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Clinical Laboratories and Pathology Groups

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Clinical Laboratories and Pathology Groups

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Joint Commission Goes International with Healthcare Quality Standards

As part of its plan to stake out a place in the international market for healthcare quality standards, Joint Commission International (JCI), the international arm of The Joint Commission (JC), in partnership with the World Health Organization (WHO), launched a new global program to improve patient care and safety worldwide.

JCI’s first demonstration project involves financially strapped, low-performing hospitals in Mexico, China and Palestine, according to JCI Chief Medical Officer David Jaimovich. In an interview with Modern Healthcare, he suggests that the demonstration project allows JCI to measure the program’s capabilities under the worst conditions.

The program, “Essentials of Health Care Quality and Patient Safety”, focuses on five high-risk areas known to have the greatest impact on quality and safety. It provides a way to evaluate progress and defines the levels of effort for each criterion. The five areas include:

1) leadership process

2) accountability,

3) competent and capable workforce,

4) safe environment for staff and patients, and,

5) clinical care of patients.

In an interview with Modern Healthcare, Asian healthcare expert Tsung-Mei Cheng, editor of Princeton’s International Forum, says China is committed to updating and upgrading its hospitals, so international benchmarking should be “enormously helpful.”

In Mexico, President Felipe Calderón emphasizes improvements to healthcare as way to maintain the healthy workforce required to sustain the strong economy vital to keeping the nation’s skilled workforce at home. Mexico’s status as a trade partner, neighbor and destination for Americans traveling and living abroad makes the United States a stakeholder in ensuring healthcare quality and safety in Mexico.

In fact, the increased migration of Americans, Canadians, and Europeans to Mexico is an important factor in Mexico’s efforts to upgrade its healthcare system to U.S. standards. Physicians in Mexico, many of whom were educated in U.S. medical schools are forming physicians groups and establishing American-style medical testing and diagnostic services. Some of these physicians have a goal and a hope that they can negotiate contracts with Medicare and other U.S insurers to provide services to U.S. citizens living in Mexico.

The push for international healthcare quality standards will continue to be a priority in a global economy. Foreign markets attractive to aging Baby Boomers, however, also provide tremendous opportunities for healthcare service providers. So it is no surprise that the Joint Commission wants to play an increased role in helping establish and maintain health quality and accreditation standards in many countries across the globe.

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UK Junior Doctors Ordering Lab Tests They Can’t Interpret

Findings of a recent study on laboratory test ordering confirm what is widely-known by laboratory professionals across the globe. In the United Kingdom, many junior doctors do not understand common hospital laboratory tests and are putting patients at risk as a result. This was the primary observation of UK biochemists in a recently-published study.

Dr. Trevor Grey from the Northern General Hospital in Sheffield, England surveyed 80 junior doctors, asking them how they felt about the clinical biochemistry tests they were expected to order on a daily basis. His findings were published as “Learning Needs in Clinical Biochemistry for Doctors in Foundation Years” in the January 2008 issue of The Annals of Clinical Biochemistry. The article reported that one in five (18%) of more than 80 junior doctors surveyed were happy to order a test they could not fully interpret. The article, along with an editorial piece by Dr. Danielle Freedman of the Association of Clinical Biochemistry, blamed both poor teaching and a reduction the amount of pathology and laboratory medicine taught at medical schools.

When asked about 12 common lab tests, junior doctors questioned during this survey said they were not entirely confident about interpreting the results for 10 of them. For three common types of lab tests, more than one-third of the junior doctors surveyed said they were not confident about interpreting the results. 18% of the junior doctors said they were happy to order a test which they did not fully understand how to interpret. Seven out of 10 junior doctors said they would find more teaching in biochemistry to be useful.

In Freedman’s editorial, she said the results revealed “a national problem” in the UK. She knew of situations where patients were discharged from a hospital, only to suffer a major heart attack because a key laboratory test had either not been ordered or the results had not triggered an appropriate clinical response. The UK’s General Medical Council is currently preparing to review its guidance on the content of medical education.

Across the laboratory medicine profession, there is recognition that time devoted to pathology and clinical lab testing in medical school is often not adequate to teach new physicians to be: 1) both competent and confident in ordering the right tests at the appropriate time; then 2) responding to the lab test results with the correct, recommended actions. Efforts to constantly improve patient safety will eventually evaluate and assess how young physicians are using laboratory tests. It will take a few more years for that to happen.

However, when real-time data is gathered that links errors in patient care to inappropriate ordering of lab tests and improper response to test results by young physicians-who were not properly trained during their medical education-only then is it likely that healthcare systems in the UK and other countries will take active steps to remedy this long-recognized deficiency.

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