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newFINALPROGRAM
SecretaryMrs.LiaKonings,ChairDr.HenkGoldschmidtCo-chairDrStacyWalzCoordinatorMrTjitzeDijkstraFoundationTQMHoefstraat2585014NRTilburgTheNetherlandsTel.+31610882603E-mail:[email protected]:www.qualityinthespotlight.com
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Qualitymanagementinlaboratorymedicine2.0Theworldisonthemove--traditionalsystemsarereplacedbybrandnewones,newtechnologiesareintroduced,newalliancesaremade,allkindofopportunitiesarepoppingup.Laboratorymedicineisalsotakingstepsforward.Whatwillbeinthespotlightinlaboratorymedicinein2025?Qualitymanagementasasystematicapproachstartedacenturyagointheslipstreamoftheindustrialrevolutionaround1900.Willtrendanalysis,Westgardrulesandtotal-errorspecificationssurviveinthe(near)future?Agraspofthechangesthesedays:thematerialchange(fromvenipuncturebloodtowardsfingerprickblood),theinstrumentalchange(fromhigh-endroboticstosmallPOCTinstrumentsandnanotechnology),thepersonnelchange(fromlabworkerstowardseverybody)andsoon…Awayfrompaperwork,backtothebench!Nowthatweaccomplishedtotalerroranduncertaintymeasurementsindailylaboratorytesting,wenowcanfocusonquality'sfuture--whataretherealneeds?,howcanthesebeachieved;whatandwherearetheopportunities,...?Awayfrompaperwork,backtothebench!AchallengingandhistoricmeetingwillbeinAntwerpinApril2021.Joinandenjoy!Bringyourquestionandwewillsearchtogetherfortheanswer.
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TheWestgardQualityAwardwillagainbepresentedtoanoutstandingscientistinthefieldofTQMinmedicallaboratories.SpeakerssuchasProf.SharonEhrmeyerandProf.JimO.Westgard,butalsoyoungstersandmanyotherswillagainguaranteeaninspiringandthought-provokingprogram.Wearealsoonthemoveandingoodcompany!The2018meetingonNEXTGENERATIONwasverypositive,inspiringandprovocativeatthesametime.Youngstersaswellasoldstersgavetheirscientificviewsonthepresentandfutureworldoflaboratorymedicine.Theroomwasfilledwithmillennial’s,intheaudienceandonstage.Havingnotedthis,itisnowtimetomoveon.Weadaptedtodisruptiveinnovations,wethoughtoutsidethebox,wedistinguishedbetweengenuinescienceandfraud,sonowitistimetomoveon.2021iscomingandthelaboratorymedicineworldischanging.Itisbecomingmorecustomer’driven,POCT,morereliableandmoreoutcomefocused.Resultsfromevidence-basedlaboratorymedicinestudiesaccompanytheintroductionofnewlaboratorytests.Thecellphoneasatestingdeviceisbecomingacommonphenomenon.Neverthelessstatisticalanalysisisstillkey.Learnfromandcontributetothisongoingdiscussion.Registerforthismeetingearly,joinyourcolleaguesinAntwerp!Conferenceaddress:L!ndnerHotelLangeKievitstraat125B-2018AntwerpBelgium
Laboratorymedicine2.0Formanyyearsweadvocated“Thinkoutsidethebox”,nowwepresumeweareoutsidetheboxbut….howdoweproceed?Herearesomeofthespeakers,edutainers,thatwillinspireusandleadtheway.
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Question: HowtoorganizeQCforPOCT?Answer: AntwerpconferenceApril19
thand20
th2021
Could a blood test for Autism be on the way?
New blood test said to predict onset of arthritis
Testaccuratewithinthree-yearwindow,saidin2019.Abloodtestforpeopleatriskforrheumatoidarthritiscanidentifythosewhowilldevelopthediseasewithin3years,newresearchshows.Doessciencehaveaclue?IndustrieslikeRocheDiagnostics,negotiatedirectlywiththehospitalmanagementexcludingthe
laboratorymanagement.Theyofferguaranteedquality,fixedpricesandscientificsupportinabusinesslikeway.ArecenteditorialofMichaelNeumaierandIanWatsontestifiedtoagrowingsenseofreality.
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Oneofakind‘greenfield’conferencewithalotofinteractionbetweenspeakersandparticipants
Whatisagreenfield?Aplacewhereonecanstartaprojectwithouttheneedtoconsideranypriorwork.Aplacetoreachoutforinnovation,nolimitationsbecauseoftheproductionsays,aplacetothinkoutsidethebox,aplacetodream….Doyouhaveagreenfieldinyourorganization,andinyourhead?Aplacethatinspires,challengesandallowsyoutothink,withoutlimitations,onyourtrade?SuchaplaceprovidesTheAntwerpConference.InApril2021wemeetagaininAntwerpwithhigh-levelspeakersandworkshopleaderstofocusonqualityinlaboratorymedicine.Nopolitics,nocolleaguestotakeintoaccount:justyou,yourheadandsoulmates.Youwillnotagreewithallofthembutthewillforsurestartyouthinking.Joinin!
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Overtheyearsweadvocated‘thinkingoutsidethebox’andthatwaspreciselywhatwearedoingintheAntwerpseriesofscientificmeetings.Inawaytheyareunique,mainlybecauseoftheatmospherethattheparticipants,togetherwiththespeakers,create.Thesespeakersareworld-classbut,happily,haveanopenmind.And,alsoimportant,theyrepresentabroadselectionofviewstoenlightenaspecificqualitysubjectsuchasMeasurementUncertainty,BiologicalVariationorQCinPOCT.Thisconferencewillbeorganizedforthe19thtimecoveringaperiodof1995untilnow,so25years.Butnowallmaterialsaredigital,theinteractionbetweentheorganizationandtheparticipantsandbetweentheparticipantsthemselvesisbymailandSkypeorFaceTime.Soallofthatisofthistimeandagebuttheoriginalideatocreateagreenfieldandtoplaytogether,todiscuss,tolearnisstillthesame,fromthestart…..Thesetting,inastate-of-the-arthotelinthecenterofAntwerpalsocontributestothisatmosphere.Joinin,youaremostwelcome.
