert Values

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5
Q

Achieving a 99% level of quality
means accepting a 1% error rate

A

Alert Values

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6
Q

An error in any part of the cycle can
produce a poor laboratory result.
A method of detecting errors at each
phase of testing is needed if quality
is to be assured.

A

COMPLEXITY OF LABORATORY
PROCESSES

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7
Q

LIST THE PROCESSES

A
  1. PRE-ANALYTICAL
  2. PRE-EXAMINATION
  3. POST-EXAMINATION/ POST
    ANALYTICAL
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8
Q

Sample receipt accesioning

A

PRE-ANALYTICAL

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9
Q

-Done before the actual testing
-Preparation before the actual test
-Assess the competency of the personnel
-Personnel competency Test Evaluations

A

PRE-EXAMINATION

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10
Q

Proper preparation of the
patient for the tests required as well
as the preparation of the equipment
of the professional for the required
test.

A

Patient/Client Prep sample
collection

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11
Q

It is the section of the laboratories
where specimens are received,
sorted, entered into the Laboratory
Information System, labeled with
barcoded labels and processed

A

Specimen Receipt and Accessioning

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12
Q

It is examining “control” materials
of known substances along with
patient samples to monitor the
accuracy and precision of the
complete analytic process. The
control sample result as well as the
given known values should be the
same or aligned

A

Quality Control Testing

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13
Q

These are management tools that
help in the continuous management
of the quality system. They also help
track samples throughout the process
and identify problems. They indicate
how your staff has been operating.
Poor record keeping is often an
indication of poor performance and
disorganization. It is also important
to keep records to see if there are
changes to previous result

A

Record Keeping

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14
Q

There should be urgency of reporting
if the patient has alert values.

A

Reporting

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15
Q

WHAT ARE THE EXAMPLES OF RECORD-KEEPING AND REPORTING?

A

POST-EXAMINATION

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16
Q

sample collection

A

THE BEGINNING

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17
Q

reporting and saving of results
all processes in between.

A

THE END

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18
Q

LABORATORY TESTS ARE
INFLUENCED BY?
LIST

A

Laboratory environment
Knowledgeable staff
Reagent and equipment
Quality control
Communications
Process management
Incident reports.

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19
Q

occurrence management

A

Process management

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20
Q

set of coordinated activities that
function as building blocks for
quality management

A

12 QUALITY ESSENTIALS

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21
Q

This quality management system
model was developed by the Clinical
Laboratory Standard Institute (CLSI)

A

12 QUALITY ESSENTIALS

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22
Q

Who developed the 12 QUALITY ESSENTIALS?

A

Clinical
Laboratory Standard Institute (CLSI)

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23
Q

It is fully compatible with ISO
standards
- It Assures accuracy and reliability
throughout the Path of Workflow

A

12 QUALITY ESSENTIALS

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24
Q

The laboratory needs to be organized
around a formal quality management
system that supports consistent
procedures. The management team
and quality unit play an integral role
in a quality-driven culture, along
with structures for monitoring
ongoing quality

GIVE EXAMPLES

A
  1. ORGANIZATION

Laboratory Structure and
Management
2. Mechanism of implementing and
monitoring
3. Quality Policy-Responsibilities,
Authorities, Communication,
Provision of Sources
- Who are the Authorities and
responsible

