Which surrogate marker can be used to assess the effectiveness of the laboratory and its contribution to clinical outcome?

Assessment of the effectiveness of the clinical laboratory and its contribu tion to outcomes is gaining increasing emphasis, as part of the overall att empts at making clinical services more transparent and accountable. Tools t raditionally used in the assessment of laboratory effectiveness and efficie ncy have included laboratory accreditation, Q-probes. performance in qualit y assurance programmes and staffing and cost issues. There is, however, a n eed to introduce different measures that highlight the laboratory efficienc y and contribution to clinical effectiveness and outcomes. Such measures sh ould, ideally, be quantifiable and evidence-based. The use of markers of ef ficiency and effectiveness could be used as tools to aid this process. Such markers could include incident reporting, the appropriateness of assay rep ertoire, adding value to reports, the quality or comments made, provision o f information on the effect or analytical and biological variation on resul ts, cascading requests to help making diagnoses and unearthing such diagnos es. We suggest that these measures contribute towards the implementation of the clinical governance agenda in relation to the laboratory, and could be used as indicators in laboratory accreditation.