POCTPOCTreallyistakingoff.Inmanyphysicians’offices,analyticalinstrumentsappearandthegamutofavailabletestsenlarges.NotonlyareCRP,glucoseandpregnancytestedfor,butalsoHbA1c,HDL-cholesterol,BNPandHIV.Isthequalitywelldefined;whoisresponsibleforacorrectanalyticaltestresult,theinterpretationandarchiving?Thistechnologyischangingourworldandalsoourperceptionandassessmentofquality.ForinstanceinthelargerAmericaninstitutions(e.g.,StLouisMedicalSystem),thecontrolofthenumberandqualitydeliveredbyPOCTglucosemetersusedthroughoutthehospitalistotallylost.Howevercorrectresultsforthe12%ofcriticallyillpatientsisstillessential.
Jointhegroove
inqualitymanagementinlaboratorymedicine
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Whitepaper“LaboratoryMedicine2021”Current status By reading and searching the literature over the past couple of years and, in addition, studying the programs, abstracts and papers of recent scientific meetings, the conclusion could be that the field of laboratory medicine has reached a standstill. There are a number of reasons for this stagnation: The scientific world organized itself in societies, committees and steering groups. Here the scientifically desired conclusions are drawn and proclaimed. Protocols and procedures are designed and introduced as if law with little or no creativity. In addition the diagnostic industry, like the rest of the established industry, produces and sells products and services that maximize profit with the least effort. So few new tests, no real improvements and no disruptive innovations. Furthermore there is a lack of charismatic ‘out-of-the-box’ thinkers. And in case they appear the traditional scientific establishment virulently attacks them. Of course the story of Elisabeth Holmes is a peculiar one but, at the least, she had a refreshing look at laboratory medicine. The quality thinking in medicine and in particular in laboratory diagnostics took a flight of the past half century. The translation of industrial quality definitions into the science of laboratory medicine was enlightened and contributed to a better, patient oriented, quality. The Westgard rules as well as the Fraser principle of biological variation should be seen in this respect. However at the same instance this clearly unveiled that the analytical quality of many tests should be markedly improved when in use in clinical practice. Almost all current tests are underperforming. Here industry as well as science is in default. They call upon so-called guidelines that release them from responsibility. On top of that the crippling discussion between the supporters of ISO and MU versus the total error (TAE) and biological approach took a lot of useless energy. Here non-statisticians enter they arena and trouble the discussion with many none arguments. Should we let other parties take responsibility in order to take the lead in this field? Why not take the lead ourselves and come-up with workable new approaches to quality in clinical testing? Given the fact that the scientific establishment as well as the industry is currently not very active in improving the quality of the analytical outcome it makes our sector vulnerable. What if a scandal breaks out highlighting poor quality of POCT results? Just look at the work that Erna Lenters did on the subject of HBA1c POCT. It would be an ideal opportunity for politicians and media to call for strict regulation by a regulatory body that does not have in-depth knowledge of the field. Or do we (science and industry preferably together) come-up with a new approach where we dare to take a “greenfield” approach. Why not join the groove in finding and promoting alternative approaches to this subject?
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Place to meet One could wonder if and how the field of laboratory medicine, industry as well as science, is capable of doing this. Probably changes from outside the field will cause such disruptions. But if there is a place to discuss this it has to be one that is independent, not linked to any society of interest group and of sufficient level and input. Fortunately that place still exists every two years now in Antwerp. Quality in the Spotlight is not only the place to be it is the place that we now establish our hope upon. Achievements Big and small steps were taken. The EFQM model was introduced to laboratory medicine; it gave a useful overview for the organization of the medical laboratory. A comprehensive model (NEXUS) defined the ultimate goals in analytical performance. The process for medical diagnosis and the contribution to that from laboratory medicine was studied and understood into detail. The biological variation could be coupled to the total allowable error as well as the measurement uncertainty. The physicians requesting laboratory tests proved to be highly sensitive for the quality delivered and the test results to be expected. Software was designed to generate accurate automated diagnosis as well as to support the patient in when to refer to and visit the GP office. However a simple algorithm to establish how many multiplicate should be measured to achieve the desired quality was not used in medical and analytical practice. But major steps were taken trough genomics, trough the automation of PCR techniques leading to POCT microbiology tests, through the application of portable XRF analytical methods, through miniaturization, etc, etc. Within laboratory medicine incidental useful practical applications were certainly revealed such as POCT troponin, POCT CRP and POCT lipid profiling. VR vaccine was a new and creative way to concur the fear of children for vaccination. A virtual reality is used to smooth the vaccination process. How to proceed A provocative program was composed for the April 2021 edition to inspire the participants and the field of laboratory diagnostics. POCTqualityspecifications
Point of care testing: report of the symposium at Eerbeek. Ulenkate HJLM and Goldschmidt HMJ. Ned Tijdschr Klin Chem 1998; 23: 154-157.
During a one day symposium entitled "Point-of-Care Testing" near patient testing was evaluated by clinical chemists, laboratory managers, health care assures, and intensive care physicians. Pros and cons were discussed in depths and the outset to a model of nine specific items, such as
1) test quality, 2) turn around time, 3) total costs, 4) hazard analysis, 5) test frequency, 6) user friendliness, 7) managed care score, 8) situation characteristic, and 9) responsibility, was given to facilitate a proper choice.
Total quality was the paramount feeling for all the persons involved. Measurements should be reliable concerning the precision as well as the accuracy without any interference.
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17:00–18:00 Registrationdeskopenandwelcomedrinkforallparticipants
bothatthe12thflooroftheL!ndnerhotel;topfloorwithadazzlingview
20:00 Speakersdinnerintown
09:00–09:05 Welcomeandopeningconference
chairmanHenkGoldschmidt co-chairmanStacyWalz09:05–09:40 AnneVegardStavelin(Noklus,Norway)GeneralinfoonPOCTTheNoklusqualitysystemusesdifferenttoolstoobtainharmonizationandimprovement:(1)externalqualityassessmentforthepre-examination,examinationandpostexaminationphasetomonitortheharmonizationprocessandtoidentifyareasthatneedimprovementandharmonization,(2)manufacturer-independentevaluationsoftheanalyticalqualityanduser-friendlinessofPOCinstrumentsand(3)closeinteractionsandfollow-upoftheparticipantsthroughsitevisits,courses,trainingandguidance(HarmonizationactivitiesofNoklus-Aqualityimprovementorganizationforpoint-of-carelaboratoryexaminations.ClinicalChemistryandLaboratoryMedicine.57:106-114.)Howistheproblemofsampleoriginsolved?Whataretherecommendationsforquality?(Essentialaspectsofexternalqualityassuranceforpoint-of-caretesting.BiochemiaMedica.27:81-85.)WhattodowithdiscrepanciesbetweenPOCTandCL?09:40–10:15 AnnetteThomas(Weqas,UK)GeneralinfoonPOCTHowrealisthesupportofanEQASschemeinPOCT?Letusgotorealliveandbacktothebasics.HowgoodorbadisthequalityofPOCT?Ingeneral,incomparisonwiththecentrallaboratory?IsitpossibletomeasurePOCTqualityusingminutewholebloodsamples?Whatcanwedemandandexpectfromnon-laboratoryworkers?ArebuildingcheckspossibleandhowcanEQAScontribute?
