Implementation of a quality system in a clinical laboratory – Evaluation of quality indicators

 The aim of this study was to evaluate the primary experience of implementing a quality system in a clinical laboratory. The second interrelated aim was to evaluate the quality and financial indicators needed for continuous measurement of quality, decision making in the laboratory management and everyday process control in analytical work. The quality process itself should be evaluated because the building up of a quality system requires a considerable amount of resources. The most effective and practical ways of using a quality system as a management tool should be found and the need for financial appraisal when the quality system is implemented is stressed. According to our study, when the effects of the quality system were evaluated, the managers of the laboratory had not considered the appropriate financial indicators. The quality indicators considered to be the best were internal quality control, external quality assessment and customer satisfaction surveys. The first benefits of the quality system evaluated by the personnel were other than the purely financial benefits, they include a more systematic and empowering approach to laboratory management, better working instructions, better knowledge of the methods and equipment, and fewer errors. The financial evaluation of a quality process in a public-owned clinical laboratory is complicated due to the fact that financial indicators are not as far developed and diverse as in industrial organisations. When starting to implement a quality system, it is important to pay attention to all measures that motivate the staff and help them benefit from the practical effects of the system. Received: 10 November 1999 / Accepted: 12 January 2000     

The application of Kohonen neural networks to diagnose calibration problems in atomic absorption spectrometry

In atomic absorption spectrometric measurements calibration lines are measured daily. These lines are not always acceptable. They can, for instance, contain outliers, have a bad precision or can be curved. To evaluate the quality of those lines a method which gives a fast diagnosis is recommended. In this study the use of Kohonen neural networks was examined as an automated procedure to classify these calibration lines. The results were compared with those obtained using a decision support system which uses classical statistical methods to classify the lines. The prediction capabilities of both approaches relative to a visual inspection and classification was found to be comparable, or even slightly better for the Kohonen networks, depending on the training set used. For both techniques a prediction error rate of <10% was obtained, relative to a visual classification.     

Development of a multicriteria assessment model for ranking biomass feedstock collection and transportation systems

This study details multicriteria assessment methodology that integrates economic, social, environmental, and technical factors in order to rank alternatives for biomass collection and transportation systems. Ranking of biomass collection systems is based on cost of delivered biomass, quality of biomass supplied, emissions during collection, energy input to the chain operations, and maturity of supply system technologies. The assessment methodology is used to evaluate alternatives for collecting 1.8×10⁶ dry t/yr based on assumptions made on performance of various assemblies of biomass collection systems is based on cost of delivered biomass, quality of biomass supplied, emissions during collection, energy input to the chain operations, and maturity of supply system technologies. The assessment methodology is used to evaluate alternatives for collecting 1.8×10⁶ dry t/yr based on assumptions made on performance of various assemblies of biomass collection systems. A proposed collection option using loafer/stacker was shown to be the best option followed by ensiling and baling. Ranking of biomass transport systems is based on cost of biomass transport, emissions during transport, traffic congestion, and maturity of different technologies. At a capacity of 4×10⁶ dry t/yr, rail transport was shown to be the best option, followed by truck transport and pipeline transport, respectively. These rankings depend highly on assumed maturity of technologies and scale of utilization. These may change if technologies such as loafing or ensiling (wet storage) methods are proved to be infeasible for large-scale collection systems.     

Interlaboratory system to ensure and improve the quality of glassware calibration and use in a large laboratory

This paper describes the implementation and methodology of an interlaboratory system that ensures the quality of glassware calibration and use in a large laboratory. The interlaboratory system involves periodic comparisons between laboratories with evaluations and improvements made over time. Two similar items are calibrated in each exercise according to a detailed calibration procedure. The reference value is traceable to the international system supplied by a metrology laboratory. The results are evaluated as normalized errors and analyzed by Youden graphs. The calibration procedure is presented. An interlaboratory experiment is described in which 7 participating laboratories performed calibrations of 2 volumetric flasks. The reported results, the interlaboratory evaluation, and the actions taken are presented.     

