Across the American healthcare system, numerous trends tug at pathologists and the laboratory medicine services they provide. Both clinical pathologists and anatomic pathologists find themselves confronted with a growing number of demands for change. Increasingly these demands can no longer be ignored or deferred, but require a response.

This issue of The Dark Report provides examples of this quandary. At the Centers for Disease Control and Prevention (CDC), first steps were taken to organize a laboratory Quality Institute (QI). (See pages 2-7.) In keeping with the need to improve patient safety and reduce medical errors, the goal is to identify relevant measures of quality in laboratory testing services, then survey the nation's labs about these quality parameters. The QI will then issue a national report and launch a monitoring system to track the performance of laboratories in reducing errors and improving quality. If everything goes according to schedule, within 24 months, clinical laboratories may be reporting these quality monitors on a regular basis.

Next is the power blackout that impacted 50 million people in the Eastern United States and Canada last week. Laboratories in affected areas lost power and their emergency response procedures were tested without advance notice. (See page 8.) In just two years, terrorist threats, emerging diseases like SARS, and last week's reminder about the possibility of power outages have required lab directors and pathologists to devote considerable time and resources to crisis planning and training.

The turbo-charged environment of change at Kaiser Permanente Northwest's (KP-NW) laboratory division in Portland, Oregon is another example of a trend starting to change lab operations. (See pages 9-14.) After deploying the ISO-9000 quality system in its lab, KP-NW has harvested considerable gains in productivity, quality, and employee morale. This is a real-world validation of how quality management systems can improve lab operations. It will inspire other lab leaders to embrace these management tools.

Finally, following a decade of declining reimbursement, pathology group practices find it tougher to meet demands for compensation, equity, and retirement benefits with existing group business models based on a 1980s fee-for-service healthcare world. (See pages 16-17.) Experts will convene in Atlanta on October 24-25 to present new approaches and business models that help pathology groups enrich their existing cash flows to provide better financial rewards to pathologists in the group.

National Lab Standards Coming For Patient Safety

CDC incubates lab Quality Institute to develop a national report and standards for lab safety

CEO SUMMARY: Because lab test data plays such an important role in medical decision-making, the Centers for Disease Control and Prevention (CDC) has launched a national effort to evaluate the quality of clinical and public health laboratories. In forming a Quality Institute, the goal is to issue a National Report on the Quality of Laboratory Services and develop quality indicators and guidelines that reflect best practices.

Gauging The Impact Of Lab Patient Safety

Plans to collect and report on patient safety in the nation's labs will trigger big changes

CEO SUMMARY: Within 18 months, the Laboratory Quality Institute plans to issue a national report on the quality of laboratory services. Not only will this bring a new level of public attention and scrutiny to clinical laboratory operations, but it will require everyone involved in delivery, use, or payment for laboratory services to respond. Labs will need to take tangible steps to reduce errors and improve quality.

Lab Crisis Planning: Last Week's Power Outage Affects Labs in Many Regions

With municipal power out, labs continue to perform critical tests and report results