1.1 Background and Aims
1.2 Agenda and Pre-reading
1.3 Attendees
1.4 Presentations
1.5 Interactive sessions
1.6 Closing Session
1.1 Background and Aims
A workshop was convened on the 6th November 2008 by the Pathology Section in the Diagnostics Services Branch of the Australian Department of Health and Ageing in conjunction with The Quality Use of Pathology Committee, the National Pathology Accreditation Advisory Council and the Royal College of Pathologists of Australasia.- The subject was patient safety and quality in Australian pathology. The workshop followed a similar workshop held on the 27th November 2007. 1 The aims of the 2008 Workshop were to:
- Provide an update to stakeholders on the progress made in the priority areas since the initial Workshop, and discuss future proposed work;
- Identify any gaps that need addressing; and
- Further scan the horizon for future issues to be addressed.
In order of priority they were:
- Workforce
- Smart Requesting
- Positive Identification
- Testing Outside the Current Quality Framework
- Smart Reporting
The report from the 2007 Workshop suggested the Department ‘consider reconvening in two years to evaluate progress and revise the plan’ but the Department decided it was timely to hold another workshop to address the progress made and further distil areas of need. Top of page
Given the predominance of participants were from the pathology sector at the 2007 workshop, the 2008 workshop sought to more explicitly engage with requesters and consumers.
To this end, a list of key stakeholders to be invited was prepared by the Pathology Section and Professor Leslie Burnett (NPAAC), Dr Michael Harrison (QUPC) and Dr Bev Rowbotham, President of the Royal College of Pathologists of Australasia (RCPA). To increase consumer involvement the Department also consulted with the Consumers’ Health Forum of Australia.
1.2 Agenda and Pre-reading
The agenda for the meeting is shown in Appendix A. Briefing papers were distributed to invitees prior to the meeting. These are provided in Appendix B and include:- Australian Pathology Quality Framework (External to Laboratories) - A possible framework to consider the players external to laboratories (and their products) that are involved in establishing the ‘safety and quality’ of the pathology system based on the categories used by the Australian Business Excellence Framework and the US Baldridge National Quality Program (Health).
- Smart Reporting – QUPP-funded projects
- Smart Requesting – QUPP-funded projects
- Pathology Workforce Issues – potential QUPP-funded projects
- The Australian Pathology Workforce Crisis – A Report by Michael Legg & Associates to the Australian Department of Health and Ageing, Diagnostic Services Branch, Pathology Section
- Report from the National Workshop on Safety and Quality in Pathology held in Canberra 28 November 2007 – A Report by Michael Legg & Associates to the Australian Department of Health and Ageing, Diagnostic Services Branch, Pathology Section
1.3 Attendees
The workshop was attended by health consumer representatives, those responsible for policy, those who write pathology reports and those who request, read and use the reports, those who design and build information systems and clinical and population researchers. It included members and representatives from the following key organisations:- Royal College of Pathologists of Australasia
- RCPA Quality Assurance Programs Pty Ltd
- Australian Association of Pathology Practices
- National Coalition of Public Pathology
- Consumers’ Health Forum of Australia
- National E-Health Transition Authority
- Australasian Association of Clinical Biochemists
- Health Informatics Society of Australia
- National Association of Testing Authorities
- Royal Australian College of General Practitioners
- Human Genetics Society of Australasia
- ACT Division of General Practice
- Cancer Institute of NSW
- University of Sydney (GP Statistics and Classification Centre)
- Medical Industry Association of Australia
1.4 Presentations
The workshop commenced with an introduction by Yvonne Korn, Assistant Secretary of the Diagnostics Services Branch, Australian Department of Health and Ageing. To share the learnings and to demonstrate progress since the last Workshop short presentations were provided by:- Professor Leslie Burnett, Chair of NPAAC - Key Findings of the KIMMS Project - the Key Incident Monitoring and Management System
- Dr Michael Brown, Anatomical Pathologist, ACT Pathology – Anatomical Pathology and QA in the ACT
- Professor David Davies, Anatomical Pathologist and former President RCPA – Quality and risk in the practice of diagnostic Anatomical Pathology
