Evaluation of a laboratory system intended for use in physicians' offices. II. Reliability of results produced by health care workers without formal or professional laboratory training.

The Kodak DT-60 tabletop chemistry analyzer was evaluated with standardized protocols to determine the system's precision and accuracy when operated by four volunteers (a secretary, a licensed practical nurse, and two family medicine residents) in a simulated office laboratory. The variability of the results was found to be significantly greater than the variability of results produced by medical technologists who analyzed the same samples during the same study period with another DT-60 placed in the hospital laboratory. The source(s) of increased variance needs to be identified so the system can be modified or new control procedures can be developed to ensure the reliability of results used in patient care.

The impact of a health screening flow sheet on the performance and documentation of health screening procedures.

We monitored physician performance of stool occult blood testing and breast exams during health maintenance visits of patients aged 50 or greater, to assess the impact of a physician education program and the use of a health screening flow sheet on performance of these health screening procedures. During the baseline study period, use of these procedures was documented for only about 40% of patients. A physician education program (conferences reviewing appropriate health maintenance screening procedures, and information on the use of a specific health screening flow sheet) did not significantly change the rate of documented physician performance of these procedures.