Diagnostic Stewardship—Our Past, Our Current Status, and Future Promise

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Laboratory medicine has been at the forefront of quality initiatives in healthcare for over a century. Diagnostic stewardship is a natural progression of our passion for quality in laboratory medicine, to assure the right tests reach the right patients at the right time and place. It represents a pivot in our quality journey as we expand our focus from primarily internal-facing quality activities to those that are more outward facing—continuing to place the laboratory at the center of patient care.

How did we get where we are today? Initial efforts to drive diagnostic quality standardization began in with the formation of the American Society for Clinical Pathology (ASCP). ASCP’s founders recognized that quality personnel and processes were needed to ensure reliable laboratory results. Under the guidance of past president Dr. F. William Sunderman, ASCP created an interlaboratory quality control program, now recognized as the College of American Pathologists Proficiency Testing Program (1).