Quality initiatives

Several organizations have developed and implemented quahty initiatives to ensure that clinical laboratories and manufacturers and providers of diagnostic products mcor-porate the principles of quality management and assurance in their daily operations. Examples include (1) Joint Committee for Traceability in Clinical Laboratories (http //www.bipm.fr/en/committees/jc/jctlm/), (2) International Organization for Standardization (http //www.iso.ch), and (3) National Institute of Standards and Technology (http //www,nist.gov). 

Joint Committee for Traceability in Laboratory Medicine (JCTLM)  

Many organizations have been involved in developing a traceable accuracy base for analytes of clinical interest (see Chapter 14). A driver for current efforts to develop such a base is the European Directive 98/79/EC on in vitro diagnostic medical devices (www.ce-mark.com/ivd.pdf), which requires that The traceability of values assigned to calibrators and/or control materials must be assured through available reference measurement procedures and/or available reference materials of a higher order.  

In 2002 the JCTLM was created to meet the requirement for a worldwide platform to promote and give guidance on 

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PSA quality is difficult to achieve, but several steps enhance the quality. Initial program... 

Continuous improvement is designed in to quality management programs. You may be able to demonstrate this in other quality initiatives within your company. Also, in many companies one or more aspects of PSM or ESH performance have stagnated and shown little improvement. A quality approach may reinvigorate these programs. 

Bellomo R, Ronco C, Kellum JA, et al. Acute renal failure—definition, outcome measures, animal models, fluid therapy and information technology needs the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004 8 R204-R212. 

Eschbach J, DeOreo PB, Adamson J, et al. NKF-K/DOQI Clinical Practice Guidelines, National Kidney Foundation, Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI) 2000, 2005 available from www.kidney.org/professionals/kdoqi/ guidelines updates/doqi uptoc.html an. 

With block polymers of more than 20% styrene decrease of solvent quality initially worsens dispersion stability, but thereafter the stability improves. This may be due to a better anchoring of block copolymers adsorbed from a micellar solution. 

Kidney Disease/Dialysis Outcomes Quality Initiative (K/DOQI) Guidelines for Calcium (C), Phosphorus (P), Calcium Phosphorus Product, and Intact Parathyroid Hormone... 

Fischer formula, 4 697 a-Ketoxime, reduction, 2 572 Kettle soap making, 22 723, 736-737 Kettle-type reboilers, 79 510 Kevlar, 70 211, 212 79 742 20 79, 399 TD resins in, 22 589 Kevlar fibers, 73 373-376 26 760 Kew laboratories, 77 248—249 Key-and-lock principle, 7 574 Keyword-in-context (KWIC) index, 78 239 KF alumina, 5 337 Kharasch process, 79 114 Kidney, citric acid in, 6 632t Kidney Disease Outcome Quality Initiative (K/DOQI), 26 823 Kidney failure, 26 813 Kidney function, normal, 26 813 Kielselguhr 22 402... 

The EPA (1994) has reviewed the model and is applying it in its Great Lakes Water Quality Initiative (EPA 1995). The model is available in a self-contained Microsoft Windows-based program which also contains a method for uncertainty analysis by Monte Carlo sim-ulation. This model can be obtained from the Internet web site http / / fas/sfu.ca/rem/era/era.html". 

USEPA, 1994. Great Lakes Water Quality Initiative Technical Support Document. EPA-822-R-94-002. Van der Oost, R., H. Heida, and A. Opperhuizen. 1988. Polychlorinated biphenyl congeners in sediments, plankton, molluscs, crustaceans, and eel in a freshwater lake Implications of using reference chemicals and indicator organisms in bioaccumulation studies. Arch. Environ. Contam. Toxicol. 17 721-729. 

Understand new quality initiatives driven by the Centers for Medicaid and Medicare Services (CMS) and their possible impact on pharmacy operations and management. 

An important part of a GEM plan is the ability to rate the company s compliance and quality status once the assessment has been completed.There are many possible rating systems that can be employed as part of a GEM plan. Figure 1 is one possible rating system that will enable executive management and QA to establish a baseline during this forward quality initiative. 

Pissarra, J., Lourengo, S., Machado, J. M., Mateus, N., Guimaraes, D., and Freitas, V. (2005). Contribution and importance of wine spirit to the port wine final quality—Initial approach. J. Sci. Food Agric. 85,1091-1097. 

US Environmental Protection Agency (1995) Great lakes water quality initiative technical support document for the procedure to determine bioaccumulation factors. Office of Water, EPA-820 - 9-95-005... 

Kellum JA, Mehta RL, Ronco C Acute dialysis quality initiative. Contrib Nephrol. 2001 132 258-265... 

KDOQI Kidney Disease Outcomes Quality Initiative MRA magnetic resonance angiography... 

The terminology associated with kidney diseases has been amended and is clarified here. Previously, renal failure was divided into either acute renal failure (ARF) or chronic renal failure (CRF). These terms indicate the rate at which damage occurs rather than the mechanism by which it occurs. Landmark guidelines developed in the USA by the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI) attempt to evaluate, classify, and stratify CKD (see Table 45-6). The term renal has largely been replaced by Iddney when referring to chronic disease since it is better understood by patients and nonspecialists. However, acute renal failure (ARF) remains standard nomenclature along with ESRD. 

Modified from National Kidney Foundation Document. CHnical practice guidelines for chronic kidney disease evaluation, classification, and stratification. Kidney Disease Outcome Quality Initiative. Am J Kidney Dis 2002 39 81-246. 

J. R. Quality enhancement research initiative in ischemic heart disease A quality initiative from the Department of Veterans Affairs QUERIIHD Executive Committee. Med. Care 2000, 38 (6 Suppl. 1), I49-I59. 

Quality initiatives manager HMO Compliance programs for PharmD... 

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