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The Uganda Makerere University provides clinical laboratory support to over 70 clients in Uganda. With increased volume, manual data entry errors have steadily increased, prompting laboratory managers to employ the Six Sigma method to evaluate and reduce their problems. The purpose of this paper is to describe how laboratory data entry quality was improved by using Six Sigma.

The Six Sigma Quality Improvement (QI) project team followed a sequence of steps, starting with defining project goals, measuring data entry errors to assess current performance, analyzing data and determining data‐entry error root causes. Finally the team implemented changes and control measures to address the root causes and to maintain improvements. Establishing the Six Sigma project required considerable resources and maintaining the gains requires additional personnel time and dedicated resources.

After initiating the Six Sigma project, there was a 60.5 percent reduction in data entry errors from 423 errors a month (i.e. 4.34 Six Sigma) in the first month, down to an average 166 errors/month (i.e. 4.65 Six Sigma) over 12 months. The team estimated the average cost of identifying and fixing a data entry error to be $16.25 per error. Thus, reducing errors by an average of 257 errors per month over one year has saved the laboratory an estimated $50,115 a year.

The Six Sigma QI project provides a replicable framework for Ugandan laboratory staff and other resource‐limited organizations to promote quality environment. Laboratory staff can deliver excellent care at a lower cost, by applying QI principles.

This innovative QI method of reducing data entry errors in medical laboratories may improve the clinical workflow processes and make cost savings across the health care continuum.

The Thailand National Institute of Health (NIH) established an external quality assessment (EQA) scheme on HIV serology testing since 1994 for many public health laboratories. For the past six years, the NIH has evaluated the activities of 226 laboratories.

Approximately 40,000 tests using 16 trial samples of external quality assessment panel performed at 226 laboratories during 2000‐2006. The methods performed were classified into five assays; machine‐based enzyme immunoassay (MBA), microplate‐based enzyme immunoassay (EIA), simple/rapid test and antigen assay only performed at blood screening laboratory centers. A few laboratories performed confirmation method by western blot (WB). Most participating laboratories performed at least two methods.

The evaluation showed that, during the six‐year period, the program had an increasing response rate among all groups of laboratories: government hospital laboratories, private hospital and clinic laboratories and blood screening laboratory centers. Moreover, there were no significantly different errors found between these groups. The highest median percent of overall errors found was in antigen assay. Very minimal errors appeared on other methods.

National HIV EQA program has played an important role in improving the quality of participating laboratory performance. The participating laboratories gained a better understanding and were able to use good quality anti‐HIV approved kits. Furthermore, HIV serology testing selection was varied over the past six years as microplate‐based EIA was mostly used in the past but currently MBA and simple/rapid test are more commonly used. The test methods were determined by test volumes and budget. In addition, sensitivity was one critical reason labs chose to use EIA. The most popular method used was simple/rapid testing. Overall errors occurred with all assays but not with WB. Errors could occur with any test techniques if good quality management is not employed.

Many new laboratories have been built and others extended in recent years. It would be surprising if, in the process, the same problems did not keep cropping up. It would be even more surprising if fairly common solutions had not been found to a good proportion of them. These areas of common ground emerge in the symposium published in this issue and the next. In the symposium, which is restricted to electrical engineering laboratories, the contributors describe the arrangements in some up‐to‐date labs in colleges of various sizes. The intention is to indicate the requirements which they were designed to meet and, in turn, to relate these requirements to the aims and organisation of laboratory work. The symposiasts, in expressing their opinions, have in total covered this wide field quite thoroughly, but it is not intended to be a survey — there is no documentation of how each point of practice is carried through in a range of different laboratories — rather, good examples of modern methods used in individual laboratories are presented. To agree on standard laboratory plans and equipment lists to meet certain sets of requirements would not be desirable — even if it were possible. Areas where opinions and practices differ will become clear, and further points of difference will, we hope, be brought out in subsequent correspondence. The symposiasts and others designing or reconsidering their laboratories will welcome reactions and suggestions from readers: practical work and laboratory experiments occupy such a significant place in technical education in this country — even judged only by the allocation of course time and the expenditure on equipment — that the fullest discussion and most careful thought must be given to the planning of teaching workshops and laboratories.

Following two pilot studies, Clinical Pathology Accreditation (CPA) accreditation was introduced to UK pathology laboratories in 1992. Since then, significant numbers of laboratories have undergone accreditation but many have never applied. We carried out a postal survey of 145 accredited laboratories in the UK to independently determine the opinions of laboratory managers/clinicians about CPA and whether accreditation had produced any significant benefits to pathology services. Ninety‐three replies were received (64 per cent) a good response to an unsolicited questionnaire. Most laboratories felt accreditation by CPA had resulted in better laboratory performance with more documentation and better health and safety and training procedures. CPA accreditation was believed to provide useful information by approximately 50 per cent of laboratories but was also felt by a significant proportion of laboratories to be over‐bureaucratic, inefficient and expensive (46 of 93 respondents). Many complaints were voiced about the excessive paperwork that CPA generated and there was also a significant body of opinion that felt that CPA assessed areas were the domain of other regulatory bodies such as the CPSM, IBMS and HSE.

Inadequate measurement capability can place a heavy burden of implicit costs on manufacturers – even drive them out of business. It can have serious consequences for stakeholders in industry, commerce or science. High‐technology manufacturing must ensure a high level of precision in measurements, often to as much as a millionth of an inch. In seeking such high levels of precision, measurement laboratories often use traceability as a key precision criterion. Two comprehensive sets of measurements made over time by high‐precision laboratories on gauge blocks are used to explore the scope of traceability in ensuring high‐precision measurements. Significant differences were found between the high‐precision primary laboratories traceable to the National Institute of Standards and Technology in the USA. Explores general implications of such between‐laboratory differences and makes recommendations for secondary laboratories and stakeholders in dimensional metrology seeking to ensure a high level of precision in their measurements.

