The Cost of Quality

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