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Introduction-
Laboratory Quality
Management System
Introduction Laboratory Quality Management System-Module 1 2
At the end of this activity, participants will be
able to:
 Explain the importance of a quality
management system
 List the quality system essential elements
 Describe the history of development of
quality principles
 Discuss relationship of this quality model to
ISO and CLSI standards
Learning Objectives
Introduction Laboratory Quality Management System-Module 1 3
Organization Personnel Equipment
Purchasing
&
Inventory
Process
Control
Information
Management
Documents
&
Records
Occurrence
Management Assessment
Process
Improvement
Customer
Service
Facilities
&
Safety
The Quality Management System
Introduction Laboratory Quality Management System-Module 1 4
What is Quality?
Introduction Laboratory Quality Management System-Module 1 5
5
Achieving a 99% level of quality
means
accepting a 1% error rate
1%
Introduction Laboratory Quality Management System-Module 1 6
In France a 1% error rate
would mean everyday
 14 minutes without water or electricity
 50,000 parcels lost by postal services
 22 newborns falling from
midwives’ hands
 600,000 lunches contaminated
by bacteria
 3 bad landings at Orly Paris airport
Introduction Laboratory Quality Management System-Module 1 7
7
Result: 1% failure
Introduction Laboratory Quality Management System-Module 1 8
Essential to all aspects of
health care are laboratory
results that are
 accurate,
 reliable, and
 timely
Introduction Laboratory Quality Management System-Module 1 9
Laboratory errors cost in
time
personnel
effort
patient
outcomes
Introduction Laboratory Quality Management System-Module 1 10
How do we
achieve
excellent
performance
in the
laboratory?
Organization Personnel Equipment
Purchasing
&
Inventory
Process
Control
Information
Management
Documents
&
Records
Occurrence
Management
Assessment
Process
Improvement
Customer
Service
Facilities
&
Safety
Introduction Laboratory Quality Management System-Module 1 11
Quality Management System Definition
Coordinated activities to direct and
control an organization with regard
to quality (ISO,CLSI).
All aspects of the laboratory operation
need to be addressed to assure
quality; this constitutes
a quality management system.
Introduction Laboratory Quality Management System-Module 1 12
Complexity of a Laboratory System
•Data & Laboratory
Management
•Safety
•Customer Service
Patient/Client Prep
Sample Collection
Sample Receipt and
Accessioning
Sample Transport
Quality Control
Testing
Record Keeping
Reporting
Personnel Competency
Test Evaluations
Introduction Laboratory Quality Management System-Module 1 13
Path of Workflow
THE PATIENT Test selection Sample Collection
Sample Transport
Laboratory Analysis
Examination Phase
Report Creation
Report Transport
Preexamination Phase
Result Interpretation Postexamination Phase
Introduction Laboratory Quality Management System-Module 1 14
WHY is the Path of Workflow essential
to consider in health laboratories?
The entire process of managing a
sample must be considered:
 the beginning: sample collection
 the end: reporting and saving of results
 all processes in between.
Introduction Laboratory Quality Management System-Module 1 15
Laboratory tests are influenced by
 laboratory environment
 knowledgeable staff
 competent staff
 reagents and equipment
 quality control
 communications
 process management
 occurrence management
 record keeping
Introduction Laboratory Quality Management System-Module 1 16
Twelve Quality System Essentials
set of
coordinated
activities that
function as
building blocks
for
quality
management
Organization Personnel Equipment
Purchasing
&
Inventory
Process
Control
Information
Management
Documents
&
Records
Occurrence
Management
Assessment
Process
Improvement
Customer
Service
Facilities
&
Safety
Introduction Laboratory Quality Management System-Module 1 17
Organization Personnel Equipment
Purchasing
&
Inventory
Process
Control
Information
Management
Documents
&
Records
Occurrence
Management
Assessment
Process
Improvement
Customer
Service
Facilities
&
Safety
Path of Workflow
Introduction Laboratory Quality Management System-Module 1 18
Organization
Responsibilities, Authorities
Communication
Provision
of
resources
Quality
Policy
Introduction Laboratory Quality Management System-Module 1 19
Personnel
human resources
job qualifications
job descriptions
orientation
training
competency assessment
professional development
continuing education
Introduction Laboratory Quality Management System-Module 1 20
Equipment
acquisition
installation
validation
maintenance
calibration
troubleshooting
service and repair
records
Introduction Laboratory Quality Management System-Module 1 21
Purchasing and Inventory
vendor qualifications
supplies and reagents
critical services
contract review
inventory management
Introduction Laboratory Quality Management System-Module 1 22
Process Control
quality control
sample management
method validation
method verification
Introduction Laboratory Quality Management System-Module 1 23
