on 11/14/02 3:54 PM, Soto, Roxanne at RSoto@covhealth.org wrote:

> QA would be like mislabeling slides.
> 
> -----Original Message-----
> From: Gary Gill [mailto:garygill@dcla.com]
> Sent: Thursday, November 14, 2002 4:49 PM
> To: 'Soto, Roxanne'; Histonet (E-mail)
> Subject: RE: QA ISSUES
> 
> 
> First define QA vs. QC.  Give an example of what you consider QA.
> 
> Gary Gill
> 
> -----Original Message-----
> From: Soto, Roxanne [mailto:RSoto@covhealth.org]
> Sent: Thursday, November 14, 2002 5:33 PM
> To: Histonet (E-mail)
> Subject: QA ISSUES
> 
> 
> Anybody have any good QA ideas you are willing to share?
> 
> Roxanne
> 
> 
> 
> 
> 
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This is just a basic overview of what I feel the differences between quality
control and quality assurance is.  Quality Assurance is different from
quality control.  In my opinion quality control is temperature charts,
recording solution changes, etc.   Quality assurance is the
outcome-orientated process by which the performance of a complete production
operation is controlled and evaluated.  It is stongly focused on the use of
resources and the end product.  In pathology the end product is information
(or a diagnosis)  A pathologic diagnosis is the result of a number of
processes.  Quality assurance schemes are structured, they are largely
dependent upon the routine practices of individuals and institutions,
therefore it is impossible to define a program that can be universally
applied.  The definition of assurance is to make certain, to give
confidence, to guarantee.  As the concept of quality assurance has advanced
in the hospital setting we not only want to guarantee the quality of work
that we provide, but we also want to improve on the existing quality.
Therefore the terms of Quality Improvement, Total quality management and
continuous quality improvement have replaced the older term of quality
assurance. 

 Quality Assurance is tied to Quality Improvement.  You want to assure the
level of quality that you provide.   To do that you need to  define
processes (how you get the work done), indicators  (turn around time,
section quality, recuts) and criteria or standards  for these indicators.
The indicators that you choose to look at should be dependent upon the areas
in the lab where you feel that there are potential problems or areas of
improvement.  Some basic indicators are turn around time, number of recuts
(due to poor quality, etc)  mislabeled specimens.  You need to c hoose your
indicators and then set standards for them (what is an acceptable turn
around time for routine slide, or frozen section turn around time, number of
recuts, etc.)  But whatever you do when you are defining your indicators and
the standards for your indicators do not do this by yourself.  Quality
assurance and quality improvement is a TEAM process, everyone in the lab
needs to have ownership of the indicators and the standards that are defined
for these indicators.    I have not been in clinical for years so I need
some help here.  Does JCAHO or CAP have specific indicators that they want
the lab to look at or do they just require that you have a quality assurance
with quality improvement program in place.

The other thing to keep in mind is that this is not a small task, it takes
time and effort.  But in my opinion that time and effort is well worth the
outcomes.  

Roxanne, I have a copy of a lecture that I have given at national, if you
give me your address I can send it to you, it might be a little out of date,
but I believe that most of the concepts are still applicable.

I hope this helps

Liz Chlipala
BolderPATH, Inc.
bolderpathec@mindspring.com