SundayApril18th2021
Day1MondayApril19th2021
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10:45–11:20 KathyFreeman(SynLabs,TDDSLabs,UK)AnimalsPOCTqualityinveterinarylaboratorytesting.OneofKathyFreemanfavoritequotesis“Bettertotrustthemanwhoisfrequentlyinerrorthantheonewhoisneverindoubt."AsaninspiredscientistKathyhasabroadviewonveterinarysciences.Beingaveterinaryclinicalpathologistshewillenlightenusonthesubjectofbiologicalvariationwithinmedicallaboratorytestingofmanyspecies,humansbeingoneofthem.HercurrentprofessionalactivitiesarebeingaclinicalpathologistatSYNLAB-VeterinaryPathologyGroup,Exeter,UK,VeterinaryInformationNetworkConsultant,andmemberECVCPCommitteeforLaboratoryStandardsandmemberQualityAssuranceandLaboratoryStandardsCommittee,ASVCP.Themainquestionhereis:whatcanwelearnfromeachother?Whereisthefieldofveterinarysciencewithregardtoqualitycomparedtohumanmedicaldiagnostics,andviceversa.TheconceptofbiologicalvariationandthebattlebetweenGUMandTAEisrelevantinveterinarydiagnosticsaswell?IsPOCTcommonpractice?HowisthequalityofPOCTdefinedandregulated?Allofthiswithatouchofbrexit….11:20–12:00 SharonEhrmeyer(WU,USA) RegulationsandguidelinesPOCTquality--whattheregulationssay.Morethan250yearsago,oneofthefoundingfathers,BenjaminFranklin,publishedayearlyPoorRichard'sAlmanackwithusefulinformationandadvice.Fordecades,thisbestsellerprovidedindispensableadviceandencouragementtostrugglingsettlersinthenewworld.Summoningthatspirit,Dr.SharonS.EhmeyerwritesThePoorLab'sGuidetotheRegulations,aplain-languagediscussionoftherules,requirementsandregulationsthatgovernUSmedicallaboratories.SharonwilldiscussbothUSandISOPOCTqualityrequirementsandwillreportonactualPOCTqualitypracticesreportedonaglobalsurveyrecentlypublishedinJALM.Q:HowtoorganizeQCforPOCT?A:AskSharon
10:15–10:45 Coffeebreak
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12:00–12:35 StenWestgard(WestgardOCInc.,USA)Training:bringyourowncaseWorkshop“ThefutureofQualityControlTestinginPOCT”.Stenexplained:“LaboratorieshavenotsignificantlymodifiedtheirQCproceduresforalmosthalfacentury.It'stimeforlaboratoriestobringqualitycontrolintothe21stcenturyandadoptmoreefficient,effectiveprocedures.TheWestgardruleshavebeenusedbylaboratoriesaroundtheworldformanyyears,allowingthedetectionofbothrandomandsystematicerrors,butapplicationoffullWestgardrulesmaynotbenecessarytomaintainstandardsforhighlyreproducible,automatedlaboratorytesting.Ifanassayisofsufficientlyhighquality,andsuitablyrigorousmaintenanceschedulesareinplace,thentheriskoferroneousresultsissignificantlyreduced.Inthesecases,wecanredesignQCtestingstrategiestoreflectthereliabilityoftheassay,freeingupstafftimeandotherresources.”Stenistravelingtheworld–whatisreallynewinqualitythinkinginlaboratorymedicine?StenwillconductaKahootinteractivesessionthatwillgiveusanopportunitytoformanopinionofwhatkindofQCshouldbeusedinPOCTtesting.
14:00–15:00 JamesWestgard(UW,USA)StatisticsIntroductionto"TheRightQC",evenforPOCT?Beingarockstarinthescientificareaofstatisticsinlaboratorymedicine,JimWestgarddevotedmuchofhistimetoexplainingtherulesthathavetobeappliedtoguaranteeanappropriatequality.HevisitedtheAntwerpconferencemanytimesandineachmeetingwelearnedalot.Buttheultimatechallenge:howtodefinequalityinaPOCTsetting;ordoesthesettingnotmatter?TheYouTubepresentation(https://youtu.be/qojpEVoTHCc)onEP23givesmaybepartofananswer…Seeingthefuturefromhistory(从历史中看未来)includingrulesforthenewgenerationinstruments.
12:35–14:00 Lunchbreak
15:00–15:30 Teabreak
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15:30–16:15 EsterTalboom-Kamp,MaartenKok(TWIHC,TheNetherlands)What’sup?Wehavenews!TogetherweinnovatehealthcarewiththeacronymTWIHCisEstherTalboom-Kamp’sspin-offofthelaboratorysheisrunning.Itdoesnotsoundveryscientificbutthewayatestresultisuseddefinesthedesiredqualitytoalargeextent.SheknowsasGPaswellasdirectorofthelaboratoryverywellhowtoputthepatientinthespotlight.Besidesofthatshehasaneckforpracticalinnovationsanddoesnot,primarily,botheraboutexistingpoliticalstructures.HoweverbeingaseniorscientistattheuniversityofLeidenaswell,shestressesthefactthatinnovationsshouldbeevidence-based.MaartenKokspeaksthelanguageofmedicallaboratorydiagnosticsandcaneaseusintothefar-fetchedideasofEsther.AninspiringPodcast(inDutch)onBNRradioisworthlisteningto;itrevealsmanyoftheideasbehindTWIHC.
