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Laboratory Quality Assurance Initiative Proposal
Jessica K. Kozel
School of Nursing, Grand Canyon University
NRS-451VN: Nursing Leadership and Management
Laura Miller
July 9th, 2023
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Quality Assurance Review Initiative
The laboratory is responsible for generating accurate, quality results within a timely
manner. In order to ensure accurate laboratory results are being reported, a quality assurance
review process should be put into place. Quality improvements can reduce costs by avoiding
repetition of exams, which results in a waste of time and money for the company, as well as
customer and physician dissatisfaction (Santos, P. R., et al., 2021). There are two approaches I
am proposing to implement this review process including either adding a Quality Assurance lead
position with a dedicated Clinical Laboratory Scientist whose responsibilities include reviewing
post analytical laboratory results, reviewing quality control results, process improvement and
writing procedures. We currently do not have an internal review process implemented in every
department of the laboratory. Some laboratories approach this issue by having the oncoming shift
review the previous shift's results as part of their daily responsibilities. This approach is a more
cost-effective way to hold the existing team responsible for reviewing the results throughout the
day. The benefits of the quality improvement initiative are ensuring patient results are reported
accurately and that quality controls are being run on time, which sometimes can affect patient
testing accuracy. I also want to explore the option of adding another staff member to support the
quality assurance initiative either a lead position or a swing shift laboratory technician that can
support the workload of the day-to-day needs of the laboratory as well as supporting this new
task of completing reviews of the results that are put out every day for the hospital.
Benefits of Quality Assurance Process
I would encourage the laboratory management, lead CLSs and the chief financial officer
to review this proposal and recognize the benefits of implementing this review process. The
benefits of introducing a quality assurance laboratory results review process are decreasing
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erroneous reported laboratory results, rectifying quality control issues, and improving process
and procedures. Another benefit to reviewing laboratory results is recognizing the source of the
error which can lead to retraining staff members or changing and improving processes within the
laboratory. Having a system for reviewing laboratory results also helps maintain communication
and interprofessional relationships within the laboratory and encourages discussions between
staff members across different shifts within the laboratory. Quality Assurances processes
improves accountability and professionalism between coworkers and aids in keeping staff
members engaged in continuing education, in addition, they can identify gaps in their
performance more readily and hence can improve their performance and patient safety (Shaikh,
M. S., et al., 2018).
Cost of Improvement Measure
The quality assurance improvement measure requires another employee being added to
the laboratory in order to have the workforce available to complete the additional task of result
review. There are two options in achieving this goal either adding a swing shift Clinical
laboratory scientist(CLS) during the weekdays or adding a Quality Assurance Lead Clinical
Laboratory Scientist. A CLS’ position has an hourly wage of $32-40 an hour with a 36-hour
work week. This salary cost comes to $59,904-74,880 annually. A CLS lead position has an
hourly salary of $33-42 an hour with a 40-hour work week. This salary cost comes to $68,64087,360 annually. CLS staff members would also need to be trained to help in the efforts of
reviewing results on the weekend shifts.
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Method of evaluation
The quality improvement measure can be evaluated at different time intervals including
one month after implementation, 3 months, and then 6 months after implementation. Measures
for gauging the success of the quality assurance process includes how often an error is caught
and if errors in reporting laboratory results are occurring less often. These processes, when
applied effectively, reduce patient risk and drive quality improvement (Badrick, T., 2021). The
quality assurance process should be patient care centered with the main purpose being protecting
patients and ensuring that they are not getting treated based on erroneous results. Every
erroneous result that is reported as an incident report should be completed so that risk and
nursing leadership can evaluate whether the patient was treated based on the erroneous result and
how it affected patient care and patient outcomes. Another important goal of the process
improvement measure is that it is not centered on punitive actions against Clinical Laboratory
Scientists. Processes and Policies should be reviewed periodically with the motivation centered
on quality laboratory results and improved patient care.
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References
Badrick, T. (2021). Integrating quality control and external quality assurance. Clinical
Biochemistry, 95, 15–27. https://doiorg.lopes.idm.oclc.org/10.1016/j.clinbiochem.2021.05.003
Santos, P. R., Silva, C. L., Gall, M. C., & Grando, A. C. (2021). Impact of pre-analytical errors
on costs of clinical analysis laboratory. Jornal Brasileiro de Patologia e Medicina
Laboratorial, 57. https://doi-org.lopes.idm.oclc.org/10.5935/1676-2444.20210023
Shaikh, M. S., Ali, S. A., Rashid, A., Karim, F., & Moiz, B. (2018). Performance evaluation of a
coagulation laboratory using Sigma metrics. International Journal of Health Care Quality
Assurance, 31(6), 600–608. https://doi-org.lopes.idm.oclc.org/10.1108/IJHCQA-072017-0134