At the end of this session, participants will be able to:
1) Understand the complexities of developing a pan-Canadian approach to laboratory quality improvement.
2) Understand the pan-Canadian initiatives at work to improve Canadian medical laboratory quality.
3) Identify sources of assistance from Canadian Quality Partners.

This lecture will describe quality assurance and quality improvement activities in the field of breast cancer pathology diagnosis with a focus on patient safety, timeliness, effectiveness, and patient centeredness.  Barriers to practice and the integration of a best practice pathology model of personalized best cancer care will be discussed.

At the conclusion of this session, participants will be able to:
1)  describe current quality improvement activities in the pathology diagnosis of breast cancer;
2)  describe common barriers to quality improvement activities in pathology breast cancer and strategies to overcome these barriers;
3)  understand a personalized medicine model of breast cancer pathology care.

Improving specimen quality shouldbe a focus of continuous improvement in the laboratory.  The root causes of poor specimen quality will be analyzed with methods to measure, improve and control preanalytical variability.  A cost model captures the true costs of poor specimen quality for the patient, laboratory, and health care facility. 

At the conclusion of this session, participants will be able to:
1) understand the impact of poor quality laboratory specimens;
2) understand the cost associated with poor specimen quality;
3) develop a plan focused on reducing laboratory errors and costs associated with poor specimen quality

This presentation will define quality management system (QMS) and patient safety, give examples of the impact of hospital-wide quality management systems on patient safety, and highlight problems experienced by laboratories in various provinces in Canada.  Then it will review the ISO 15189 / Ontario Laboratory Accreditation (OLA) requirements and the Ontario laboratory experience.  Finally it will briefly describe a role for quality requirements beyond a quality management system.

At the conclusion of this session, participants will be able to:
1)  appreciate the scope of quality management system requirements
2)  understand how OLA has resulted in improvements in Ontario laboratories
3)  recognize that other quality requirements also contribute to patient safety.

This lecture will describe the development of a model of quality indicators to identify and decrease errors in laboratory medicine.  In fact, in the last decade, the approach to errors in laboratory medicine has been strongly modified, moving from a “laboratory-centered” scenario which recognized only analytical errors, to a “patient-centered” scenario that focus on errors in the errors in the total testing process.  In particular, we will discuss the model of quality indicators launched by the IFCC Working Group on “Laboratory errors and patient safety” which complies with the requirements of the Standard UNI-EN 11097.  25 QIs have been identified, of which 16 are in the pre-analytical, 4 in the intra- and 5 in the post-analytical phase and collected data will be reported.

At the conclusion of this session, participants will be able to:
1)  appreciate the state-of-the-art on errors in laboratory medicine;
2)  update knowledge on the taxonomy of laboratory errors;
3)  understand the aims of the project on quality indicators;
4)  appreciate the potential usefulness of quality indicators and related quality specifications to improve patient safety in laboratory medicine.

At the end of this session, participants will be able to:
1) Identify laboratory analysis needed to monitor assisted human reproduction (AHR), and their requirements for response delays;
2) Compare the different organizational approaches (analysis performed at the central laboratory versus at the AHR clinic), on the level of risk for patients and impacts for the laboratory.

Anti-Müllerian hormone is produced in granulose cells of pre-antral and antral follicles.  AMH exerts regulative functions on folliculogenesis, and serum concentrations were shown to be proportional to the numbers of antral follicles.  AMH’s reported stability during periods of hormonal change, such as menstrual cycles and in association with pregnancy, supports the assumption that AMH may, indeed, be reflective of a woman’s total follicle pool.  This AMH characteristic also makes it a more practical clinical tool in comparison to other modalities. 

At the conclusion of this session, participants will be able to:
1)  describe the role of Anti-Müllerian hormone in folliculogenesis.
2) compare the predictive value of Anti-Müllerian hormone for response to ovulation induction to other measures of ovarian reserve.
3)  compare the predictive value of Anti-Müllerian hormone for pregnancy outcome to other measures of ovarian reserve.

This lecture will describe the biology and clinical applications of using cell-free nuleic acids for noninvasive prenatal testing.  The lecture will discuss applications for fetal gender testing, fetal RhD status, and the use of massively parallel DNA sequencing to detect fetal whole chromosome aneuploidy.

At the conclusion of this session, participants will be able to:
1)  learn about the biology of cell-free fetal DNA in maternal blood and specific laboratory techniques used to analyse it
2)  apply this technology to clinical medicine, specifically in the diagnosis of fetal sex, blood groups, and in the screening for aneuploidies (Trisomies 21, 13 and 18)
3) understand potential future clinical applications for fetal sex chromosome abnormalities, other cytogenetic abnormalities (deletions, duplications) and single gene disorders.

While living in an ever-changing world and particularly in its lifestyle practices, the population is exposed to different sources of contaminants and environmental stresses that might alter emerging diseases to which tomorrow’s medicine will be exposed.  These contaminants must be identified and quantified to evaluate their impacts.  This is part of the many challenges facing environmental toxicology.  More specifically, laboratories play an important role in the quantitative measure of exposure and in diagnosis of intoxication.  Their expertise in analytical toxicology will help to implement the required means to comply to specific needs in environmental toxicology.  Those means apply to technical and scientific skills, the quality of laboratory services, the knowledge of state-of-the-art technologies used to provide measure specificity and efficiency, the development of universal screening methods, and a toxicological watch. 

At the conclusion of this session, participants will be able to:
1) understand the importance of emerging substances in our environment;
2) recognize potential sources of emerging substances in our environment;
3)  understand why state-of-the-art technologies are required to identify and quantify emerging substances;
4) understand the importance of implementing methods for becoming a leading laboratory in analytical toxicology

Plasmonic sensors based on nanotechnology offer solutions to analytical monitoring in complex biological media.  We will present the basics on how plasmonic detection works.  We will discuss our advances in increasing detection sensitivity, reducing instrumentation cost and improving background to allow detection of small molecules or biomarkers in complex biological media.  We are developing a prototype plasmonic instrument to allow the rapid, simple and accurate quantification of molecules in bio-media, and seek input from users about current needs in clinical practice.

At the conclusion of this session, participants will be able to:
1)  understand the benefits of the plasmonic technology in biomarker detection;
2)  contribute to the development of such technologies by proposing targets that are compatible with these detection methods and for which current technologies are either insufficient or too expensive.

The field of Genomic Medicine is reapidly evolving and ushering in a new era of predictive, preventative and personalized approaches to medicine.  With the introduction and advancement of microarray technologies and next-gneration sequencing platforms into clinical practice, the level of diagnostic resolution in the investigation of human disease has significantly increased.  These technologies have facilitated more precise diagnoses and have enhanced our knowledge of the fundamental molecular mechanisms of disease.  This lecture will describe the latest technologies in Genomic Medicine and illustrate the major impact they have had and will continue to have in clinical practice.

At the conclusion of this session, participants will be able to:
1)  understand the fundamental working principles of DNA microarrays and next-gneeration sequencing.
2)  recognize how DNA microarrays and next-generation sequencing have revolutionized the field of Diagnostic Medicine.
3)  appreciate the advantages and limitations of these new technologies in clinical application.