16:30–17:00 WestgardawardeeVanessaGhislain Whyislaboratorytestingnotflawless?AfterobtainingaMaster’sdegreeinbiomedicalsciencesin2002(VrijeUniversiteitBrussel),VanessaGhislainworkedfor11yearsasascientificcollaboratoratthepathologydepartmentoftheBrusselsUniversityHospital.Shestartedwithexecuting,supervisinganddevelopingmolecularbiologyassaysdedicatedtocancerdiagnosisandtherapy,mainlyFISH(fluorescentinsituhybridization).Asfrom2009an
ISO15189accreditationformoleculartestingbecamemandatory,shetookontheroleofqualitymanagerofthedepartment.Lateron,shestartedperformingdissectionofroutinesurgicalpathologyandbiopsyspecimens.Shewasalsoinvolvedinseveralresearchprojectsofmolecularoncologyandreproductivemedicine.
In2013,shejoinedtheformerInstituteofPublicHealth(WIV-ISP),nowSciensano,toworkasascientificcollaboratorattheDepartmentQualityofmedicallaboratories.Ascoordinatorofthenationalexternalqualityassessment(EQA)programfortheBelgianpathologylaboratories,sheisnowresponsiblefortheexecutionanddevelopmentofqualityassessmentschemesinthefieldofpathology.Worksin:
• Qualityoflaboratories• EQAforhistopathologyandimmunohistochemistry• Pathologyandmolecularpathology • Virtualmicroscopy
16:15–16:30 Westgardawardceremony
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EQAprogramshavebecomeimperativetogiveconfidenceinthequalityoflaboratorytestingandtoensuredeliveryofconsistentandaccurateresultsthat,ultimately,impactapatientdiagnosis.Theyenablelaboratoriestoevaluatetheirperformanceandmethodscomparedwiththatoftheirpeersorwiththewholelaboratorycommunity.ThisreportprovidesaninsightintotheBelgianEQAprogramfortheimmunohistochemicalassessmentofHER2expression,estrogenreceptorandprogesteronereceptorstatusinbreastcancer.17:00–17:05 Closing
19:00–23:45 Receptionanddinner
AdmissiononlywithadinnerticketThedinnerspeechwilladdressTheQualityofLifebyStrahinjaMedić(VetLabDOO,Belgrade,Serbia)Qualityoflifeisputinthespotlight!Laboratorymedicaldiagnosticscontributestothequalityofourlife.Canthisbeincreasedandinwhatway?Isgenetictestingablessingoracurse?IsPOCTablessingoracurse?Hotel-restaurantAugustJulesBordetstraat5 B-2018AntwerpAformerAugustiniancloisterbecomesamodern-daysanctuaryundertheguidanceoflegendaryBelgianarchitectVincentVanDuysen.TheAugustsiteisacombinationoffivebuildings.ThebiggestchallengeforVanDuysenandhisteamwastolinkthemtogetherinanoptimalwaywithoutfallingfoulofheritagerestrictions.Thenuns’formerprivatechapelwillbethemainloungeandbararea.Therearetwoterracedtownhouseswithgardensadjacenttothesite,oneofwhichwillaccommodateaspacompletewithanoutdoorswimmingpoolwithitsownfilteringreedbed.Thebuildingbehindthechapel,whichwasthenuns’livingquarters,willcontainmostoftheguestrooms,thekitchen,andaguests’library.
EveningprogramatRestaurantAugustaformercloisterofParisiannuns
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09:00–09:05Opening:backtobusiness09:05–09:35 StacyWalz(ArkansasStateUniversity,USA)Q:HowtoproceedwithPOCT?
StacyWalzistheChairoftheClinicalLaboratorySciencesprogramatArkansasStateUniversity.UnderstandingAnalyticalCharacteristicsandTheirImpactonCardioClinicalCarewithCardiacTroponinAssaysPOCTaswellasfromthecentralizedlaboratory,willbecommentedon.
A:ThispowergirlisverywellabletoenlightenusontheirideasupontheUSPOCTsituation.Ishometestingthefuture?WhatkindoftestsisandwillbeofferedbyWalgreen?AreviewofPOCTriskmanagementisconstructed.RiskmeaningwhatarethechangesthatthePOCTiswrongasopposedthecentrallaboratorytesting(PointOfLaboratoryTestingversusPointofCareTesting).Riskofdamagingthepatient’shealththroughPOCTbecauseittooktolongtogettheanswer.
09:35–10:00 Oralposterpresentations
10:30–11:10 IvanBrandslund(SDU,Denmark)Wehavemorenews!ThesolutionweneverthoughtourselvesbutIvandid!ThinkingoutsidetheboxisaruleoflifeforIvan.Nexttothatheisaninspiringandchallengingcolleague.FromhispointofviewisPOCTnotreallyaneedforinDenmarkbecausehislabprocessessamplesextremelyfast.WhyisPOCTfakenews?Orisn’t?
Day2TuesdayAril20th2021
10:00–10:30 Coffeebreak
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11:10–11:30 HuubvanRossum(AntonivanLeeuwenhoek
hospital,Amsterdam,TheNetherlands)Themovingaverage(MA)methodisoneoftheoldestinQCinLM:canitbeappliedtoPOCTaswell?Letusaskoneoftheexperts.HuubvanRossumismemberoftheIFCCworkinggrouponthesubjectandwillsharehisideas.Newinsightsintheunderstandingandpracticalapplicationofpatientbasedrealtimequalitycontrolalsoknownasmovingaveragequalitycontrol(MAQC)havebeenobtained.MAQCdiffersinseveralwaysfromstatisticalinternalQCandcombiningbothtechniquesallowsimprovedanalyticalqualityassuranceandamore(cost-)efficientQCplan.ChallengesforlaboratoriesarehowtoobtainproperlaboratoryspecificsettingsandhowtooperateMAQCinroutinepractice.Recentlytoolsanddocumentationthataddressestheseissueshasbecomeavailableformedicallaboratories,amongstothersviaanIFCCworkinggroup.InwhatwaycanMAQCbeofvalueforPOCTtestingespeciallybecausethequalitycontrolmaterialsincurrentusearefarfromthenatureofpatientmaterials?Ishereanopportunityavailable?11:30–12:00 IndustryviewonPOCTquality,JohnYPacheco(BioRad,USA)HowdoesindustryregardPOCT,justanothersegmentorthepavedwaytothefuture?QConPOCTisanewchallenge!Patientoutcomesdependonaccuratetestresultsthatdependonoperatorproficiency.Thecalibrationissueisaddressed.ThissessionwillpresentacomprehensivemodelformanagingtheriskofpatientharmfromerroneousresultsfromapopulationofPOCTinstruments.Operatorproficiencyaswellastheintegrityofindividualdevicesandtheunittestingcartridgeswillbeaddressed.12:00–12:30ChristianSchoenmakers(Elkerlickhospital,TheNetherlands)
Andhowaboutthepatient?POCTinabroaderperspective;apatients’view.Therelationshipsbetweenthevariousfieldsinmedicalcarewithregardtolaboratorydiagnosticsarediscussed.Christianisaregisteredclinicalchemistbutalsochairmanofthemedicalboardofthehospitalheisworking.Inthepastheranaprogramthatpatientsallowedmedicallaboratorytestingontheirowninitiative.Soinawayhehaspersonalexperienceinvariouslinesofmedicalcare.HowdoesPOCTfitinhere?Whatistheminimalquality?Whatarethelogisticsneeded?Hewillelaboratethepaper“Point-of-CarevsCentralLab‘Discrepancies”:Gettingthemessageacross”(RobertMoran,JALM,Febr.2017),baseduponhisownexperience.Itisclearthattheroleoftheclinicalchemisthastochange.Notonlythecommutablequalityhastobeaccountedforbutmuchmorethequalityofthe
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laboratorytestresultisdefinedashowwellitfitsthecontextofthepatient.POCT:curseorblessingforthetreatingphysicianandhis/herpatient?
