Resolution and medical utility frequency improves on minimum distinguishable difference.
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Chemistry, Clinical↗
Biomedical subjects
K Castañeda-Méndez
Publications and source records attributed to K Castañeda-Méndez.
Proficiency testing from a total quality management perspective.
Public concern over increasing health-care costs plus dramatized testing errors, has resulted in CLIA '88 with its more stringent rules governing laboratory performance. The purpose of the 1990 U.S. Health Care Financing Administration Final Rules for Proficiency Tests is to separate the quality laboratory from the poorly performing one. From the perspective of total quality management, the customer (patient) defines quality as virtually error-free test results. The current proficiency testing format defeats this. Its effective purpose is not to identify quality laboratories but to shut down the most prolific laboratories--regardless of their quality. There are two reasons for this. First, the proficiency testing format is incomplete: it is missing a minimum frequency criterion. Second, the data for determining the quality of a laboratory's performance (the degree of error-free results) are not being used. I propose a solution based on continuous improvement that promotes voluntarism, favors the quality laboratory, and reduces federal regulation.
Chemistry, Clinical↗
Chemometrics: measurement reliability.
Applying the principles of chemometrics can lead to development of a powerful, simple, comprehensive system for characterizing measurement reliability of analytical processes. The system described here consists of a format for specifications, definitions, and decision rules for evaluating and comparing analytical processes. Two cases illustrate its advantages over the use of precision, accuracy, total error, and regression statistics for such evaluations.
Chemistry, Clinical↗
Medical utility frequency.
Judging the medical acceptability and comparing the medical utility of laboratory methods requires standards for reproducibility with regard to medical performance. A completely general and flexible performance standard for reproducibility consists of the reproducibility criterion, the allowable error, and the concentration value. Neither precision, accuracy, nor total error correctly addresses this standard. The medical utility frequency of a method does do so, however, its use making method evaluation and comparison simple, completely flexible, and exact.
Clinical Laboratory Techniques↗
Value-based cost management: the foundation of a balanced performance measurement system.
Healthcare organizations need critical performance measures if they are to lead, manage, and operate effectively. Traditional financial measures or report cards on patient satisfaction and clinical outcomes are insufficient, however. Value-based cost management directly links cost accounting, processes, clinical outcomes, and patient and employee satisfaction through organizational, work environment, and financial relations measures. These measures address three levels of performance: strategic, diagnostic, and operational. Their linkages identify value in three areas: business-related financial and operational measures; employee-related measures such as those related to satisfaction and well-being; and learning and patient-related measures linked to clinical outcomes, satisfaction, and population.
Cost Control↗
Linking costs and quality improvement to clinical outcomes through added valued.
A byproduct of outcome measures is the provision of financial benefit to the healthcare providers while ensuring healthcare access and quality to the patient. Consequently, a framework for measuring outcomes must integrate the "customer's perspective" of perceiving value of the services provided, the "provider's perspective" of acting as the patient's fiduciary, and the "business's perspective" of achieving net income. Value-based cost management (VBCM) accomplishes this integration by linking several measures with three financial tools: activity-based costing, value-added analysis, and cost of quality. This article illustrates the use and benefit of VBCM to the laboratory as a partner in the delivery of healthcare services with an example of chest pain triage.
Chest Pain↗
The role and application of the balanced scorecard in healthcare quality management.
To connect practices, outcomes, quality, value, and costs, healthcare organizations must start using a balanced scorecard. A balanced scorecard is a set of measures that reveals the interdependency of the organization, its employees, and its patients. It thus serves as a balanced perspective on the organization for senior management to use in designing, developing, deploying, and directing the strategic plan, consistent with total quality management principles.
Education, Continuing↗
Results of the CLMA membership survey on laboratory information systems.
This article presents the results of the CLMA membership survey concerning Laboratory Information Systems. A variety of factors are discussed, including purchase and maintenance cost of systems, user satisfaction, staffing requirements, processor location and control, applications installed, and interfacing to the Hospital Information System.
Clinical Laboratory Information Systems↗