Information Management
 confidentiality
 requisitions
 logs and records
 reports
 computerized laboratory
information systems (LIS)
Introduction Laboratory Quality Management System-Module 1 24
Documents Records
creation collection
revisions and review review
control and distribution storage
retention
Introduction Laboratory Quality Management System-Module 1 25
Occurrence Management
complaints
mistakes and problems
documentation
root cause analysis
immediate actions
corrective actions
preventive actions
Introduction Laboratory Quality Management System-Module 1 26
Laboratory Assessment
External
Proficiency
testing (EQA)
Inspections
Accreditations
Internal
Internal
Introduction Laboratory Quality Management System-Module 1 27
Process Improvement
opportunities for improvement (OFIs)
stakeholder feedback
problem resolution
risk assessment
preventive actions
corrective actions
Introduction Laboratory Quality Management System-Module 1 28
Customer Service
customer group identification
customer needs
customer feedback
Introduction Laboratory Quality Management System-Module 1 29
Facilities and Safety
safe working environment
transport management
security
containment
waste management
laboratory safety
ergonomics
Introduction Laboratory Quality Management System-Module 1 30
Implementing
Quality Management
does not
guarantee
an
ERROR-FREE
Laboratory
But it detects
errors that may
occur and
prevents them
from recurring
Introduction Laboratory Quality Management System-Module 1 31
Organizatio
n
Personnel Equipment
Purchasing
&
Inventory
Process
Control
Information
Management
Documents
&
Records
Occurrence
Manageme
nt
Assessmen
t
Process
Improvement
Customer
Service
Facilities
&
Safety
Laboratories not
implementing a
quality management
system guarantees
UNDETECTED
ERRORS
Introduction Laboratory Quality Management System-Module 1 32
Laboratory
Quality Management System
Coordinated activities to direct and
control an organization with regard to
quality.
ISO 9000:2000
Introduction Laboratory Quality Management System-Module 1 33
Innovators of Quality
Walter
Shewhart
1891-1967
W. Edwards
Deming
1900-1993
Joseph Juran
1904-2008 (103 years)
Philip Crosby
1926-2001
Robert Galvin
b. 1922
Introduction Laboratory Quality Management System-Module 1 34
A Brief History of Quality Management
Innovator Date Cycle
Walter A.Shewhart 1920s Statistical Process
Control
W. Edwards Deming 1940s Continual
Improvement
Joseph M. Juran 1950s Quality Toolbox
Philip B. Crosby 1970s Quality by
Requirement
Robert W. Galvin 1980s Micro Scale Error
Reduction
Quality Management is not new.
Introduction Laboratory Quality Management System-Module 1 35
Standards Organizations
ISO
International Organization
for Standardization
CLSI
Clinical and Laboratory
Standards Institute
(formerly known as NCCLS)
Guidance for quality in
manufacturing and service
industries
Standards, guidelines, and
best practices for quality in
medical laboratory testing
Broad applicability; used
by many kinds of
organizations
Detailed; applies
specifically to medical
laboratories
Uses consensus process in
developing standards
Uses consensus process in
developing standards
Introduction Laboratory Quality Management System-Module 1 36
ISO Documents - Laboratory
ISO 9001:2000 Quality Management
System Requirements
Model for QA in design, development
production, installation, and servicing
ISO/IEC 17025:2005 General
requirements for the competence of
testing and calibration laboratories
ISO 15189:2007 Quality management
in the clinical laboratory
Introduction Laboratory Quality Management System-Module 1 37
ISO 15189:2022
 The foundation of international
medical laboratory quality
management
 Medical laboratories–Particular
requirements for quality
and competence
Introduction Laboratory Quality Management System-Module 1 38
CLSI Quality Documents
HS1-A2 A Quality Management System Model
for Health Care
describes quality system model, 12 essentials
aligns to ISO 15189 and parallels ISO 9000
applies to all health care systems
GP26-A3 Application of Quality Management
System Model for Laboratory Services
describes laboratory application of quality system model
relates the path of workflow to the quality system essentials
assists laboratory in improving processes
relates to HS1-A2 and ISO 15189
Introduction Laboratory Quality Management System-Module 1 39
In summary
 Quality management is not new.
 Quality management grew from the good works of
innovators who defined quality over a span of 80
years.
 Quality management is as applicable for the medical
laboratory as it is for manufacturing and industry.
Introduction Laboratory Quality Management System-Module 1 40
 A laboratory is a complex system and all
aspects must function properly to achieve
quality.
 Approaches to implementation will vary with
local situation.
 Start with the easiest, implement in
stepwise process.
 Ultimately, all quality management system
elements must be addressed.
Key Messages
Introduction Laboratory Quality Management System-Module 1 41
Questions?
Comments?