Duringthebreakthescientificadvisoryboardaswellastheboardofrecommendationwillmeet.
14:00–14:30GilbertWieringa(NHS,UK)IsPointofCareTestingadisruptiveinnovation?The20thcenturydigitalrevolutionhasseentheintroductionoffaster,innovativeandeasiertousetechnologiesthathavetakenlaboratorymedicineservicesclosertopeopleandpatientsatthepointofcare.The21stcenturyisusheringinopportunitiesforglobal,informationtechnologyproviderstodisruptclinicalanddiagnosticserviceswithevidence-basedartificialintelligence-drivenalgorithms.Anewleadershipchallengeemergesforspecialistsinlaboratorymedicinetoextendtheirknowledge,skillsandcompetencebeyondthelaboratoryfora)guidingappropriateservicesforlocalenvironmentsbasedonclinicalneed,b)ensuringPOCTsolutionsarecost-effective,safeandreliable,c)developingthebusinessacumentomarket,negotiateandmanagechanged)gainingabetterunderstandingofimagingtechnologies,genomics,andhealthinformationscience(dataminingandhealtheconomics).Inprovidingexamplesofthenewwaysofworkingthistalkwillalsohighlighttheleadershiproleofthespecialistatthecenterofpotentiallyconflictingagendastoensureeffectiveuseofresourceacrossthediagnosticsandinformationtechnologyindustries,clinicians,servicecommissioners,academiaandpolicyrelatedhealthcareorganizations.14:30–14:50 OswaldSonntag(Technopath,DE)IndependentQCandPOCT:acontradictiointerminis?OswaldwillpresenthisviewonqualitywithinthefieldofPOCT,whichqualitysupportingproducts(alsofromTechnopath)areavailableandsensible.14:50–15:15 IndustrialandscientificsnapshotsFinbiosoftincooperationwithTommiHirvonenwillpresenttwosubjects.
ValidationManager:FromExcelstowardsabrighterfuture:HowtoensurequalityandsavetimeinvalidationandverificationsstudiesbyusingValidationManagertocollectyourverificationdata,analyzetheresultswiththelatestCLSIprotocolsandcreate
12:30–14:00 Lunchbreak
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standardizedreportsautomatically.IntroductiontoValidationManagersoftwareservicealongwithcustomerexperiencesfromaroundtheEurope. EQAManager:FromExcelstowardsabrighterfuture:HowtoensurequalityandsavetimeinqualityassessmentroundsbyusingEQAManagertokeepupwithyourEQAroundswithtotalvisibilitytothestateofeachround,requiredcorrectiveactionsandoverallperformance.IntroductiontoEQAManagersoftwareserviceandhowitcanhelpyourlaboratorymanageyourEQAroundseffectively.
15:45–16:15 SnežanaJovičić(Centerfor
MedicalBiochemistry,Belgrade,Serbia)
Let’sgetpractical.ThequalityevaluationofsmartphoneapplicationsforlaboratorymedicinewasperformedbyanEFLMworkinggroup.Theirconclusionsweredevastating:appsdesignedforpatients,areofthepoorestquality,consideringthetotalqualityofthecontentandinformationtheyprovide,estimatedusingtheMARStool.Thisestimationneedstobevalidatedforlaboratorymedicineapps,andeventuallymodifiedafterconsiderationofspecificqualitybenchmarks.Howeverthistrendisunstoppable….sohowtodealwiththesequalityissues?16:15–16:30Let’sgetpracticaloncemore,pendingThestoryoftheAPSchartenablingthecalculationwithinthemedicallaboratoryofAPS(AnalyticalPerformanceSpecifications,seethesummaryoftheconferenceof2018fordetails).InaMathildeKjaerisworkingonherPhDthesisunderthesupervisionofIvanBrandslund.Atthe2018editionoftheQualityinthespotlightmeetinginAntwerpshepresentedanenergeticlectureonhowtheprincipleofbiologicalvariationanderrorbudgetingwasputintothepracticeofmedicaldiagnostics.Sheshowedusaflowchartthatwasintroducedonthemedicalwards.Now,aftertwoyearswewouldliketonowthestatusofthisproject.Diditdieordiditsurvive?CanoneusethiscartalsoinPOCTsituations?InaMathildeisunabletopresentbutthequestionsstatedwillbeanswered.16:30–16:45 ConferencestatementBaseduponanhistoricaloverviewofPOCTdevelopmentsespeciallywithregardtoquality.Whataretheanalytical,logisticalandfinancialdesiredspecifications?IsxPOCTthefuture?16:45–17:00 Closingremarks17:00–17:30 Socialgathering
15:15–15:45 Teabreak
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countries indicated below.
Times change.Times change.
We all have the techniques that work for us: the tried and trusted methods we turn to every day. We
Fromslowqualitytofastqualityseemsalogicaldevelopment
Inparallelwewentfromfastfoodtoslowfood,fromfoodcheaplyandfastproducedtowardsslowfood
thatgrownaturallyandwithrespectfortheenvironment,preparedinasimple,traditionalway
Inlaboratorymedicineweareusedtoslowquality;itissolidasarock,takestimeandcausesamarkeddelaytotheresultsproduced.Agoodexampleofsuchisthereportingofastronglydeviatingandclinically
relevanttestresult.WewilltakeanextralookattheQC,tomakesureitwaspassedandwewillrerunthesampletomakealsosuretheresulttobereportediscorrect.Thiswhilebecauseofthenatureoftheresultonewouldexpectbotaslowerbutanfasterresponse.WeespeciallyinPOCT
weneedfastquality.
