Quality Control Audit Research Articles

Quality control and data-handling in multicentre studies: the case of the Multicentre Project for Tuberculosis Research.

BackgroundThe Multicentre Project for Tuberculosis Research (MPTR) was a clinical-epidemiological study on tuberculosis carried out in Spain from 1996 to 1998. In total, 96 centres scattered all over the country participated in the project, 19935 "possible cases" of tuberculosis were examined and 10053 finally included. Data-handling and quality control procedures implemented in the MPTR are described.MethodsThe study was divided in three phases: 1) preliminary phase, 2) field work 3) final phase. Quality control procedures during the three phases are described. Results: Preliminary phase: a) organisation of the research team; b) design of epidemiological tools; training of researchers. Field work: a) data collection; b) data computerisation; c) data transmission; d) data cleaning; e) quality control audits; f) confidentiality. Final phase: a) final data cleaning; b) final analysis.ConclusionThe undertaking of a multicentre project implies the need to work with a heterogeneous research team and yet at the same time attain a common goal by following a homogeneous methodology. This demands an additional effort on quality control.

Audit des dépôts de produits sanguins labiles

An audit of the quality control system is part of an ongoing improvement process. The hospital-based facilities for the transfusion services not involved in collecting and processing donor blood but issuing blood cell products are expected to achieve quality standards. A quality control audit is considered an essential tool to assess and improve deficiencies or deviations for greater effectiveness. A global approach to transfusion processes added to a strict follow-up by all concerned are necessary for the proper management of transfusion practices and the risks involved. Its function is to achieve a certain quality of health, thus requiring confidence and respect. The end result is to ensure blood transfusion safety.

Hoshin kanri ‐ a participative way of quality management in Japan

The essential steps of “hoshin kanri”, or policy management, in Japanese companies are described. They are annual policy and medium‐ to long‐term policy, basic company philosophy and quality policy, converting methodological policy into objective policy, the composition of policy, two deployment styles of target ‐ top‐down and bottom‐up, target deployment and “catch‐ball”, and top management internal quality control audit

The Kleihauer technique: an accurate method of quantifying fetomaternal haemorrhage?

Blood was taken from 100 consecutive asymptomatic women at 17 to 18 weeks of pregnancy for Kleihauer testing. When a proportion of these slides were assessed at a different hospital there was agreement in only 46%. When the number of fetal cells were quantified there were differences of over 500%. These results show a large inter-observer and inter-hospital variation in interpreting Kleihauer slides. If these investigations are to be performed, it is essential that clinicians can rely on the results. There is a need for quality control measures and audit so that laboratories can rectify any deficiencies in their techniques.

Respiratory symptoms.

Workers with breathlessness or other respiratory symptoms warrant lung function testing with spirometry, which identifies the lung as the cause of the symptoms and separates obstructive lung diseases (mainly asthma and COPD) from restrictive disease (e.g., alveolitis). Occupational health departments should have quality control audits in place for lung function testing. A surveillance questionnaire suitable for use by a responsible person is described.

Computed radiography X-ray exposure trends.

Computed radiography provides correct optical density on film, independent of the incident radiation exposure, but it can result in under- or overexposure of the imaging plate. In the current study, we evaluated the radiation exposure trends of computed radiography over a 2-year period for portable chest examinations to determine and compare the radiographic techniques of the computed radiography system relative to conventional screen-film detectors. A Fuji computed radiography system was interfaced to a digital workstation to track system usage and examination demographics, including examination type and sensitivity number. Hard-copy films were used for diagnosis. The sensitivity number, a value inversely related to incident exposure on the imaging plate, was used to determine whether the proper techniques were used by the technologists. The initial use of the computed radiography system revealed a broad distribution of exposures being used; complaints regarding noisy films (e.g., underexposure) resulted in subsequent overexposure for a significant number of films. A quality-control audit indicating excessive exposure resulted in educational feedback and a tighter distribution of exposures within the optimal range as determined by our radiologists. The average technique was approximately equivalent to a 200-speed system. Computed radiography provides excellent dynamic range and rescaling capabilities for proper film optical density, and thus fewer repeat examinations. However, underexposure results in suboptimal image quality that is related to excessive quantum mottle. Overexposure requires film audits to limit unnecessary radiation exposure. In general, the optimal exposures are achieved with approximately 1.5-2 times the incident detector exposure of a 400-speed rare-earth system. The ability of computed radiography to reduce radiation exposure is unlikely when compared with a typical rare-earth screen-film combination (400 speed) in terms of adequate image quality for the diagnosis of subtle, low-contrast findings. For certain diagnostic procedures (e.g., nasogastric tube placement verification), lower exposures can be tolerated.

Quality Assurance for Environmental Monitoring

Abstract A data quality management framework for ecological monitoring programs is described. A total quality management framework has three key elements: quality management planning, quality control, and quality assessment and audit. The quality management plan establishes the data quality objectives, the protocols and procedure documents to be followed, reporting schedules, training needs and the individuals to be held accountable. Quality control is the systematic set of procedures carried out by each operational unit involved in the measurement process. Quality assessment is the set of procedures designed to provide the overall check on data quality while verifying that the other components of the framework are adequate.

Data Discrepancies and Audit Effects in the Umbilical Artery Catheter Trial

This paper examines the results of a quality control audit of a randomized trial of umbilical artery catheter placement in very low birth weight infants. A single auditor traveled to 12 neonatal intensive care units (NICUs) which participated in the trial to audit a random sample of 10% of the charts of the first 600 infants enrolled. Demographic, medical history, and clinical information were abstracted from the medical records. The greatest discrepancies between the audit results and the original data occurred in the recording of heparin intake. Selected results of the audit were mailed to the participating NICUs. This attempt to point out the discrepancies between the auditor's recording of heparin intake and the original heparin intake recorded by the NICU staff may have resulted in a significant increase in the recorded mean heparin intake of the last 300 infants enrolled in the study. The mean ± s.d. heparin intake among the preaudit cohort was 321 ± 235 units/kg/day compared to 366 ± 237 among the ...