Quality system implementation in a Brazilian university laboratory

The introduction of quality systems in laboratories at universities is a difficult task. Test services for external customers are provided to generate additional budget, and there may be a clear awareness about the need for systematic QA/QC actions. However, offering services is not of the highest priority within most university environments. The staff performance is commonly evaluated on basis of published papers and teaching activities, giving little or no weight for the test services. Therefore, implementation of a quality system is often pushed back to a lower priority leading to postponement. The efforts for creating a quality system in a laboratory from a Brazilian university are described in this paper, along with the results produced.     

Experience of implementing ISO 17025 for the accreditation of a university testing laboratory

The experience of implementing a quality system on ISO 17025, and the accreditation of some tests for a university laboratory, is presented in the example of the Environmental Radiology Laboratory. Such implementation in a university institution is a difficult task, since the setting and environment are both unfavourable. The particularities are the collaboration of many independent units of the university, and the involvement of teachers and young researchers who have to coordinate all these different tasks, which makes the number of people working quite variable. Some specific aspects of the system are discussed. The conclusion is that implementation of a quality system on ISO 17025 and accreditation are completely achievable, and are helpful activities to put university members in touch with the real world and broaden their minds, which in the end has a positive impact on research studies and academic content.     

A review of the role of DSC analysis in the design of fluorozirconate glasses for fibre optic applications

The relatively poor thermal stability of fluorozirconate glasses is a major factor preventing the realisation of their true potential for fibre optic applications. A range of methods based on both isothermal and non-isothermal DSC techniques, which can be employed to evaluate the thermal stability of fluorozirconate glasses, are described. The relevance of these thermal stability criteria to the design of fluorozirconate compositions capable of yielding high quality optical fibres is discussed.     

Internal user inquiries as a useful tool for adjustment of the quality system and for quality improvement

Who could be better than the staff themselves to point out inappropriate and ineffective elements in a quality system? A dialogue between the supplier and the customer for clarification of the customers' requirements and possible quality problems is often part of a quality management system. Of no less importance is a dialogue with the staff who "live" with the quality system in the everyday work environment, handling procedures, keeping records, and controlling documents, etc. For this reason a simple internal user inquiry was conducted. The anonymous inquiry form considered areas which effect daily work, and posed questions which, we had reasons to believe, could be tender points among staff. The result was a very positive feedback on the questions, and several advantages and disadvantages were brought forward. Our experience after 2 years with ISO 9001 certification is that internal inquiries are just as important as the dialogue with customers in maintaining an appropriate and effective quality system. Furthermore, such inquiries focus on the quality system and involve the staff in adjustments, tailoring the system and in quality improvements.     

Computer graphics for quality control in the INAA of geological samples

A data reduction system for the routine instrumental activation analysis of samples is described, with particular emphasis on interactive graphics capabilities for evaluating analytical quality. Graphics procedures have been developed to interactively control the analysis of selected photopeaks during spectral analysis, and to evaluate detector performance during a given counting cycle. Graphics algorithms are also used to compare the data on reference samples with accepted values, to prepare quality control charts to evaluate long term precision and to search for systematic variations in data on reference samples as a function of time.     

Qualitative evaluation of chromatographic data from quality control schemes using a support vector machine

The qualitative evaluation of chromatographic data in the framework of external quality assurance schemes is considered in this paper. The homogeneity in the evaluation of chromatographic data among human experts in samples with analytes close to the limit of detection of analytical methods was examined and also a Support Vector Machine (SVM) was developed as an alternative to experts for a more homogeneous and automatic evaluation. A set of 105 ion chromatograms obtained by anti-doping control laboratories was used in this study. The quality of the ion chromatograms was evaluated qualitatively by nine independent experts (associating a score from 0 to 4) and also more objectively taking into account chromatographic parameters (peak width, asymmetry, resolution and S/N ratio). Results obtained showed a high degree of variability among experts when judging ion chromatograms. Experts applying extremely outlying evaluation criteria were identified and excluded from the data used to develop the SVM. This machine was built providing the system with qualitative information (scores assigned by experts) and with objective data (parameters) of the ion chromatograms. A seven-fold cross-validation approach was used to train and to evaluate the predictive ability of the machine. According to the results obtained, the SVM developed was found to be close to the reasoning process followed by the homogeneous human expert group. This machine also could provide a scoring system to sort laboratories according to the quality of their results. The qualitative evaluation of analytical records using a scoring system allowed the identification of the main factors affecting the quality of chromatographic analytical data, such as the specific analytical technique applied and the adherence to guidelines for reporting positive results.     