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Antwerp2021Conferencevenue:
L!ndnerHotelLangeKievitstraat125B-2018AntwerpBelgium
YouwillfindthechicbutcasualLindnerWTCHotel&CityLoungeAntwerpintheglitzydiamonddistrict,rightnexttothecathedral-likecentralstation(wellworthavisitbytheway).Itisacharminghomeawayfromhomeandatopbusinesslocationthatleavesnothingtobedesired.Centrallylocatedyetabsolutelyquiet,itoffersbreathtakingviewsofthecitywhetheryouarerelaxingintheloungeorworkingoutinthefitnessroom.
Hotellobby
Skyloungeconferenceroom
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AbstractSubmissionFormforPosters
FillintheformandsaveitasMSworddocumentunder“Name.poster.doc”Senditto:TQMantwerp@gmail.comconfirmingthereceptionwillbesenttothee-mailaddressindicatedintheform.
Posterswillbeondisplayduringtheentireconference,withappointedtimesforinteractionwiththeauthors.Posterswillcoverawiderangeofsubjectsincluding:softwareforQM,accreditationcosts,laboratory-hospitalinterface,referencematerials,errormanagement,validation,andhumanresourcesmanagement.AposterawardwillbepresentedattheConferenceDinner.
E-mailaddress
Titleoftheposter
NameandTitleofthecorrespondingandpresentingauthor
AdditionalAuthors
Abstract:Maximumof200words;usefontTimesNewRoman12
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Submissionsforthepostersessionwillbereviewedbytheprogramcommitteeonthebasisofashortabstractofnotmorethan200words.Asaguideline,thefollowingquestionsshouldbeanswered:• Describetheproblemyouhaveaddressed.• Whyisthisproblemimportant?• Whatistheoriginalcontributionofthiswork?• Doesitcheckand/orextendpreviouslyreportedwork?Optional:ifaccepted,theauthormaychoosetoprepareafullpaperonthetopicforpublicationintheworkshopproceedings.Deadline:forpostersubmissions1stofApril2021willbeusedasadeadlineforapprovalandinclusionwithintheprogram.ProceedingsInthepasttheconferenceproceedingswerepublishedinthe“JournalofAccreditationandQualityAssurance”,atleastinpart.ThepapersinJAQAgiveafairimpressionofwhatthequalitycommunionkeptbusyoverthelastdecade.Sofarsogood.Whatwillhappenwiththepapersduringthenextdecadeisunclear.Theconferenceorganizationisstilllookingforaproperplatformtopublish,Prof.IvanBrandslund(editorCCLM)isinvolvedinexploringthepossibilities.PracticalinformationConferenceLocationAntwerpliesattheheartoftheEuropeanUnion:Itisalivelycitywhoseinternationalfeelingandhospitablepeopleenthusiasticallywelcomeforeignguests.ThetownfirstbecameaworldcommercialcentreinthesixteenthcenturyandwasthecradleofcommercialprintingandFlemishart.Itpossessesaverylargeandvigorousharboraswellasbeingthediamondcentreoftheworld.Thecityisamixtureofmanycultures.ThecitizensarecalledSinjoors(Seigneurs)becauseoftheireleganceandenthusiasmforstyleandBurgundianwayoflife.Thisinternationalawarenessmakeseachpersonacitizenoftheworldandkeenlysupportiveofcommerce,industry,artandculture.TheblindingsuccessofAntwerp,designatedthe“cultural”capitalofEuropein1993,illuminatedthisyetagain.
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Antwerp,intheheartofEuropeandBeneluxandlessthananhourawayfromtheCommunityheadquarters,isacitywhichisfullyalivedayandnight.OntheSchelderiver,thismetropoliswelcomesmerchants,businessmen,artistsandtravelersfromallovertheworld.Spaniards,Jews,Greeks,Turks,Russians,Dutch-men,Germans,Chinese,IndiansandAmericans,tonamebutafew,arerepresentedamongthemorethan135nationalitieswhichareathomeinthisworld-classcity.Thevariousnationalitieshavetheirownclubs,centres,andreligiousinstitutions,whichgotowardsmakingAntwerpintoacosmopolitanregion.Conferenceaddress:
L!ndnerHotelLangeKievitstraat125B-2018AntwerpBelgium
Tel+3232277700ItissituatednexttothecentralrailwaystationofAntwerpAddressforConferenceinformation
Dr.H.M.J.Goldschmidt,FoundationDCT,Hoefstraat258,5014NRTilburg,TheNetherlands.Tel:+31610882603,E-mail:[email protected]:www.qualityinthespotlight.com
SecretaryoftheconferenceMrs.LiaKonings,Tel:0492-529416E-mail:[email protected]
RegistrationdeskTheregistrationdeskandconferencesecretariatarelocatedinthe12thfloor(topfloor)ofthehotel.Thesecretariatwillbeopen:
SundayApril18th,from16.00till20.00MondayApril19th,from08.30till18.00TuesdayApril20th,from08.30till18.00
VenuesTheScientificprogram,symposiumlunchandcoffeebreaks,posterexhibitionandcommercialexhibitionwillalltakeplaceinthehotelLindner.RegistrationfeesPleaseusetheregistrationformontheconferencewebsiteandreturnitassoonaspossibletoDr.H.M.J.GoldschmidtorLiaKonings,togetherwiththefullregistrationfee(s).
