Comprehensive assessment of medical laboratory performance: a 4D model of quality, economics, velocity, and productivity indicators

Laboratory diagnostics play a crucial role in modern medicine and healthcare economics. The effective management of a medical laboratory is based on reliable assessment of indicators characterizing quality of testing, productivity, velocity (speed) and cost-effectiveness. The usual concepts of laboratory management focus on one or two groups of these indicators and exclude a comprehensive assessment of the effectiveness of a medical laboratory. Various guidelines and concepts (ISO, Lean, Six Sigma, etc.) often provide similar approaches but use different terms. This review discusses common options for performance indicators in medical laboratories, as well as practical experience in using these indicators to assess the overall effectiveness of the laboratory and improve medical care for patients. All indicators were divided into four broad groups: quality, economy, velocity, and productivity. Based on these four groups, we describe the new"four-dimensional model"for assessment of medical laboratory performance based on different combinations of indicator groups for different types of laboratories. © 2025 Elsevier B.V., All rights reserved.