Bachner P, Howanitz P J
Department of Pathology and Laboratory Medicine, United Hospital Medical Center, Port Chester, NY 10573.
Qual Assur Health Care. 1991;3(3):167-77. doi: 10.1093/intqhc/3.3.167.
This paper will review the reasons for the increasing emphasis on quality assurance in American healthcare and laboratory medicine. This emphasis is driven in part by economic, social and regulatory concerns as well as the traditional commitment to the search for excellence in services provided to patients. The Q-Probes Program of the College of American Pathologists (CAP) represents a response to these pressures and will be described in some detail. The program is based upon the historical success of interlaboratory comparison programs developed and sponsored by the CAP in achieving demonstrable improvement in laboratory performance. These programs are dependent on the gathering of data from large numbers of laboratories in order to establish provisional "benchmarks" of quality practice which serve as a baseline for systematic quality improvement efforts. The Q-Probes Program gathers peer-group specific institutional data concerning defined aspects of quality practice in pathology and laboratory medicine. These highly structured programs provide laboratories and pathology services with a format to collect data for submission to the CAP for analysis and to compare their performance against that of appropriately stratified peer groups. Several representative examples chosen from clinical laboratory medicine and pathology will be presented. We will attempt to demonstrate how individual laboratory and pathology services utilize aggregate data to effect specific changes in practice that lead to improvement in processes of patient care and better patient outcomes.
本文将回顾美国医疗保健和检验医学中日益重视质量保证的原因。这种重视部分是由经济、社会和监管方面的担忧驱动的，也是对为患者提供优质服务这一传统承诺的体现。美国病理学家学会（CAP）的Q-Probes计划就是对这些压力的一种回应，将对此进行详细描述。该计划基于CAP制定和发起的实验室间比对计划在实现实验室性能显著提升方面的历史成功经验。这些计划依赖于从大量实验室收集数据，以建立质量实践的临时“基准”，作为系统性质量改进努力的基线。Q-Probes计划收集有关病理和检验医学质量实践特定方面的同组机构数据。这些高度结构化的计划为实验室和病理服务提供了一种格式，用于收集数据并提交给CAP进行分析，以及将其性能与适当分层的同组进行比较。将给出几个从临床检验医学和病理学中选取的代表性例子。我们将试图展示单个实验室和病理服务如何利用汇总数据在实践中实现特定变革，从而改善患者护理流程并带来更好的患者结局。