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Yourregistrationwillthenbeconfirmed.Forpaymentinstructions,pleaseseebelow.Registration BeforeFebruary1st2021: €855 AfterFebruary1st2021: €955Thisfeecovers:
• participationinallscientificsessions• symposiumprogram• abstractbook• lunches• morningandafternoonrefreshments• welcomeandfarewellreceptionsatthehotelL!ndner
PaymentinstructionsParticipantsarekindlyrequestedtoforwardtheirregistrationfees,inEuro’s,bybanktransfertothefollowingbankaccount:ABN-AMROBank,Heuvelring88,5038CLTilburg,TheNetherlandsAccountNo:63.08.57.385IBAN:NL56ABNA0630857385BICcode:ABNANL2AAccountholder:FoundationTheQualityMeetings,Tilburg,TheNetherlandsPleaseindicatethenamesoftheparticipantsonallpaymentdocuments;orifknown,theregistrationnumber.Registrationandreceiptoffeeswillbeacknowledgeduponreceivingpayment.Pleasenotethatnoregistrationwillbefinalizedwithoutproofofprepayment.UseofcreditcardPaymentcanonlybemadebyVisacreditcardCancellationofregistrationRegistrationfeesless50euroforadministrativecosts,ifwrittennoticeofcancellationisreceivedbeforeMarch1st,2021Norefundswillbemadeafterthisdate.ProceedingsExtracopiesoftheproceedingscanbeorderedduringtheconferencefor€75,-.Thisfeeincludespostageandhandlingandconsistsoftheentireconferencepackage.AccommodationThefollowinghotels,inadditiontoHotelL!ndnerandHotel-restaurantAugust,havebeensuggestedastheconferencehotels:TheaterHotel(Arenbergstraat30,16minuteswalk)andHotelIbisAntwerpCentrum(Meistraat39,14minuteswalk).ButtherearemanymoreinthedirectenvironmentofHotelL!ndner.Inpreviousyearswearrangedabookingagency.Butnowadaysitissoeasytotakecareofthisthroughtheinternetusingvariousbookingsite,wewouldliketosuggesttodoso.Trivago.com,Booking.comandothersfacilitatesuchaswellasthepossibilitytocomparehotelsand,inthatway,fine-tuneyourbooking.
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Howeverincaseyouneedassistance,pleasecontactLiaKoningsthroughTQMantwerp@gmail.comandwearepleasedtohelpyouout.AccesstoAntwerp
A. FromBrusselsairport(bytrain)TrainsfromBrussels-Airport-ZaventemtoAntwerp–Centralstationrunevery30minutes.TrainsareavailablefromBrusselsairporttoAntwerpfrom00:02to23:41.Thejourneywilltake31minutesandcosts11.80€foraone-wayticket.Takingthetrainisaquicktransferoptionforthoseonabudget.Stationisa3-minutewalkfromtheconferencesite.B. BycarAntwerpiseasytoreachbycar,followingtheE19motorwayfromBrussels.Carrental.MostmajorcarrentalcompanieshaveadeskattheBrusselsAirport.Parkingfacilitiesareavailablenearbytheconferencevenue.Pleasenotethatyouhavetopayforyourparkingplace.theCityofAntwerphasdecidedtoexcludethemostpollutingvehiclesfromthecity.Thecitycenterhasbecomealowemissionzone(LEZ).ThehotelsaremostlysituatedwithinthisLEZ.C. BybusfromBrusselsairporttoAntwerpBrussels(BRU)offersadirectAirportExpressbustoAntwerponceanhour.Thebusjourneytakes45minutesinlighttrafficandaone-wayticketcostsjust10€,makingitthecheapesttransportationoption.Youcanonlypurchaseyourticketincash,directlyfromthedriveronthebus,sobesuretocarrychangeinEuros.TherearecitybusesbutnosubwayinAntwerp.D. BytaxiTakingaBrusselsairporttaxifromBrussels(BRU)airporttoAntwerpisahighlyconvenientandfasttransferchoice.Thejourneyshouldn'ttakemorethan36minutesinlighttonormaltraffic.TaxisatBrusselsairportdon'thaveaflatratefeetoAntwerp,instead,theychargeusingataximeterbasedondistance,whichwillbearound120€.Taxisareavailable24/7atBrussels(BRU)airport.
BankandPostofficehoursBanksareclosedonMonday,SaturdayandSunday,allotherdaystypicalopeninghoursarefrom9.30until16.00hrs.ThepostofficeintheCentralStationisclosedonSunday,Saturdayfrom9:00until13:00hrs.andopenonworkingdaysfrom9:00until18:00hrs.EmergenciesinBelgiumThenumberforemergencycallsis112.
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InsurancedisclaimerWhiletheOrganizingCommitteeandConferenceSecretariathavemadeeveryefforttoensurethesafetyandwellbeingofallconferencemembersandtheirassociates,responsibilitycannotbetakenforanyaccidentsordamagethatmayoccurduringthesymposium.SpeakersbriefingSpeakersshouldmeettheirsessionchairmenintheroomofthepresentation20minutesbeforethestartofthesession.SocialprogramOnSundayevening(17.00–18.00houraWelcomeCocktailwillbeprovidedbytheconferenceorganizationatthetopfloorofthehotel.TheConferenceDinnerisplannedinAugust(JulesBordetstraat5,B-2018Antwerp)onMonday,April19that19:00hours.Thisrestaurantiswithinwalkingdistanceoftheconferencesite(approximately18minutesi.e.1,4km,ortakesneltramnumber2).ThecostsfortheTQMconferencedinnerare€125perperson.StudentsLimitedfundingfortravelandattendanceofthemeetingmaybecomeavailable.Students(noothers!)inneedoffinancialassistancearerequestedtoapplyinwritingthroughtheSecretariattotheChairmanoftheOrganizingCommitteebeforeFebruary1st,2021.Acopyofthestudentcardmustbeenclosed.GeneralinformationThemeetingwillbeheldintheL!ndnerhotelinAntwerp(Belgium).Theprogramconsistsofplenarysessionsandposterpresentations.TheworkinglanguagewillbeEnglish,nosimultaneoustranslationfacilitieswillbeprovided.AcknowledgementsThissymposiumhasbeenmadepossible,inpart,bythefinancialsupportofthefollowingcompaniessponsoring(thislistisprovisional):
BioRadFinbiosoftDimensionalinsightAbbott–AlereMIPS
andothersarependingConferenceaddress:
HotelL!ndnerLangeKievitstraat125B-2018AntwerpBelgium
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Daretoleavethemainstream?JustbeinAntwerp!
Thenextconferenceisin2023,May8thand9thsameplace,sametime….seeyouthenandthere!
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POCT:theansweroflaboratorymedicinetothe24/7economy,itempowersindividualsthroughopportunity,connectivity,knowledgeandproductivity.
POCTisthegamechangerinQualityinLaboratoryMedicine
ThestatusofthiseventwithintheMedTechconferencevettingsystemis“compliant”onallassessmentcriteria.