Organization Personnel Equipment
Purchasing
&
Inventory
Process
Control
Information
Management
Documents
&
Records
Occurrence
Management
Assessment
Process
Improvement
Customer
Service
Facilities
&
Safety
1_d_introduction QMS.ppt it is step by step information about quality management system

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1_d_introduction QMS.ppt it is step by step information about quality management system

  • 2. Introduction Laboratory Quality Management System-Module 1 2 At the end of this activity, participants will be able to:  Explain the importance of a quality management system  List the quality system essential elements  Describe the history of development of quality principles  Discuss relationship of this quality model to ISO and CLSI standards Learning Objectives
  • 3. Introduction Laboratory Quality Management System-Module 1 3 Organization Personnel Equipment Purchasing & Inventory Process Control Information Management Documents & Records Occurrence Management Assessment Process Improvement Customer Service Facilities & Safety The Quality Management System
  • 4. Introduction Laboratory Quality Management System-Module 1 4 What is Quality?
  • 5. Introduction Laboratory Quality Management System-Module 1 5 5 Achieving a 99% level of quality means accepting a 1% error rate 1%
  • 6. Introduction Laboratory Quality Management System-Module 1 6 In France a 1% error rate would mean everyday  14 minutes without water or electricity  50,000 parcels lost by postal services  22 newborns falling from midwives’ hands  600,000 lunches contaminated by bacteria  3 bad landings at Orly Paris airport
  • 7. Introduction Laboratory Quality Management System-Module 1 7 7 Result: 1% failure
  • 8. Introduction Laboratory Quality Management System-Module 1 8 Essential to all aspects of health care are laboratory results that are  accurate,  reliable, and  timely
  • 9. Introduction Laboratory Quality Management System-Module 1 9 Laboratory errors cost in time personnel effort patient outcomes
  • 10. Introduction Laboratory Quality Management System-Module 1 10 How do we achieve excellent performance in the laboratory? Organization Personnel Equipment Purchasing & Inventory Process Control Information Management Documents & Records Occurrence Management Assessment Process Improvement Customer Service Facilities & Safety
  • 11. Introduction Laboratory Quality Management System-Module 1 11 Quality Management System Definition Coordinated activities to direct and control an organization with regard to quality (ISO,CLSI). All aspects of the laboratory operation need to be addressed to assure quality; this constitutes a quality management system.
  • 12. Introduction Laboratory Quality Management System-Module 1 12 Complexity of a Laboratory System •Data & Laboratory Management •Safety •Customer Service Patient/Client Prep Sample Collection Sample Receipt and Accessioning Sample Transport Quality Control Testing Record Keeping Reporting Personnel Competency Test Evaluations
  • 13. Introduction Laboratory Quality Management System-Module 1 13 Path of Workflow THE PATIENT Test selection Sample Collection Sample Transport Laboratory Analysis Examination Phase Report Creation Report Transport Preexamination Phase Result Interpretation Postexamination Phase
  • 14. Introduction Laboratory Quality Management System-Module 1 14 WHY is the Path of Workflow essential to consider in health laboratories? The entire process of managing a sample must be considered:  the beginning: sample collection  the end: reporting and saving of results  all processes in between.
  • 15. Introduction Laboratory Quality Management System-Module 1 15 Laboratory tests are influenced by  laboratory environment  knowledgeable staff  competent staff  reagents and equipment  quality control  communications  process management  occurrence management  record keeping
  • 16. Introduction Laboratory Quality Management System-Module 1 16 Twelve Quality System Essentials set of coordinated activities that function as building blocks for quality management Organization Personnel Equipment Purchasing & Inventory Process Control Information Management Documents & Records Occurrence Management Assessment Process Improvement Customer Service Facilities & Safety
  • 17. Introduction Laboratory Quality Management System-Module 1 17 Organization Personnel Equipment Purchasing & Inventory Process Control Information Management Documents & Records Occurrence Management Assessment Process Improvement Customer Service Facilities & Safety Path of Workflow
  • 18. Introduction Laboratory Quality Management System-Module 1 18 Organization Responsibilities, Authorities Communication Provision of resources Quality Policy
  • 19. Introduction Laboratory Quality Management System-Module 1 19 Personnel human resources job qualifications job descriptions orientation training competency assessment professional development continuing education
  • 20. Introduction Laboratory Quality Management System-Module 1 20 Equipment acquisition installation validation maintenance calibration troubleshooting service and repair records
  • 21. Introduction Laboratory Quality Management System-Module 1 21 Purchasing and Inventory vendor qualifications supplies and reagents critical services contract review inventory management
  • 22. Introduction Laboratory Quality Management System-Module 1 22 Process Control quality control sample management method validation method verification
