Evaluating the Adoption of Laboratory Practice Guidelines.

Area of Science:

• Laboratory Medicine
• Clinical Pathology
• Healthcare Quality Improvement

Background:

• The College of American Pathologists (CAP) develops laboratory practice guidelines (LPGs) to enhance diagnostic accuracy and patient care.
• A cooperative agreement with the Centers for Disease Control and Prevention (CDC) supports efforts to improve LPG effectiveness.

Purpose of the Study:

• To evaluate awareness and adoption of two CAP LPGs: immunohistochemical (IHC) assay validation and acute leukemia initial workup.
• To inform future updates of CAP guidelines based on current laboratory practices.

Main Methods:

• Surveys, telephone interviews, and focus groups were used to assess awareness and adoption of the IHC Validation LPG.
• A total of 1624 survey responses, 40 interviews, and 5 focus group participants were analyzed for the IHC Validation LPG.
• Baseline surveys were conducted in 2010 and 2015; follow-up studies assessed guideline adoption.

Main Results:

• High awareness and adoption rates of the IHC Validation LPG were reported across all assessment modalities.
• Survey responses (46% rate) indicated widespread adoption of most or all IHC Validation LPG recommendations.
• Respondents requested enhanced communication, greater specificity, and more prescriptive content in future guideline revisions.

Conclusions:

• Data collection on guideline gaps and adoption is crucial for improving laboratory testing and patient outcomes.
• The CAP has developed sustainable methods for tracking metrics to enhance guideline development and implementation.
• Written or electronic surveys proved to be the most feasible and effective method for assessing guideline adoption due to higher response rates.