In the current atmosphere of closer scrutiny of healthcare practices and procedures, front-line managers and health care providers must investigate potential problems in their work environment, whether at the behest of upper management, in order to meet Joint Commission on Accreditation of Health Care Organizations (JCAHO) standards, or through their own sense that “weÆre doing something wrong.” For the investigator with limited previous experience in evaluation or research, the prospect of undertaking this kind of investigation can appear daunting, to say the least. Quality Improvement Projects in Health Care was written just for this individual. Author Eleanor Gilpatrick, a seasoned investigator and professor of health services administration, provides a review of the basic terminology and guidelines for carrying out “nuts-and-bolts” quality improvement research. She then demonstrates how such a research project can be implemented through 14 case studies involving actual health care situations. Altogether, the cases speak to a broad array of issues and potential pitfalls for the unwary investigatorŭand they show that progress can be made in even the most difficult circumstances. Quality Improvement Projects in Health Care will be of interest to students and professionals in health sciences administration, nursing, allied health, and public health.

Dealing with Hemolyzed Blood Samples in a Hospital Laboratory1
Case 7: Dealing with hemolyzed blood samples in a hospital laboratory

In this case, the internal consultant found a set of nested problems. The original problem was thought to be too many hemolyzed blood specimens sent to the laboratory, but it eventually appeared that there was also a problem with the way the laboratory itself dealt with and reported hemolyzed specimens.

Proving the Problem

The Problem

Gwen was an assistant section manager in a special chemistry laboratory of a proprietary hospital. As part of the organization's increasing interest in quality improvement, Gwen was asked to study the incidence of hemolyzed blood specimens reaching the laboratory for testing. When a blood sample is taken for testing, it can become hemolyzed: The ...

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