Laboratory data are extensively used in medical practice; consequently, laboratory errors have a tremendous impact on patient safety. Therefore, programs designed to identify and reduce laboratory errors, as well as, setting specific strategies are required to minimize these errors and improve patient safety. The purpose of this paper is to identify part of the commonly encountered laboratory errors throughout our practice in laboratory work, their hazards on patient health care and some measures and recommendations to minimize or to eliminate these errors.

Recording the encountered laboratory errors during May 2008 and their statistical evaluation (using simple percent distribution) have been done in the department of laboratory of one of the private hospitals in Egypt. Errors have been classified according to the laboratory phases and according to their implication on patient health.

Data obtained out of 1,600 testing procedure revealed that the total number of encountered errors is 14 tests (0.87 percent of total testing procedures). Most of the encountered errors lay in the pre- and post-analytic phases of testing cycle (representing 35.7 and 50 percent, respectively, of total errors). While the number of test errors encountered in the analytic phase represented only 14.3 percent of total errors. About 85.7 percent of total errors were of non-significant implication on patients health being detected before test reports have been submitted to the patients. On the other hand, the number of test errors that have been already submitted to patients and reach the physician represented 14.3 percent of total errors. Only 7.1 percent of the errors could have an impact on patient diagnosis.

The findings of this study were concomitant with those published from the USA and other countries. This proves that laboratory problems are universal and need general standardization and bench marking measures.

Original being the first data published from Arabic countries that evaluated the encountered laboratory errors and launch the great need for universal standardization and bench marking measures to control the laboratory work.

This study aims to dissect the multifaceted impact of ISO/IEC 17025 accreditation, specifically within civil engineering testing and calibration laboratories. To achieve this, it intends to explore several key objectives: identifying the prominent benefits of accreditation to laboratory performance, understanding the advantages conferred through participation in proficiency testing schemes, assessing the role of accreditation in enhancing laboratory competitiveness, examining the primary challenges encountered during the accreditation process, investigating any discernible adverse effects of accreditation on laboratory performance and evaluating whether the financial cost of accreditation justifies the resultant profitability.

This study employs a qualitative approach through semi-structured interviews with 23 industry professionals—including technical managers, quality managers, external auditors and clients. Thematic analysis, guided by Braun and Clarke’s six-stage paradigm, was utilized to interpret the data, ensuring a comprehensive understanding of the accreditation’s impact.

Findings reveal that accreditation significantly enhances operational processes, fosters quality awareness and facilitates continuous improvement, contributing to greater client satisfaction. In addition, standardized operations and rigorous quality controls further result in enhanced performance metrics, such as staff capability and measurement accuracy. However, the study also uncovers the challenges of accreditation, including high resource costs and bureaucratic hurdles that can inhibit innovation and slow routine operations. Importantly, the research underscores that the impact of accreditation on profitability is not universal, but contingent upon various factors like sector-specific regulations and market demand. The study also highlights sector-specific variations in the role of accreditation as a marketing tool and differing perceptions of its value among clients. It further emphasizes the psychological stress of high-stakes evaluations during audits.

This study represents the first in-depth investigation into the impact of ISO/IEC 17025 accreditation on civil engineering testing and calibration laboratories, directly contributing to the enhancement of their quality and operational standards. Providing actionable insights for laboratories, it underscores the importance of weighing accreditation costs and benefits and the necessity for a tailored approach to the unique market and regulatory landscapes they operate in.

A review of the first year physics laboratory program in 1991 at the University of Technology, Sydney (UTS) revealed that student laboratory experiences did not: resemble the practice of physicists; give a realistic picture of the contribution of physics to everyday life, or; enhance students’ capabilities of broad value, such as their communication skills. Physics academics at UTS committed themselves to reforming students’ laboratory experiences with inquiry-oriented learning as a center-piece of the reform. This chapter explores the drivers that led to the reconceptualization of the role of the laboratory in the undergraduate curriculum and the strategies and processes we adopted over more than 20 years to embed inquiry-oriented activities into first year physics laboratory programs.

This paper provides a general comparison between the ethos, methodological mission, and theoretical standpoint of the New Iowa School, established by Carl Couch and his students and Second Life, a three dimensional virtual world that invites particular forms of sociation. Despite differences in orientation and purpose, as well as biases in communication, we propose that the methodological and conceptual emphasis underlying the research generated from New Iowa School experimental studies can provide a useful framework for research into the virtual worlds created in Second Life. In the course of citing similarities and differences between the New Iowa School and Second Life, we also note that contrived worlds in laboratories and virtual worlds in user domains not only have relevant analogical processes to outside, in situ social worlds, but consist of social stages for performances that have application to the various social stages constructed by actors in the real world. In conclusion, we suggest that the New Iowa School and Second Life represent different but compatible realities in their own right, that the conceptual depth associated with the New Iowa School can inform research into Second Life interactions, and that each offer insights into the external worlds inhabited by real actors who navigate across time and space in their everyday lives.

In this chapter, we discuss the Change Laboratory as an intervention-research methodology in higher education. We trace its theoretical origins in dialectical materialism and activity theory, consider the recommendations made by its main proponents and discuss its use in a range of higher education settings. We suggest that the Change Laboratory offers considerable potential for higher education research, though tensions between Change Laboratory design recommendations and typical higher education contexts require consideration.