4 types of quality costs
Prevention Costs
Appraisal Costs
Internal Failure Costs
External Failure Costs
Prevention costs include (5)
Quality Planning
Validation of Laboratory Processes
Preventative Maintenance
Quality Management Systems
Quality Improvement Activities
Quality Planning
this is where the laboratory management team(s) get together to periodically work on strategies to meet certain quality goals.
Validation of Laboratory Processes
this is the process where the laboratory validates new equipment. Do the analyzer stand up to what the manufacturer claims.
Preventative Maintenance
this doing AND documenting maintenance performed on the analyzers.
Quality Management Systems
this refers back to the 12 building blocks that support the lab’s pre-analytic, analytic, and post-analytic processes.
Quality Improvement Activities
these are activities used to improve processes. For example tracking turnaround times, contamination rates on blood culture bottles,
Appraisal costs include (4)
Ongoing competence assessment
Equipment Calibration
Quality control
Proficiency testing
Ongoing competence assessment
this includes having your team perform proficiency surveys, reviewing competency annually and more often during the employee’s first year.
Equipment Calibration
as it states, this involves making sure analytes are calibrated as required, but also making sure our timers, thermometers are verified against an NIST (National Institute of Standards and Technology)
Quality control
this is making sure all quality control is performed according to manufacturers instructions. It also means reviewing QC daily, weekly, and monthly for trends/shifts.
Proficiency testing
this is used to assess your team, but it is also used to assess the performance of your analyzers as compared to other labs running the same analyzer.
Internal failure costs include (4)
Unacceptable samples
Retesting, reinspectionWasted blood components
Wasted blood components
Downtime
Unacceptable samples
any type of sample received in lab that is clotted or not meeting the laboratory’s acceptance criteria.
Retesting, reinspection
for units that are not used and exceed their expiration time.
Wasted blood components
rerunning of QC due to instrument issues, or again getting a recollected sample
Downtime
this is due to when the analyzer may be down, or you may have computer issues where the interface goes down.
External failure costs include
Customer complaints
Report recalls.
Misdiagnosis
Lawsuits
Customer complaints
these could be issues with their blood draw experience, or may a provider has not received lab reports timely.
Report recalls
this is the discovery of the lab reporting the wrong result on the wrong patient and the lab would need to contact the affected patients for recollects
Misdiagnosis
an example, is for instance, if a severely hemolyzed specimen has a potassium reported and the provider treats the patient on this falsely elevated potassium.
Lawsuits
an example would be transfusing the wrong blood unit on a patient and it causing harm or even death.
What is the best way to reduce the cost of failure?
prevention and appraisal.
aka put time and money into good quality costs.
Examples of how to reduce cost of failure
Plan for Quality
Streamline processes
Validate processes
Write effective documents
Improve training* important in reducing costs