- Dr Michael Legg, Consultant – A Quality Framework for Australian Pathology; and The Australian Pathology Workforce Crisis
- Ms Debbie Stanford, Director of Pathology (Quality) Section, Diagnostics Services Branch, Australian Department of Health and Ageing – Draft Pathology Workforce Plan; and Response to the Phillips Fox Report: A review of the level of public health risk and adequacy of controls over non-Medicare pathology services
- Dr Tony Badrick, Chair Pathology Associations Workforce Steering Group – Scientist Workforce
- Dr Mark Shephard, Community Point-of-Care Services Flinders University Rural Clinical School, and Ms Janice Gill, RCPA Chemical Pathology Quality Assurance Programs – Testing Outside The Framework - The National ‘QAAMS’ Point-Of-Care Testing Program
- Ms Rosy Tirimacco, Integrated Cardiovascular Clinical Network SA – iCCnet SA PoCT Services
- Dr Caroline Laurence, Disciplines of General Practice and Public Health School of Population Health and Clinical Practice The University of Adelaide – The Role of Point of Care Testing in managing chronic conditions: results from the PoCT Trial
- Dr Janny Wale, CHF Consumer Representative – Pathology and Consumers
- - can we develop a partnership approach?
- Dr Michael Harrison, Chair of QUPC – Quality Use of Pathology Program Connections
- Dr Bev Rowbotham, President RCPA – The pathologist’s role in smart requesting
- Dr Helena Britt, Director Family Medicine Research Centre – Evidence practice gap in GP pathology test ordering - a QUP Project
- Dr Graeme Suthers, Chair Genetics Advisory Committee RCPA – Towards best practice in requesting genetic testing
- Dr David Ellis, Chair Structured Pathology Reporting of Cancer Project (CINSW, RCPA, CA) – Project update
- Dr Christopher Wagner, NEHTA Clinical Leader and General Practitioner – E-Health and Pathology Services - A Clinician’s perspective
- Mr Dean Meston, NEHTA Pathology – ePathology
1.5 Interactive sessions
Two interactive sessions were held during the workshop. The first of these 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 the national pathology quality framework (outside of the actual laboratories). Each table was assigned a category and asked to write suggestions for additions or edits on to a post-it note. These were collected and have been used to expand and modify the report on a ‘Quality Framework for Australian Pathology’ which is being produced as a separate piece of work.The second session invited open discussion on the work that is being done to help and protect consumers using pathology testing under their own control (as opposed to that requested by medical practitioners). The consensus of the room was that 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. This will be considered by the QUPC when developing priorities for funding potential QUPP projects.
1.6 Closing Session
In the closing session the Chairs of NPAAC – Professor Leslie Burnett; the QUPC –Dr Michael Harrison; and the RCPA – Dr Bev Rowbotham were invited to provide the meeting with an indication of the activities that their organisations were intending to consider in the coming year.
These included:
- NPAAC – See Appendix E – Priorities for NPAAC: 2007-2009 for the presentation
- Quality and Safety
- Workforce Shortage
- New and Emerging Technologies
- Collaboration
- QUPC
- Workforce
- Structure & Supply of the Pathology Workforce
- Career Structures and Pathways for Scientists, Technical Officers and Health Informatics Professionals in Pathology Laboratory Settings
- Review of Pathology Specialist Development Pathways
- Quality consumer services
- Quality referrals
- Quality pathology practice
- RCPA
- Workforce
- Work with the Pathology Associations Committee and separately to gain recognition of the workforce issue as the major threat to quality and safety in pathology
- Initiate action on the mitigation strategies identified in the workforce report
- Participate in workforce audit and need surveying and measurement
- Education
- Continued participation and leadership in pathology education
- Smart Requesting and reporting
- Participate in the development of innovations in requesting and reporting
1 A report on the workshop was published entitled ‘Report from the National Workshop on Safety and Quality in Pathology Held in Canberra 28 November 2007’ by Michael Legg & Associates – The report forms part of APPENDIX B of this report and is also available at
http://wcmprd01.central.health/internet/main/publishing.nsf/Content/qupp-report-safety-qualrept07-toc