. Author manuscript; available in PMC: 2020 Jan 3.

Published in final edited form as: Arch Pathol Lab Med. 2018 Dec 10;143(4):518–524. doi: 10.5858/arpa.2018-0093-OA

Table 2.

Laboratory Medicine Quality Gap Topics Considered

Gap		Testing Phase(s) Impacted	How Gap Identified	Consideration Status
Topic	Subtopic(s)	Testing Phase(s) Impacted	How Gap Identified	Consideration Status
Decrease inappropriate test ordering	CK-MB	Preanalytic	Gap Identification Core Team	Finalist
	PSA
	1,25-dihydroxyvitamin D
	Genetic tests
Improve diagnosis, detection, and documentation	CKD at risk—no diagnosis; laboratory test evidence of CKD	Preanalytic and postanalytic	Gap Identification Core Team	Finalist
	Diabetes and prediabetes
	Anemia
Improve high-risk medication monitoring	Anticoagulants	Preanalytic and postanalytic	Organizational leaders	Finalist and selected for future intervention
Improve high-risk medication monitoring	DMARDs	Preanalytic and postanalytic	Organizational leaders	Finalist and selected for future intervention
Improve CKD monitoring, automated ordering	CKD diagnosis; no microalbuminuria/creatinine ratio, SCr	Preanalytic	Gap Identification Core Team	Preliminary only
Improve CKD monitoring, automated ordering	Test grouping with orders (microalbuminuria, SCr, lipids)	Preanalytic	Gap Identification Core Team	Preliminary only
Improve workup of polycythemia	JAK2 testing for unexplained polycythemia	Preanalytic	Gap Identification Core Team	Preliminary only
Address posttesting gaps in colorectal cancer screening	Follow-up testing for positive fecal immunochemical test results	Postanalytic	Gap Identification Core Team	Preliminary only
Address posttesting gaps in colorectal cancer screening	Time to diagnosis	Postanalytic	Gap Identification Core Team	Preliminary only
Address failure to retrieve laboratory test results	Test pending at discharge but after discharge, primary care provider unaware	Postanalytic	Gap Identification Core Team	Preliminary only
Address failure to retrieve laboratory test results	Results not looked at until the next office visit	Postanalytic	Gap Identification Core Team	Preliminary only
Reduce diabetes-related gaps	Prediabetes diagnosis not in problem list	Postanalytic	Gap Identification Core Team	Preliminary only
Reduce diabetes-related gaps	Microalbumin annually	Postanalytic	Gap Identification Core Team	Preliminary only
Improve secondary hyperparathyroidism recognition	Elevated parathyroid hormone without a diagnosis of hyperparathyroidism	Postanalytic	Organizational leaders	Preliminary only
Address laboratory testing noncompletion	By test type	Preanalytic	Organizational leaders	Preliminary only
	By patient characteristics
	By clinic

Abbreviations: CKD, chronic kidney disease; CK-MB, creatine kinase–MB isoenzyme; DMARD, disease-modifying antirheumatic drug; JAK2, Janus kinase 2 gene; PSA, prostate-specific antigen; SCr, serum creatinine.