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ReviewofthePOCTliteratureannoDecember2019InanextensivesearchforemailaddressestobeusedatourupcomingconferenceonqualityoflaboratorymedicineandPOCTIbrowsedtheglobalvillage.Itwasaninterestingexperience.ForhoursIwasbusytocopyauthorsofscientificandsemi-scientificpapers.Inthemeantimereadingpartsofthesepapers,browsingtheabstractsandtitlesusingdifferentlibrarysearchenginesafewremarkablethingscouldbeobserved.IngeneralIwasandamimpressedbythecollectedPOCTliteratureatthismoment(December2019).Overthelast25yearsremarkableprogresshasbeenbookedwithaverypositiveinputfromindustry.Notonlyinnovativeandrobustsmallinstrumentsincludingsmarttechnologiesweredevelopment.Butthesupportoftheuserswasprovidedthroughideasonqualitycontrol,useofmeasurementsdata,riskanalysis,patientfriendlinessandsoon.ThenextgenerationPoint-of-caresystemsisonitsway.Multiplexedpoint-of-care-testingwasintroduced,criticaldriversinthedevelopmentofPoint-of-carediagnosticsweredeterminedandtheterminologyofNear-patient-testingwasabandoned.Thenumberofpapersonthissubjectisexploding.Manyclearreviewswerewrittenandpresentedintheformalscientificliterature.Thedifferencebetweenthewrittenreports,theguidelinesdesignedandthepracticaluseandabuseisstrikingalthoughsomeauthorstrytobridgethisgap.Theveterinarylaboratoryandhumanlaboratorymedicinehaveanincreasingnumberofaspectsincommon,aswasreflectedintheliteratureaswell.POCTasapartofcommonmedicaldiagnosticspracticeismoreapparentincertaincountriesasopposedtoothers.Herethenextstageincludinginnovationisdawning.FromtheliteratureitcanbeobservedthattheEnglishspeakingcountriesasUSA,UK,CanadaandAustraliaputalotofeffortinunderstandingandimprovingPOClaboratorytestinginhumanaswellasveterinarymedicine.HoweverallkindofothercountriesinAfricaaswellasthefareastusedalsoPOCTtestingbutappliedtoothertestsuchasHIV,Ebola,Malaria,DengueandZikavirusprotein(fromsaliva).Invariouscountriesareseatsofactivitiesthathookontothatspecificcountry.InGermany,supportedfromseveraluniversities,technicaldevelopmentsarereported.InSpainandItalythefocuslaysmoreontheconceptualaspectsfromPOCT.IntheUKandTheNetherlandsThefocuslaysontheGPoffice,thefinancialaspectsandthequalityofmedicaldecisionmaking.IntheScandinavianareaaswellasIrelandqualitycontrolproceduresaredescribed.AlmosteverysocietyofclinicalchemistryoflaboratorymedicinehasaworkinggrouportaskforceonPOCT.Itisclearthatthetraditionalmedicallaboratoriesaremissingthedrive
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ofthecurrentdevelopments.Withintheirorganizations,suchasahospital,thisisunderstandableandexplainablefromtheirresponsibility.ButoutsideforinstancetowardsGPpracticestheysupportthisrestrictingbehaviorworksdestructive.POCTprofessionalcertificationshouldsupporttheusers,alsotheendusersbeingthepatients’themselvesandnotwithholdingthemtogetaccredited.Manyregional,nationalandinternationalmeetingsconcernPOCTtesting.Herespeakerswhoshadedtheirlightonotheraspectsoflaboratorymedicine,gaveagaintheiropinion.Soonlyafewgroundbreakingpapersandspeakerswerefound.Newgurusforthisspecificbrancharenotyetemerged,asfarasIcouldsee.AllmajormanufacturersofmedicaldiagnosticinstrumentstargetandreleasePOCTinstrumentationonaregularbasis.Theyoftenreleasedafourthoffivegenerationofthose.Alargenumberofnicefirmsisalsoactivewithallkindofspecialtestingandspecificapplications,inhumanaswellasinveterinarymedicine.MostquestionsconcerningPOCTareposedandansweredhowevermissinginactionaretheanalyticalcharacteristicsforPOCT.Applyingtheoldrulesastheyweredevelopedwithinthecentrallaboratorydoesnotmakesense.NeitherdoesapplicationoftheGUMand/ortheTAEapproach.TheconceptofBVhasbeenintroducedinPOCtesting.ButagainthequestionsandapproachwithinthePOCsettingisfundamentallydifferent.Soonehastodeviseforeachoftheanalyticalphases,frompre-pretopost-post,newqualityrequirements.Walk-in-clinics,Skypephysicianvisits,Internetcollectiveknowledgearealldevelopmentsaregettingapropersettinginaneverchangingworld.POCTandselftestingaretheretostayandgainrapidlyinmarketshare.Point-of-caretestingbasedonsmartphoneisunderdevelopmentattheMinzuuniversityinBeijing,China,asonotherplaces:forinstancetoanalyzesemen.Contactlensesthatcontainbiosensorsaremade.Theconceptssuchascustomerexperience(CX)anduserexperience(UX)knownfrommarketingsuchbetranslatedintopatientexperience(PX).Or,probablymorerealistic,thepatientwillbecomeauser.DisruptiveinnovationwithinthefieldofPoint-of-Carediagnosticsisheruleratherthantheexception.SmartphonebasedPOCT,contactlensbiosensors,andothersarerevolutionaryemergingtechnologies.Industryisacrossawidefrontactiveinthisfield.AlsobecausethemarketshareofPOCTdiagnosticsisrapidlyincreasingandwasin2017aslargeas24billionUSD,in2022itissupposedtobeaslargeas38billionUSD.Thescientificworldhasmanydedicatedjournalsorsectionsofjournalsaswellassocietiesactiveonvariouslevels:local,regional,andnationalaswellasinternational.Manyregulationsandguidelinesweredeveloped.AdjacentscientificfieldssuchasveterinarymedicineanddentalcarearegettingtheirspecificPOCtestingfacilities.InChina,IndiaandSouthAfricaarethemostactiveinnewdevelopments.
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Manyscientificpapersarewrittenon‘POCTandcosts’andon‘POCTversustheCentralLaboratory’.Mostofthemaredefensivetowardsthesedisruptiveinnovationsandwillbepassedoverbythedesiresofthepatientswiththeaidoftheindustry.Itisreminiscentofthephotoindustrythatdeniedtheexistenceofcamerasinsmartphones.
OurupcomingconferenceinAntwerpwillfacilitateasanctuaryforout-of-the-boxthinkerswiththepurposetoenlighten,inspireandenergizeallpresent.Website:www.qualityinthespotlight.com
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