To examine the relation between operational performance, integrated clinical care performance, and financial sustainability, relevant items were arithmetically combined to form subscales of the questionnaire: each item was normalized to the range of 0–100, then the mean was taken for the items contained in each subscale. Scoring of questionnaire items and building of subscales First, which measures might be in use on a large enough scale to be able to compare laboratories in Europe and second, which results might a benchmark pilot survey yield for Germany, Austrian, and Switzerland? In the face of this rather unconstrained situation, the research question of this study was twofold. Thus the need arose for a common estimator for laboratory performance with similar data gathering procedures in different countries as a basis for safe and efficient health care. Due to the heterogeneity of healthcare systems and educational background of laboratory professionals in Europe, direct generalizability of estimates may further be limited. Data for the Asia-Pacific region have been published, but there exist no comparable publications for Europe in general and Germany, Austria, and Switzerland in particular.
The literature on laboratory performance benchmarking, accordingly, is sparse. Examples for the latter are grand totals (such as number of patients, number of orders, number of samples), temporal measures (various measures for turn-around times), and resource measures (such as number of full-time equivalents and laboratory space available). There are, however, a few that appear to be widely used with at least similar definitions of measures. But because laboratory management methods have traditionally been developed rather hands-on and have not yet been well-established in the academic literature, the number of clearly defined and commonly used key performance indicators is limited.
īefore estimating the relation between laboratory operations (one aspect being, e.g., quality) and patient safety, standards of measurement need to be established for both domains.
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The overall picture has led to the coining of the term “quality indicator paradox”, suggesting that there might be a hiatus between the interest of laboratories to improve on the three concepts of efficiency, quality, and patient safety and asking how to speed up the process. regarding execution of the IFCC scheme, still appear to be on a national basis, ongoing efforts have slowly born fruit. The interest in standardization and quality indicators has been increasing over the last years, even though the actual number of laboratories participating in quality indicator schemes appears to be stagnant.
Indeed, apart from the Q‑Probes program of the American College of Pathologists and the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Working Group on Laboratory Errors and Patient Safety (WG-LEPS) there exist little strategic efforts to benchmark and thus support standardization regarding the level of quality or efficiency in diagnostic laboratories. Benchmarking overall diagnostic laboratory performance meets the same challenges as harmonizing external quality assessment schemes, but challenges may even be more basic. Īltogether, laboratory-based diagnostics appear to be an effective and efficient tool albeit not always a standardized one. During the recent months of the SARS-CoV‑2 pandemic, laboratory support has been critical in supporting “rapid and effective contact tracing, implementation of infection prevention and control measures in accordance with national recommendations, and adequate support to the patient”. In particular, it has been shown that the laboratory support has been critical in establishing a safe and efficient diagnostic process, potentially influencing the majority of clinical decision-making while accounting for only about 2% of direct healthcare cost. This has led to deliberations on how to actually improve quality and safety, as described in the Institute of Medicine report “Improving diagnosis in health care”. Strongly influenced by the publication of “to err is human”, awareness regarding the need for improving on patient safety has increased for the last two decades.
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