3-methyl-2-oxazolidone as a solvent for acid-base titrations

3-Methyl-2-oxazolidone has been evaluated as a solvent for the titration of various weak carboxylic acids and phenols. Its high dielectric constant and wide liquid range contribute to its outstanding solvent properties. Tetrabutylammonium hydroxide was the titrant. End-points were determined potentiometrically with a glass-calomel electrode system. FORTRAN computer programs were used to evaluate the results, and relative acid strengths were determined and related to the aqueous acidity. The accuracies obtained are comparable to those for other solvent media. An 800-mV potential span is available in this solvent, which may allow differentiating titrations to be performed. No titrations of acid mixtures were attempted, but it was found possible to distinguish both neutralization steps for salicylic acid and o-phthalic acid.     

ISO 17025 quality system in a university environment

The experience of working under an ISO 17025 compliant quality system in a university environment is described in the example of the Testing Centre of University of Tartu. University-specific features of the quality system include that the Testing Centre acts as the “quality system server” for other units of the university and graduate students participate in the work carried out under the quality system. The benefits for the university and the graduate students are discussed. It is concluded that implementation of an ISO 17025 compatible quality system in a university is fully accomplishable and gives significant added value to the university by helping to destroy the ivory tower perception about universities and by introducing real-world flavour into the studies and broaden the minds (quality awareness) of the students.     

Current experiences with a quality management system for non-clinical research and development in pharmaceutical industry

Quality management is one of the most important issues in pharmaceutical research as it determines the validity and reliability of data, data and data evaluation being the central products of all research activities. In this business it is of outstanding importance to generate valid data for the assessment of drug development candidates to assure that the huge financial investment, which is based on such assessments, can be successful. Efficacy and safety of products are the final goals of such developments. Therefore, Merck/Merck Serono implemented an additional specifically developed quality management system that covers all areas and locations in Merck Serono Research that were not yet regulated by an existing regulatory quality management system, e.g. GLP (Good Laboratory Practice). The system is known under the name Merck Serono Research-Quality Management System (MSR-QMS). Thus, we describe the implementation process of MSR-QMS as a research specific quality management system in a global company. Furthermore, the implementation process in one specific research department will be highlighted. Using a practical example, the validation of an analytical instrument in a MSR-QMS-regulated research laboratory will be shown and compared to a validation process in a strictly GLP-regulated area. A summary of the experiences with the new quality system will complete this article and the advantages of high quality research results in industry will be discussed.     

The effects of errors in measurements of absorbance and time on the calculated value of a pseudo-first-order rate constant

When data on the variation with time of the absorbance of a reactant or product are used to evaluate the rate constant of a first- or pseudo-first-order reaction, the precision of the result depends on the precisions with which both the time and the absorbance are measured. The natures of the dependences, and the ways in which they are affected by both constant and linearly varying background absorbances, are examined. If the standard error σ_t of a measurement of time is below about 0.005 t_{$\text{1}\text{2}$}, the standard error of the rate constant is virtually identical for an experiment in which the concentration of the reactant is followed as for one in which the concentration of the product is followed, but for larger values of σ_t it is better to follow the concentration of the reactant. In any event, errors in the measurements of time are much more likely to be significant than they are usually assumed to be. Other sources of error in such experiments, including constant and time-dependent background absorbances, are examined more briefly, with emphasis on the requirements that should be satisfied in work of the highest quality.     