  • 23. Introduction Laboratory Quality Management System-Module 1 23 Information Management  confidentiality  requisitions  logs and records  reports  computerized laboratory information systems (LIS)
  • 24. Introduction Laboratory Quality Management System-Module 1 24 Documents Records creation collection revisions and review review control and distribution storage retention
  • 25. Introduction Laboratory Quality Management System-Module 1 25 Occurrence Management complaints mistakes and problems documentation root cause analysis immediate actions corrective actions preventive actions
  • 26. Introduction Laboratory Quality Management System-Module 1 26 Laboratory Assessment External Proficiency testing (EQA) Inspections Accreditations Internal Internal
  • 27. Introduction Laboratory Quality Management System-Module 1 27 Process Improvement opportunities for improvement (OFIs) stakeholder feedback problem resolution risk assessment preventive actions corrective actions
  • 28. Introduction Laboratory Quality Management System-Module 1 28 Customer Service customer group identification customer needs customer feedback
  • 29. Introduction Laboratory Quality Management System-Module 1 29 Facilities and Safety safe working environment transport management security containment waste management laboratory safety ergonomics
  • 30. Introduction Laboratory Quality Management System-Module 1 30 Implementing Quality Management does not guarantee an ERROR-FREE Laboratory But it detects errors that may occur and prevents them from recurring
  • 31. Introduction Laboratory Quality Management System-Module 1 31 Organizatio n Personnel Equipment Purchasing & Inventory Process Control Information Management Documents & Records Occurrence Manageme nt Assessmen t Process Improvement Customer Service Facilities & Safety Laboratories not implementing a quality management system guarantees UNDETECTED ERRORS
  • 32. Introduction Laboratory Quality Management System-Module 1 32 Laboratory Quality Management System Coordinated activities to direct and control an organization with regard to quality. ISO 9000:2000
  • 33. Introduction Laboratory Quality Management System-Module 1 33 Innovators of Quality Walter Shewhart 1891-1967 W. Edwards Deming 1900-1993 Joseph Juran 1904-2008 (103 years) Philip Crosby 1926-2001 Robert Galvin b. 1922
  • 34. Introduction Laboratory Quality Management System-Module 1 34 A Brief History of Quality Management Innovator Date Cycle Walter A.Shewhart 1920s Statistical Process Control W. Edwards Deming 1940s Continual Improvement Joseph M. Juran 1950s Quality Toolbox Philip B. Crosby 1970s Quality by Requirement Robert W. Galvin 1980s Micro Scale Error Reduction Quality Management is not new.
  • 35. Introduction Laboratory Quality Management System-Module 1 35 Standards Organizations ISO International Organization for Standardization CLSI Clinical and Laboratory Standards Institute (formerly known as NCCLS) Guidance for quality in manufacturing and service industries Standards, guidelines, and best practices for quality in medical laboratory testing Broad applicability; used by many kinds of organizations Detailed; applies specifically to medical laboratories Uses consensus process in developing standards Uses consensus process in developing standards
  • 36. Introduction Laboratory Quality Management System-Module 1 36 ISO Documents - Laboratory ISO 9001:2000 Quality Management System Requirements Model for QA in design, development production, installation, and servicing ISO/IEC 17025:2005 General requirements for the competence of testing and calibration laboratories ISO 15189:2007 Quality management in the clinical laboratory
  • 37. Introduction Laboratory Quality Management System-Module 1 37 ISO 15189:2022  The foundation of international medical laboratory quality management  Medical laboratories–Particular requirements for quality and competence
  • 38. Introduction Laboratory Quality Management System-Module 1 38 CLSI Quality Documents HS1-A2 A Quality Management System Model for Health Care describes quality system model, 12 essentials aligns to ISO 15189 and parallels ISO 9000 applies to all health care systems GP26-A3 Application of Quality Management System Model for Laboratory Services describes laboratory application of quality system model relates the path of workflow to the quality system essentials assists laboratory in improving processes relates to HS1-A2 and ISO 15189
  • 39. Introduction Laboratory Quality Management System-Module 1 39 In summary  Quality management is not new.  Quality management grew from the good works of innovators who defined quality over a span of 80 years.  Quality management is as applicable for the medical laboratory as it is for manufacturing and industry.
  • 40. Introduction Laboratory Quality Management System-Module 1 40  A laboratory is a complex system and all aspects must function properly to achieve quality.  Approaches to implementation will vary with local situation.  Start with the easiest, implement in stepwise process.  Ultimately, all quality management system elements must be addressed. Key Messages
  • 41. Introduction Laboratory Quality Management System-Module 1 41 Questions? Comments? Organization Personnel Equipment Purchasing & Inventory Process Control Information Management Documents & Records Occurrence Management Assessment Process Improvement Customer Service Facilities & Safety

Editor's Notes

  • #26: Proficiency Testing is the equivalent of External Quality Assessment (EQA).