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25
Capable, qualified staff members are the single most important asset to a laboratory. Training, motivation, and engagement are key parts of the quality management system. You also need to document all of your training processes within your quality management system GIVE EXAMPLE
PERSONNEL 1. Orientation 2. Professional development 3. Continuing education 4. training 5. Competency assessment 6. Qualified and Competent, motivated staff 7. CPD 8. CPE
26
There should be a minimum of 15 units every three years
CPD (Continuing Professional Development Points)
27
referring to the points professionals receive for participating in specialized training
CPE (Continuing professional education)
28
Every piece of equipment used in the laboratory must be maintained to operate safely. Also, laboratories need to monitor how equipment is installed, which suppliers provide the equipment, any calibration processes, and when the equipment needs to be replaced to maintain the highest possible quality GIVE EXAMPLE
EQUIPMENT 1. Acquisition 2. Installation 3. Validation 4. Maintenance Calibration 5. Troubleshooting 6. Service and repair 7. Records
29
Properly managing the supply chain is critical to ensure that raw inputs and other supplies are consistently high-quality. Inventory activities should verify that materials and supplies are stored in a way that protects integrity. Make sure you purchase inventory from suppliers who also follow a quality GIVE EXAMPLES
PURCHASING AND INVENTORY 1. Vendor qualifications 2. Supplies and reagents 3. Critical services 4. Contract review 5. Inventory management-First in and First Out basis
30
1. Quality Control 2. Sample Management GIVE EXAMPLES
PROCESS CONTROL 1. Quality Control 2. Sample Management 3. Method Validation- Proper Methods should be done 4. Method Verification-Verification of methods after validation
31
the lab processes patient information such as medical exams, results, and more. This data needs to be managed in a way that ensures all information is accurate, secure, confidential, and accessible to individuals with the right privileges, such as lab managers and leadership. GIVE EXAMPLES
INFORMATION MANAGEMENT 1. Confidentiality 2. Requisition- Accdg. to the urgency 3. Logs and Records 4. Reports
32
Documents are a similar concept to information management, and there’s a significant overlap between these categories. One of the most essential lab documents is standard operating procedures (SOPs) to create a standard for each process. Documents need to be available at the point of work, maintained, accurate, and secure.
DOCUMENTS AND RECORDS
33
is any error or non-conformance. A QMS software can help you detect these issues and facilitate investigations to discover the root cause and prevent reoccurrence. A laboratory QMS can also assist you if you’re going through an audit, as it’s much easier to document these occurrences and what you did to fix them. GIVE EXAMPLES
OCCURENCE AND MANAGEMENT 1. Complaints 2. Mistakes And Problems 3. Documentation 4. Root Cause Analysis 5. Immediate Actions 6. Corrective Actions
34
GIVE EXAMPLES
35
A quality management system should support the continuous improvement of laboratory processes GIVE EXAMPLES
ASSESSMENT 1. INTERNAL ASSESMENT 2. EXTERNAL ASSESMENT
36
A quality management system should support the continuous improvement of laboratory processes. GIVE EXAMPLES
PROCESS IMPROVEMENT 1. Opportunities For Improvement (Ofis) 2. Stakeholder Feedback 3. Problem Resolution 4. Risk Assessment 5. Preventive Actions 6. Corrective Actions
37
s the ultimate goal of a laboratory. A laboratory’s QMS should support operations that consistently provide a positive customer experience through the production of consistently high-quality products or other missions. The laboratory needs to understand the customers and their needs and use customer feedback for improvement. GIVE EXAMPLES
CUSTOMER SERVICE 1. customer group identification 2. customer needs 3. customer feedback
38
within laboratory, GIVE EXAMPLES
Internal Assessment - within laboratory - Quality Indicators - Audit Program - Audit Review
39
Outside the Laboratory Give example
External Assessment PQA
40
-In proficiency testing, an organization provides unknown samples for testing to a set of laboratories and the results from all laboratories are analyzed and reported to the laboratories. EQA identifies systematic errors in testing, training needs, and objective evidence of testing quality.
Proficiency testing (EQA)
41
Certification for the competence of the laboratory Ex. Joint Accreditation Committee ISCT-Europe & EBMT (JACIE) is Europe's only official accreditation body in the field of haematopoietic stem cell transplantation (HSCT) and cellular therapy. Philhealth Accredited
Accreditations
42
Proper Methods should be done
Method Validation
43
Verification of methods after validation
Method Verification
44
Creation. Review and reviews. Control and distribution
Documents
45
Collection. Review. Storage. Retention
Records
46
Laboratories need a comprehensive set of procedures and standards to ensure a safe, secure, and clean environment. This includes physically securing the lab, containment procedures for hazards, worker safety, and ergonomics. GIVE EXAMPLES
FACILITIES AND SAFETY 1. Safe Working Environment 2. Transport Management 3. Security 4. Containment 5. Waste Management 6. Laboratory Safety 7. Ergonomics
47
Model for QA in design, development
ISO 9001:2000
48
General requirements for the competence of testing and calibration laboratories
ISO/IEC 17025:2005
49
Quality management in the clinical laboratory
ISO 15189:2007
50
The foundation of international medical laboratory quality management
ISO 15189:2007
51
describes quality system model, 12 essentials
HS1-A2 A Quality Management System Model for Health Care
52
- describes laboratory application of quality system model
GP26-A3 Application of Quality Management System Model for Laboratory Services
53
- aligns to ISO and parallels ISO 9000 - applies to all health care systems
HS1-A2 A Quality Management System Model for Health Care
