The Westgard Rules

What's New: January 2016

Posted by Sten Westgard, MS

It's 2016.
Do you know where your IQCP is?


EQC is dead and gone and IQCP has gone live. Two years of anticipation have culminated in a flurry of last minute efforts to meet the deadline. But now that we've reached the Era of IQCP, what have labs actually accomplished?

Your Risk-Free IQCP inspection tips
An example simplified IQCP Primer
An example IQCP for C.Difficile

 

---

Sigma-metric Analysis:
cobas 8000 c701

A recent study in Revista de Caldida Asistencial analyzed the latest core laboratory system from Roche Diagnostics and the importance of implementing an analytical quality control system. The University Hospital of Salamanca in Spain scrutinized the analytical performance of their chemistry assays, with the help of Bio-Rad Multiqual controls, and calculated Sigma-metrics to help assess that performance.

When you apply the toughest Ricos goals, can today's latest instrument stand up? Or are the CLIA goals still relevant and practical?
 

---

Sigma-metric analysis:
Mindray BC-5000

We don't often analyzer hematology instruments at Westgard Web. It's been too long since our last review.  So we're looking at a study of a new minature automated hematology analyzer as detailed in the International Journal of Laboratory Hematology. Are today's hematology instruments meeting the necessary performance specifications?

In hematology, do we need to worry about assay quality?

 

---

Welcome SiPH, Param 9 and Ramathibodi Hospitals to Sigma VP


Praram 9 Hospital


Ramathibodi Hospital


Siriraj Piyamaharajkarun Hospital (SiPH)

Three more hospitals have achieved the Sigma Verification of Performance.

Pop Quiz: How much time should it take to build an IQCP?

Posted by Sten Westgard, MS

Now that the age of the IQCP is here, laboratories are grappling with the time and effort it takes to build their Individualized Quality Control Plans. How long should it take to build an appropriate IQCP?

• 40+ hours
• 21-40 hours
• 11-20 hours
• 5-10 hours
• Less than 5 hours?

How much time has it taken for you? How much time do you think it should take?

Are we measuring too much?

Posted by Sten Westgard, MS

A recent op-ed in the New York Times by Dr. Robert Wachter as well as an interview with Don Berwick in HealthLeaders Media broached a taboo topic: is healthcare measuring too much?

'[T]he measurement fad has spun out of control. There are so many different hospital ratings that more than 1,600 medical centers can now lay claim to being included on a “top 100,” “honor roll,” grade “A” or “best” hospitals list. Burnout rates for doctors top 50 percent, far higher than other professions. A 2013 study found that the electronic health record was a dominant culprit. Another 2013 study found that emergency room doctors clicked a mouse 4,000 times during a 10-hour shift. The computer systems have become the dark force behind quality measures.'
How Measurement Fails Doctors and Teachers, New York Times, January 16, 2016

As the global debate over establishing the best error models and performance specifications rages, laboratories are probably asking themselves the same questions that the doctors are asking: how many metrics are too much?

A possible answer, or at least some more questions, after the jump...

New publication: Quality Control Review

Posted by Sten Westgard, MS

The January issue of Annals of Clinical Biochemistry has an updated Quality Control Review article from Westgard and Westgard:

Quality Control Review: Implementing a scientifically based quality system 2016, Westgard JO, Westgard SA, Annals of Clinical Biochemistry, Jan;53(Pt 1):32-50
[subscription required]

More than a decade ago, back in 2003, Dr. Westgard provided a comprehensive overview of Quality Control for Annals of Clinical Biochemistry. Since then, the broader implementation of sigma-metrics and the introduction of the new "Risk-based" approach to QC (IQCP in the US) have changed the landscape of quality control in the laboratory.

This is a thorough discussion of the new quality ecosystem and we are grateful to the journal for allowing us enough space to give it the discussion it deserves.

Westgard in the Fab Four (of Pathologists)?

Posted by Sten Westgard, MS

Last year the Pathologist magazine released their 2015 Power rankings. Guess who made the Fab Four?

2015 Power Pathologist List

That fellow in the orange coat, the 4th beatle, if you will, is our very own James O. Westgard. Congratulations to my father for being including in a power ranking, especially a Pathologist power ranking,

We're all used to "Westgard Rules", but I guess now we also have "Westgard Rocks", too. The power ranking is here: https://thepathologist.com/the-power-list-2015/ The full issue is here: https://thepathologist.com/issues/1015/