The Importance Of Validating Examination Results [continued]

from the May 2006 issue

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One method of alternative quality assurance that can be used to augment and enhance the QA program is implementation of peer review policy. The peer review should include all members of the medical and technical staff and will evaluate the quality of examinations and interpretations. A defined number of random cases are selected for each staff member at intervals included in the laboratory policy (i.e. monthly, quarterly). The reviews should be anonymous whenever possible and the anonymity maintained by the individual responsible for collecting the quality assurance data. Discrepancies should be defined as minor or major, and discrepancy trends should be tracked. All discrepancies are noted, forwarded to the appropriate personnel and discussed at the laboratory QA meeting.

Physician Review
The physician review will include a review of the exam findings and comparison to the final report by another member of the medical staff. Inconsistencies between the test findings and the final report should be documented. As well, the reports should be evaluated for adherence to the diagnostic criteria, report content and format, and timeliness of report availability. A worksheet can be developed which will aid in this process (figure 1).

Technologist/Sonographer Review
The technologist/sonographer is primarily responsible for the performance and documentation of test findings. They are trained to follow a laboratory protocol in order to obtain the most complete study possible for each patient. The technical staff review will consist of random case reviews completed by the technical director. The review should include assessment of exam completeness, adherence to protocol and the technical quality. As with the physician review, a worksheet can be developed to document and track the review findings (figure 2).

FINAL COMMENTS

Though executing a quality assurance program takes additional time and energy in an environment that is often stretched to its limit, a quality assurance program can reinforce existing practices or provide laboratory staff with a mechanism for the early detection of a need for change. The assumption of quality and consistency in the laboratory can leave any laboratory in a very compromising position in the event that complications or complaints arise. Maintaining and utilizing the quality assurance/quality control information collected can prove to be an invaluable educational tool for both the technical and medical staff members in the laboratory, while enhancing the level of patient care and utilization of resources.

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