54
-is a part of quality management focused on fulfilling quality requirements ISO 9000:2000 (3.4.10)
Quality Control
55
is examining “control” materials of known substances along with patient samples to monitor the accuracy and precision of the complete (analytic) process
QC
56
is to detect errors and correct them before patient results are reported
Quality Control
57
-Examinations that do not have numerical results -Growth or no growth -positive or negative -reactive or non-reactive -color change
QUALITATIVE EXAMINATION METHODS
58
-Results are expressed as an estimate of the measured substance
SEMI-QUANTITATIVE EXAMINATION METHODS
59
-”trace amount”, “moderate amount”,or “ 1+, 2+, or 3+” -number of cells per microscopic field -titers and dilutions in serologic tests
SEMI-QUANTITATIVE EXAMINATION METHODS
60
refers to the measures that must be included during each assay run to verify that the test is working properly.
Quality Control
61
A series of analytical measurements used to assess the quality of the analytical data (The tools)
Quality Control
62
defined as the overall program that ensures that the final result reported by the laboratory are correct
Quality Assurance
63
Overall management plan to guarantee the integrity of data (The system)
Quality Assurance
64
simply to ensure that the results generated by the test are correct.
quality control
65
concerned with much more: that the right test is carried out on the right specimen, and that the right result and right interpretation is delivered to the right person at the right time.
quality assurance
66
(Also known as proficiency testing) is a means to determine the quality of the results generated by the laboratory. Quality assessment is a challenge to the effectiveness of QA and QC programs.
Quality Assessment
67
may be external or internal, examples of external programs include NEQAS, HKMTA, and Q-probes
Quality assessment
68
GIVE THE VARIABLES THAT AFFECT THE QUALITY OF RESULTS
● The educational background and training of the laboratory personnel ● The condition of the specimens ● The control used in the test runs ● Reagents ● Equipment ● The incorporation of the results ● The transcription of Results ● The reporting of results
69
this is an ideal concept which cannot be achieved. The known, accepted value of a quantifiable property.
True Value
70
the value approximating the true value, the difference between value is negligible. The measure of an individual’s measurement of a quantifiable property.
Accepted True Value
71
the discrepancy between the result of a measurement and the true (or accepted true value)
Error
72
An error which varies in unpredictable manner, in magnitude and sign, when a large number of measurements of the same quantity are made under effectively identical conditions
Random Error
73
create a characteristic spread of results for any test method and cannot be accounted for by applying corrections. Random errors are difficult to eliminate but repetition reduces the influences of random errors
Random errors
74
What type of error is this? errors in pipetting and changes in incubation period. Random errors can be minimized by training, supervision and adherence to standard operating procedures.
Random Error
75
Unavoidable errors that are always present in any measurement. Impossible to eliminate.
Random Error
76
An error which in the course of a number of measurements of the same value of a given quantity,remains constant when measurements are made under the same conditions, or varies according to a definite law when conditions change.
Systematic Error
77
create a characteristics bias in the test results and can be accounted for by applying a correction
Systematic errors
78
may be induced by factors such as variations in incubation temperature, blockage of plate washer, change in the reagent batch or modifications in testing method ● Available error due to controlled variables in a measurement
Systematic errors
79
How well a measurement agrees with an accepted value
Accuracy
80
How well a series of measurements agree with each other
Precision
81
commonly used to analyze data in Shewhart control charts
WESTGARD RULES
82
used to define specific performance limits for a particular assay and can be used to detect both random and systematic errors.
WESTGARD RULES
83
What are the six commonly used Westgard rules?
three are warning rules and the other three mandatory rules
84
should trigger a review test procedures, reagent performance and equipment calibration
violation of warning rules
85
should result in the rejection of the results obtained with patient’s serum samples in that assay
violation of mandatory rule
86
It is a graph that quality control data is plotted on to give a visual indication whether a laboratory test is working well. The distance from the mean is measured in standard deviations
Levey–Jennings chart
87
It is violated if the 2𝑠𝑑 IQC value exceeds the mean by 2±SD. It is an event likely to occur normally in less than 5% of cases
Warning 1 2SD
88
It detects systematic 𝑠𝑑 errors and is violated when two consecutive IQC values exceed the mean on the same side of the mean by 2±SD.
Warning 2𝑠𝑑
89
It is violated if four consecutive IQC values exceed the same limit (mean ±1SD) and this may indicate the need to perform instrument maintenance or reagent calibration.
Warning 4 1𝑆𝐷
90
: It is violated when the IQC value exceeds the mean by ±3SD. The assay run is regarded as out of control.
Mandatory 1 3𝑆𝐷
91
It is only applied when the IQC is tested in duplicate. This rule is violated when the difference in SD between the duplicates exceeds 4SD.
Mandatory R 4𝑆𝐷
92
This rule is violated when the last 10 consecutive IQC values are on the same side of the mean or target value.
Mandatory 10x
93
this usually applies when only a warning rule is violated.
Accept the test run in its entirety
94
this applies only when a mandatory rule is violated.
Reject the whole test run
95
this option can be considered in the event of a violation of either a warning or mandatory rule.
Enlarge the greyzone and thus re-test range for that particular assay run
96