AARC Diagnostic Section Meeting



AARC Diagnostic Section Meeting Minutes from

October 8, 2002

Chair Bulletin Editor:

Catherine Foss, BS, RRT, RPFT Michael Snow, RPFT, RCPT

Duke University Health Systems Medical Graphics Corporation

Tel: (919) 668-3599 ph Vice President , Research and Development

Tel: (919) 668-0494 fax (651) 766-3378 ph (651) 766-3389 fax

e-mail: foss0005@mc.duke.edu Michael.Snow@

• Communication

Section Bulletins 4 per year, decreased from 6

□ Looking for peer input for article ideas, authors

□ Sign up if you have suggestions or are interested in being an author (or contact editors or chair)

□ Feature Topics

Cardiac and multi-disciplinary

Pulmonary Physiology/Function Adult

Pulmonary Physiology / Function Pediatric

Bronchoscope, Sleep Issues

Blood gase

□ 2 major topics 1500 words or less in each bulletin

• Networking

AARC Website -

□ Diagnostic Section Members-only site

□ List-serve everyone needs to sign up!

□ Helpful Websites e.g. NCCLS, JCAHO, ATS, Dr. Westgard’s site, virtual hospital pulmonary areas, PFT interpretation. We need more suggestions! What are favorite sites?

□ SWAP shop in specialty area

□ Internet Coordinator – Open position

□ State Society Diagnostic sections - listings and chairpersons, still trying to get on website

□ Resource Directory - Sign up on web-site, to become part of the expert panel. Utilize the expertise of these volunteers willing to share with you. Needs update

• Practitioner of the Year

Structured selection process

Nomination forms available mid-year

Dale Mayers, 2002 SPOY

• Diagnostic Section’s Future

Recruitment of new members

□ Implications for strength of section, seat on AARC board

□ Nominations for Chair-Elect position in 2003

□ Volunteers needed for section committee positions

Internet coordinator 1 or 2 people

Bulletin Co-Editor 1 or 2 people

Authors for articles

Nominations committee

Practitioner of the year Coordinator

• Clinical Practice Guidelines

(CPG’s) Carl Mottram Chairing

□ Current AARC CPG’s , On-line at AARC

Spirometry,Cardio-pulmonary Exercise

Diffusing Capacity, Metabolic Testing

Static Lung Volumes, Infant Testing

Body Plethysmography, Bronchoscopy

Arterial Blood Gas Puncture, Pulse Oximetry, Arterial Blood Gas Analysis

□ Suggested CPG’s what is in the pipeline? 6 minute walk,

Muscle Strength Testing

• Educational Materials

□ Individual Independent Study Packages (IISP’s) On-line in future

Static Lung Volumes, Peak Flow

Spirometry, Diffusing Capacity

Whole Body Plethesmograph

□ ATS Function Procedure Manual

(212) 315-8700 Update

□ ATS Six Minute Walk Statement

□ Alpha -1 ATD Educational Brochure

Pulmonary Function Testing .30 /ea if ordering >10 brochures, Available in English and Spanish



1-800-521-3025

• Uniform Reporting Manual Update for Diagnostics - Available for Purchase at the AARC booth or on web-site

• Research and Outcomes studies

□ Abstracts for 2003 conference

□ NETT Emphysema trial in final year, update

□ Others from audience…

• Government Issues

□ APC’s Ambulatory Procedure Categories

PPS changes for 2002 delayed

□ CDC committee updates

□ Physician supervision rules

• National Committee for Clinical Laboratory Standards Update: Sue Blonshine, NCCLS Representative and Carl Mottram

1. Carl Mottram attended CLIAC Advisory meeting in 1/02 regarding the CDC working group recom-mendations on unregulated tests held 8/8/01.

2. The publication of HS4, A Quality System Model for Respiratory Services, released at an approved level this fall. A revision of the document is scheduled immediately to align all NCCLS quality documents with HS1, A Model for Quality Systems for Health-care. A working group meeting was held July 18 and 19, 2002. Carl Mottram and Susan Blonshine attend-ed. The purpose of the meeting was to determine a revision plan for the discipline specific quality system documents and to develop a new document applying the quality system model to in patient medication delivery.

3. GP26-A2, A Quality System Model for Clinical Laboratory Services will be released easily 2003.

4. HS3-P, Pulse Oximetry, has been reviewed by the subcommittee and comments addressed. It is an-ticipated for release at the approved level late 2002.

5. NCCLS has accelerated document development, dec. the time from 36 to 24 months to move a document from a project proposal, to an approved document.

6. Newly approved documents include M29-A2: Pro-tection of Laboratory Workers from Occupationally Acquired Infections and POCT1-A: Point of Care Connectivity, X3-R Needlestick Report and GP2-A4 Clinical Laboratory Technical Procedure Manuals-Fourth edition. GP2-A4 is document used in accreditation checklists for CAP, CLIA, & JCAHO.

7. Through an agreement with the American National Standards Institute, selected International Organ-ization for Standardization (ISO) documents will be available for purchase from NCCLS.

8. Susan Blonshine and Carl Mottram continue to participate in the panning of the CDC Quality Institute Conferences scheduled April 2003.

9. NCCLS admin. procedures have been changed to designate the Area Committees as consensus body. The impact of this decision on document development requires all delegates and constit-uencies to enter comments early in the process.

10. NCCLS continues to strengthen its mission to globalize and harmonize all documents. The global expansion to healthcare standards in medical testing continues.

CDC Quality Institute

The CDC is developing a Quality Institute with 3 primary components:

1. Develop Quality Institute Conf. 4/03

2. Develop measures of lab quality

3. Develop permanent foundation for best practices in laboratory services

The Quality Institute Conference is the first step towards the development of an ongoing Quality Institute. No decisions have been made regarding how such an institute would operate, however, having a formal structure to help deal with issues related to laboratory testing in the changing healthcare environment, is something most seem to agree on. Laboratory testing is a $35 billion industry, with almost 8 billion tests performed each year and it has been estimated that over 65% of medical decisions are based on laboratory test results.

The Quality Institute Conference being planned for April, 2003 is aimed at developing a framework for a National Report on the Health Laboratory System. The recent Institute of Medicine report “To Err is Human” focused on preventable medical errors that occur annually. Since the laboratory is a major factor in medical decisions a report on the laboratory system could be beneficial. What is envisioned is the development of a set of quality indicators for laboratory service with the aim of making laboratory testing safe, effective, timely and responsive to patients and their healthcare needs

The theme of the conference in April 2003 is “Making the Laboratory a Partner in Patient Safety”. As new threats to the public’s health (such as bioterrorism, food safety and antimicrobial resistance arise) the CDC- Division of Laboratory Systems would like to address these issues in a joint and coordinated fashion. The hope is to include a wide variety of healthcare providers and consumers to foster innovative mechanisms to improve quality rather than looking at regulatory solutions. Regulations often set a very low bar for performance and we would like to use a voluntary process to define a higher bar of practice.

Co-sponsorship for the Quality Institute means that the organization supports the basic aims of the conference, an endorsement of the meeting.

• CLIAC :

Carl Mottram and Susan Blonshine are both on working group to make a recommendation con-cerning unregulated tests. The recommendation is likely to be adherence to CPGs/ATS standards. CLIAC meets late January and will receive recommendation at that time. Carl will attend the meeting.

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