Economic issues in managed care.

Economic issues abound in managed care. The advent of health insurance in the United States, which was created to ensure payment to hospitals, diminished an early emphasis on charity care. Escalating health care costs have ensued. Today, economic considerations dictate the need to control health care expenditures while guaranteeing responsible care. Managed care organizations can achieve both goals by establishing financial partnerships with physicians while instituting quality-control audits, management review teams, and home-care arrangements.

QA at FaAA

Whether the acronyms read QA, QC, or TQM, the concept of ensuring a high level of quality and consistency in products and services is a key management issue of the 1990s. The Information Services staff at Failure Analysis Associates, Inc., frequently provide preliminary research and information for engineering and scientific projects through primary, electronic and/or manual research, and acquisition of relevant documents. To ensure that a consistent level of quality is provided to its clients, all research activities must conform to FaAA's standardized quality assurance (QA) operating procedures. Through a peer research review process, a quality control audit is performed.

Quality education in Japan

Along with the development of modern quality control in Japan into the form of company-wide quality control, all the employees started to participate in the activities, and the importance of their education and training has been recognized. Not only the off-the-job training but also the on-the-job training are emphasized. For example, the internal quality control audit by the upper managers and the quality control circle activities of the workers are the effective on-the-job training for each of them respectively. The quality education of employees is also started in the overseas companies: the example of Matsushita is demonstrated. The key points in the application of basic concepts and tools of quality control are also explained.

The Development of a Postal Pack for Quality Control Audits of Diagnostic X Ray Equipment

A postal pack which will measure tube kilovoltage (kV), total filtration, tube output coupled with patient dose and light beam diaphragm (LBD) alignment in one exposure is under development. It is thought that this will provide a cheap, yet efficient means of carrying out Quality Assurance audits on diagnostic X ray equipment, including mammography.

The Development of a Postal Pack for Quality Control Audits of Diagnostic X Ray Equipment

A postal pack which will measure tube kilovoltage (kV), total filtration, tube output coupled with patient dose and light beam diaphragm (LBD) alignment in one exposure is under development. It is thought that this will provide a cheap, yet efficient means of carrying out Quality Assurance audits on diagnostic X ray equipment, including mammography.

Quality Assurance Audits of Medical Surveillance Programs for Hazardous Waste Workers

The Occupational Safety and Health Administration (OSHA) Hazardous Waste Operations and Emergency Response Regulation (29 CFR 1910.120) requires medical surveillance examinations for hazardous waste workers. We investigated the consistency and appropriateness of the services provided under OSHA 29 CFR 1910.120 as part of a quality control audit. Our study revealed that in most cases the required paperwork including fitness for duty and restrictions or limitations was completed. However, it is also apparent that many of the components of a complete occupational history were not performed. Spirometric examinations often were performed incorrectly. Documentation of baseline tests was not uniformly done, nor were patients always informed of the findings of their examinations. Our study indicated there may be a lack of education, training, and experience of occupational health providers. This suggests that further efforts should be made to educate physicians and nurses providing medical surveillance and other services to hazardous waste workers.

Framework for continuous quality improvement in the provision of pharmaceutical care

Implementation of the continuous quality improvement (CQI) process by health-care organizations is described. CQI involves a chain of events: Improvement in quality leads to decreased costs because of less rework, fewer mistakes, fewer delays, and better use of people and materials; productivity improves; better quality and lower price facilitate capturing the market, staying in business, and providing more jobs. The implementation of CQI within an organization involves the development, standardization, and deployment of standard methods and the use of daily management, cross-functional management, policy management, departmental management, and quality control circles to maintain, improve, or innovate standard methods. An organization's standard methods, key indicators (indicators for measuring performance of the organization's key functions), and standards emanate from its vision and mission statements and midterm and short-term strategic plans. In a quality control audit, an agreed-upon method, as monitored through a key indicator, is used to measure a result against an established standard; when a problem is detected, a quality control diagnosis is conducted and the method is changed if necessary. Use of this process requires the creation of standard methods for all important aspects of the organization's services, including operations, clinical services, and training of personnel. Health-care managers can use the principles of CQI in assessing the quality of care provided.

Quality Control Audits by Top Management

Quality Control Audits by Top Management

Materiality Allocation in Audit Planning: A Feasibility Study

The purpose of the research described in this paper was to develop and test the feasibility of a new and more systematic approach to audit planning. The focal point of the proposed approach is the use of the concept of materiality allocation to plan the assignment of audit effort to various phases of the The ultimate goal of the proposed approach is to make possible more efficient audits, that is, audits which achieve greater levels of assurance at reduced audit costs. Increasing pressures faced by the auditor with respect to audit quality control, monitoring of questionable payments, reporting on internal control, detection of management fraud, and so forth, could lead to an escalation of audit costs. However, a countervailing force operating to inhibit such escalation is the increasingly competitive nature of the auditing industry (Bernstein [1978]). Thus, the auditor is under pressure to provide more services, perform better audits, and charge his clients less. Clearly these factors point to the need for more efficient auditing methods. As stated by Albrecht [1977, p. 50]: ... it is clear that resistance to increased audit fees and a changed audit environment require that we carefully consider ways to improve the audit. More than ever before, the auditing profession needs to develop techniques which enable the auditor to attain maximum levels of assurance at minimum audit costs. As the professional accountant well knows, planning is the key to success in this type of environment.