Basic steps towards a self-sustainable quality system and laboratory accreditation

 Laboratory managers are facing the task of altering the attitudes of themselves and their employees in order to implement a quality lifestyle, which is the prerequisite for successful implementation of a quality system complying with appropriate international standards. The alterations require a painstaking and constructive approach. Not all laboratories have the resources to secure the assistance of quality consultants. For those laboratory managers who have to find their way towards quality management on their own, some recommendations are given for a path towards a self-sustaining quality system. Several practical aspects of the basic steps in this path, which starts with assessing the current status of the laboratory and is followed by awareness building, are discussed. The recommendations are derived from the experience of the authors in their own laboratories. Received: 5 June 1997 · Accepted: 7 December 1997     

Bleach gel: a simple agarose gel for analyzing RNA quality

RNA-based applications requiring high-quality, non-degraded RNA are a foundational element of many research studies. As such, it is paramount that the integrity of experimental RNA is validated prior to cDNA synthesis or other downstream applications. In the absence of expensive equipment such as microfluidic electrophoretic devices, and as an alternative to the costly and time-consuming standard formaldehyde gel, RNA quality can be quickly analyzed by adding small amounts of commercial bleach to TAE buffer-based agarose gels prior to electrophoresis. In the presence of low concentrations of bleach, the secondary structure of RNA is denatured and potential contaminating RNases are destroyed. Because of this, the 'bleach gel' is a functional approach that addresses the need for an inexpensive and safe way to evaluate RNA integrity and will improve the ability of researchers to rapidly analyze RNA quality.     

Development of a new file search system for nuclear magnetic resonance spectra: Production of an Enlarged Data Base and Search Test

A practical search system for proton n.m.r. spectra is reported. The coding rules and search algorithms are described in detail. Data for 8000 spectra have been converted into a computer-readable file from printed charts. Several search tests are used to evaluate the usefulness of the search system, and various effects of experimental conditions such as different instruments, frequencies and solvents on recall efficiency are described. The results presented indicate that the system should be applicable to routine analytical work.     

Selex: An expert system for evaluating published data on selenium in foods

Providing consistent and objective evaluation of published data on nutrient composition is critical for planning future analytical studies and for effective use of data. Based on a commercial expert system shell, a computer system of approximately 200 rules has been created to evaluate and ratre quantitatively published data on selenium in foods. The evaluation scheme uses five general categories for its rule-making process: number of samples, analytical method, sample handling, sampling plan, and analytical quality control. For each selenium value to be evaluted, rating ar assigned in each category by the expert system based on input which is derived from the information reportedin a given paper. A quality index, which is derived from the ratings, is a measure of the reliability of a given selenium value over all categories for a given study. The concepts used in developing SELEX have the potential of establishing criteria for evaluation of proposed analytical methods prior to their publication.     

Synthesis and Profiling of a Diverse Collection of Azetidine-Based Scaffolds for the Development of CNS-Focused Lead-like Libraries

The synthesis and diversification of a densely functionalized azetidine ring system to gain access to a wide variety of fused, bridged, and spirocyclic ring systems is described. The in vitro physicochemical and pharmacokinetic properties of representative library members are measured in order to evaluate the use of these scaffolds for the generation of lead-like molecules to be used in targeting the central nervous system. The solid-phase synthesis of a 1976-membered library of spirocyclic azetidines is also described.     

First-principles electronic transport calculations in finite elongated systems: a divide and conquer approach

We present a first-principles method for the evaluation of the transmittance probability and the coherent conductance through elongated systems composed of a repeating molecular unit and terminated at both ends. Our method is based on a divide and conquer approach in which the Hamiltonian of the elongated system can be represented by a block tridiagonal matrix, and therefore can be readily inverted. This allows us to evaluate the transmittance and the conductance using first-principles electronic structure methods without explicitly performing calculations involving the entire system. A proof of concept model based on a trans-polyacetylene chain bridging two aluminum leads indicates that our divide and conquer approach is able to capture all the features appearing in the transmittance probability curves obtained by a full scale calculation.