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Quality Assurance in Clinical Chemistry: A Touch of Statistics and A Lot of Common Sense

. Lippi G, Banfi G, Church S, Cornes M, De Carli G, Grankvist K, et al. Preanalytical quality improvement. In pursuit of harmony, on behalf of European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working group for Preanalytical Phase (WG-PRE). Clinical Chemistry and Laboratory Medicine 2015; 53(3): 357–70. 51. Lippi G, Becan-McBride K, Behulova D, Bowen RA, Church S, Delanghe J, et al. Preanalytical quality im provement: in quality we trust. Clinical Chemistry and Laboratory Medicine 2013; 51(1): 229–41. 52. Lippi G, Chance JJ, Church S

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Status of Development and Implementation of Medical Laboratories Accreditation in Serbia

as a model of quality improvement in an organisation. Jugoslov Med Biohem 2006; 25: 1-9. Poštić-Grujin A, Majkić-Singh N. Implementation of the ISO 15189 standard in medical laboratory accreditation. Jugoslov Med Biohem 2004; 23: 93-6. Markićević L. J. The significance of medical laboratory accreditation. Jugoslov Med Biohem 23; 2004; 89-91. Huisman W, Horvat R, Burnett D, Blaton V, Czikkely R, Jansen RTP, Kalner A, Kenny D, Mesko P, Plebani M, Queralto J, Schumann G, Šprongl L

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Improving the Preanalytical Process: The Focus on Specimen Quality

-7. Plebani M, Ceriotti F, Messeri G, Ottomano C, Pansini N, Bonini P. Laboratory network of excellence: Enhancing patient safety and service effectiveness. Clin Chem Lab Med 2006; 44: 150-160. Lippi G, Guidi GC. Preanalytic indicators of laboratory performances and quality improvement of laboratory testing. Clin Lab 2006; 52: 457-62. Lippi G, Salvagno GL, Montagnana M, Franchini M, Guidi GC. Phlebotomy issues and quality improvement in results of laboratory testing. Clin Lab 2006; 52: 217-30.

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Governance of Preanalytical Variability and Error Detection

References Lippi G, Guidi GC, Plebani M. One hundred years of laboratory testing and patient safety. Clin Chem Lab Med 2007; 45: 797-8. Lippi G, Guidi GC, Mattiuzzi C, Plebani M. Preanalytical variability: the dark side of the moon in laboratory testing. Clin Chem Lab Med 2006; 44: 358-65. Lippi G, Salvagno GL, Montagnana M, Franchini M, Guidi GC. Phlebotomy issues and quality improvement in results of laboratory testing. Clin Lab 2006; 52: 217

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Pre-Analytical Workstations as a Tool for Reducing Laboratory Errors

Pre-Analytical Workstations as a Tool for Reducing Laboratory Errors

Reducing errors and improving quality are an integral part of Laboratory Medicine. Laboratory testing, a highly complex process commonly called the total testing process (TTP), is usually subdivided into three traditional (pre-, intra-, and post-) analytical phases. A series of papers published from 1989 drew the attention of laboratory professionals to the pre-analytical phase, which currently appears to be more vulnerable to errors than the other phases. Consequently, the preanalytical phase should be the main target for further quality improvement. Therefore, identifying the critical steps in the pre-analytical phase is a prerequisite for continuous quality improvement, further error reduction and thus for improving patient safety. Use of automated systems where feasible, and use of error reduction/improved quality as a factor when selecting instrumentation are the main tools we have to insure high quality and minimize errors in the pre-analytical phase. The reasons for automation of the pre-analytical phase have become so compelling that it is no longer simply a competitive advantage for laboratories, but rather a competitive necessity. These systems can impact on the clinical/laboratory interface and affect the efficiency, effectiveness and quality of care.

