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2006 Leadership Conference

2006 Clinical and Laboratory Standards Institute General Session presentations

Creating a Culture of Patient Safety Through Risk Management: 

This introductory presentation describes the fundamentals of risk management that is, "what is risk to us?" It provides an overview of the risk cascade and approaches to risk mitigation.

Patient Safety during an Emergency:  An emergency uniquely challenges healthcare operations and patient safety. This presentation provides a brief review of potential process defects spanning the emergency continuum of care, and their effects regarding patient safety. General preparedness recommendations are also provided.

Managing risk in the pre-analytical testing process:   Studies have shown that most errors in the laboratory testing process occur in the preanalytic portion of the testing cycle.  Major sources of error include order entry, patient and sample identification, and inadequate patient preparation.  This presentation will include data on the frequency of errors and possible approaches to reduce error to improve patient safety. 

Managing risk in the analytical testing process:  This session considers the basic types (failure modes) or sources of error in the analytical testing process. Consideration is given to error detection approaches for each type of failure mode, and error prevention approaches.

Managing risk in the post-analytical testing process:  This presentation focuses on where risk is found in the post-analytical portion of the total testing process. Risk related to entry of data into the reporting system, post-analytical modification, notification, application of interpretive, report formatting, transmission of reports, provider awareness and provider action are considered.

Risk management – An international perspective:  This presentation looks at WHO and Joint Commission International initiatives as well as the ISO documents on risk management in medical laboratories The experience of five Italian laboratories - promoting a network of excellence- in the field of risk analysis is analyzed.