Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations...

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Transcript of Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations...

Page 1: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology.
Page 2: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology.

Why do Q.A.?Why do Q.A.?

• Physician’s Expectations

• Diagnosis

• Therapy

• Technology

• Physician’s Expectations

• Diagnosis

• Therapy

• Technology

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Physician’s ExpectationsPhysician’s Expectations

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DiagnosisDiagnosis

• Specificity – True Positive in Disease

• Sensitivity – True Negative

• Specificity – True Positive in Disease

• Sensitivity – True Negative

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TherapyTherapy

• Adjustment of Medication• Adjustment of Medication

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TechnologyTechnology

• Complex Instruments

• Complex Reagents

• Micro Techniques

• Complex Instruments

• Complex Reagents

• Micro Techniques

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What is Q.A.?What is Q.A.?

• Samples

• Control Material

• Assay Conditionsa. Reagentsb. Instruments

• Daily Review

• Retrospective Peer Review

• Samples

• Control Material

• Assay Conditionsa. Reagentsb. Instruments

• Daily Review

• Retrospective Peer Review

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ControlsControls

• Similar to patient samples• Respond like samples• Stability like samples

• Similar to patient samples• Respond like samples• Stability like samples

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Daily ReviewDaily Review

• Decision Rules• Random Error• Systematic Error

• Decision Rules• Random Error• Systematic Error

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CalculationsCalculations

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Gaussian DistributionGaussian Distribution

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Abnormal DistributionAbnormal Distribution

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Graphing – Levey-Jennings ChartsGraphing – Levey-Jennings Charts

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NormalNormal

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Westgard RulesWestgard Rules

1 – 3s

2 – 2s

R – 4s

4 – 1s

10x

1 – 3s

2 – 2s

R – 4s

4 – 1s

10x

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1 – 3s1 – 3s

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2 – 2s2 – 2s

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2 – 2s2 – 2s

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R – 4sR – 4s

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4 – 1s4 – 1s

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10x10x

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Retrospective Peer ReviewRetrospective Peer Review

• Measurement of Peer Precision

• Method Comparisons

• Proficiency Surveys and Routine Q.C.

• Measurement of Peer Precision

• Method Comparisons

• Proficiency Surveys and Routine Q.C.

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SDI-Standard Deviation IndexSDI-Standard Deviation Index

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SDI InterpretationSDI Interpretation

• Like Signs

• Spread of 1 SDI

• Reproducibility

• Like Signs

• Spread of 1 SDI

• Reproducibility

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SDISDI

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E = mcE = mc

Excellence =Methods x Controls x Calculations

Excellence =Methods x Controls x Calculations

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