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Developing a Lean Consciousness for the Clinical Laboratory

References Stanković AK, DiLauri E. Quality improvements in the preanalytical phase: Focus on urine specimen workflow. Clin Lab Med 2008 (in press). Masaaki I. Kaizen: The key to Japan's competitive success. New York, NY: McGraw-Hill: 1986. Lowell R. Six Sigma: Motorola does it right. www.motorola.com/mu Bonini P, Plebani M, Ceriotti F, Rubboli F. Errors in laboratory medicine. Clin Chem 2002; 48: 691-8. Harry M, Schroeder R

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Medical Biochemistry as Subdiscipline of Laboratory Medicine in Serbia

Summary

Medical biochemistry is the usual name for clinical biochemistry or clinical chemistry in Serbia, and medical biochemist is the official name for the clinical chemist (or clinical biochemist). This is the largest sub-discipline of the laboratory medicine in Serbia. It includes all aspects of clinical chemistry, and also laboratory hematology with coagulation, immunology, etc. Medical biochemistry laboratories in Serbia and medical biochemists as a profession are part of Health Care System and their activities are regulated through: the Health Care Law and rules issued by the Chamber of Medical Biochemists of Serbia. The first continuous and organized education for Medical Biochemists (Clinical Chemists) in Serbia dates from 1945, when the Department of Medical Biochemistry was established at the Pharmaceutical Faculty in Belgrade. In 1987 at the same Faculty a five years undergraduate study program was established, educating Medical Biochemists under a special program. Since the academic year 2006/2007 the new five year undergraduate (according to Bologna Declaration) and four-year postgraduate program according to EC4 European Syllabus for Postgraduate Training in Clinical Chemistry and Laboratory Medicine has been established. The Ministry of Education and Ministry of Public Health accredited these programs. There are four requirements for practicing medical biochemistry in the Health Care System: University Diploma of the Faculty of Pharmacy (Study of Medical Biochemistry), successful completion of the professional exam at the Ministry of Health after completion of one additional year of obligatory practical training in the medical biochemistry laboratories, membership in the Serbian Chamber of Medical Biochemists and licence for skilled work issued by the Serbian Chamber of Medical Biochemists. In order to present laboratory medical biochemistry practice in Serbia this paper will be focused on the following: Serbian national legislation, healthcare services organization, sub-disciplines of laboratory medicine and medical biochemistry as the most significant, education in medical biochemistry, conditions for professional practice in medical biochemistry, continuous quality improvement, and accreditation. Serbian healthcare is based on fundamental principles of universal health coverage and solidarity between all citizens.

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How ISO-15189 laboratory accreditation assures patient safety? / Kako ISO-15189 akreditacija laboratorija osigurava bezbednost pacijenta?

quality improvement and patient safety. Hospital board and medical staff leadership challenges. Chest 2010; 138(1): 171-8. 15. Rose K. H. Project Quality Management: Why, What and How. 2005, J. Ross Publishing, Florida. 16. Lundberg GD. Acting on significant laboratory results. JAMA 1981; 245: 1762-3. 17. Lundberg GD. How clinicians should use the diagnostic laboratory in a changing medical world. Clin Chim Acta 1999; 280: 3-11. 18. Plebani M, Laposata M, Lundberg GD. The brain-tobrain loop concept for

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Primena »Six Sigma« U Kontroli Kvaliteta Zdravstvenih Laboratorija

. Panning R. Using data to make decisions and drive results: a LEAN implementation strategy. Clin Leadersh Manag Rev 2005; 19: E4. Bartel M. Case study: improving efficiency in a large hospital laboratory. Clin Leadersh Manag Rev 2004; 18: 267-72. Sunyog M. Lean Management and Six-Sigma yield big gains in hospital's immediate response laboratory. Quality improvement techniques save more than $400,000. Clin Leadersh Manag Rev 2004; 18: 255-8.

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Quality Indicators of the Pre-Analytical Phase

, Chance JJ, Church S, Dazzi P, Fontana R, et al. Preanalytical quality improvement: from dream to reality. Clin Chem Lab Med 2011; 49: 1113-26. Villa D. Automation, Lean, Six Sigma: Synergies for improving laboratory efficiency. Journal of Medical Biochemistry 2010; 29: 339-48.

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