The Second National Workshop on Safety and Quality in Pathology (2008)
Description
This one-day workshop on 6 November 2008 was the second platform to highlight and discuss Quality Use of Pathology Program (QUPP) initiatives. It showcased current and recent QUPP-funded initiatives and further work to date on priorities identified in the Report from the National Workshop on Safety and Quality in Pathology on page 163. This second Workshop also sought to more explicitly engage with requesters and consumers.
Stakeholders represented included:
Royal College of Pathologists of Australasia (RCPA)
to further scan the horizon for future issues to be addressed.
These aims and objectives were achieved by this workshop.
Outcomes
Two interactive sessions were held during the workshop.
The first was to test the ‘Quality Framework’ Map provided in the pre-reading for completeness of the list by category of the organisations and their products that are involved in the national pathology quality framework (outside of the actual laboratories), and suggestions were collected which will be used to expand this report.
The second session was an invited open discussion on the work being done to help and protect consumers using pathology testing under their control (as opposed to those requested by medical practitioners).
Recommendations
Emphasis should be placed on producing guidelines (perhaps incorporating patient pathways) allowing informed choices to be made by consumers rather than on difficult to develop and administer regulation.
Continue to develop strategies to address workforce shortages in pathology and reconvene a group for that purpose in March 2009.
Follow on Initiatives and Projects
Best Practice in Pathology Requesting and Reporting Workshop .
Areas for Future Consideration
As per recommendation No. 1 above.
Best Practice in Pathology Requesting and Reporting Workshop (2009)
Description
This one-day workshop on 9 December 2009 sought to promote collaborative, evidence-based pathology requesting and reporting strategies. It included presentations and some discussion in respect to the latest studies ensuring patient safety and quality in pathology communications, emerging issues and priorities and opportunities for future collaboration of agreed priorities.
Stakeholders represented included:
Royal College of Pathologists of Australasia (RCPA)
Quality Use of Pathology Committee (QUPC)
National Pathology Accreditation Advisory Council (NPAAC)
National Prescribing Service (NPS)
Australian Association of Pathology Practices (AAPP)
Australian General Practice Network
Royal Australian College of General Practitioners (RACGP)
Cancer Australia
National Coalition of Public Pathology (NCOPP)
Confederation of Post Graduate Medical Education Council
A broad range of topics were presented and discussed covering the latest studies, ensuring patient safety and quality in pathology communications, emerging issues and priorities and opportunities for future collaboration on agreed priorities.
A Plenary Session focused on priority areas for future development and collaboration in pathology requesting and reporting.
Findings
Where clear clinical pathways/guidelines exist and are well known, pathology requesting patterns largely appear to mirror guidelines. Problems tend to be found where there are not clear, agreed guidelines and/or clinicians have to juggle competing and possibly non-aligned guidance for several conditions.
Adhering to patient and sample identification and collection protocols external to pathology providers is one evidence-based method of preventing harm to patients.
Recommendations
The workshop identified priority areas for further development and exploration including:
Ensuring eHealth system capacity provides an effective platform for transferring clinical information and results between requesters and pathology providers.
Increasing the focus on the format and content of pathology test request forms and the possible inclusion of more clinical information to draw on pathologists’ expertise regarding smart requesting.
Targeting requester training at critical education and training points e.g. post graduation year one (PGY1) and PGY2 curriculum and general practice (GP) registrar training programs.
Developing clinical practice guidelines on test requesting for health checks and the management of obesity, common multi-morbidity combinations and uncomplicated hypertension.
Focusing on consumer empowerment and engagement through:
better education and training of clinicians to support this
improved access to information including awareness of risks and dangers of unnecessary testing
better communication (readability of pathology reports, need for consumer-friendly language, cultural sensitivity)
guidelines for monitoring/maintenance including self-management.
Exploring the need for further research on the rationales for pathology ordering across various settings and provider types.
Promoting the development of more comprehensible and useful reporting of pathology test results.
Exploring clinical governance issues around accountability and transparency of pathology request and result transactions.
Exploring the capacity for requesters to order tests according to patient circumstances.
Improving mechanisms to monitor testing algorithms and/or managed under shared care arrangements (e.g. anaemia).
Exploring the need to collate and analyse public sector best practice requesting strategies for possible application to the fee-for-service testing model.
Areas for Future Consideration
Review the pathology test request forms for relevance to the current provider/requester/consumer climate.
Explore options to develop guidelines/testing pathways, especially for health checks, obesity, and common multi-morbidity combinations and hypertension.
Explore options to target requesters at critical education and training points.
