Objective: Managing the safety and security of medical treatment information is critical for every clinical department in a hospital, and improving safety and security management is increasingly emphasized. Our laboratory, the Department of Clinical Laboratory, Tohoku Medical and Pharmaceutical Hospital, acquired ISO 15189 accreditation in January 2019. We sought to assess the effect of ISO 15189 quality management on medical safety by analyzing incidents and accidents before 2017 and from ISO 15189 acquisition until 2022.
Methods: We assessed the classification of incident severity, the medical services in which incidents occurred, the specific laboratory test steps in which incidents occurred, the variety and number of recurrences, and the medical services in which recurrent incidents were observed.
Results: No accidents above level 3b were observed over the study period, and the total number of incidents decreased significantly after 2020. Level 1 incidents in particular decreased notably after 2021. Incidents that occurred during the night shift/day duty dramatically decreased after 2019 (2017–2018, 21 cases; 2019–2022, 10 cases, p < 0.001). The proportions of incidents by laboratory test step remained unchanged. The number of recurrent incidents was highest in 2018 (12 cases) and then gradually decreased (2019, eight cases; 2020, five cases; and 2021, one case). No recurrent cases were observed after 2022.
Conclusions: Implementing a quality management system that meets ISO 15189 standards is associated with fewer incidents, especially in night shift/day duty services. Reducing recurrent incidents may require additional time, even with the application of ISO 15189 systems.

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Background: Nonfasting triglyceride levels have an equal or greater impact on predicting cardiovascular disease events than fasting levels.
Objectives: To examine the effects of consuming a high-fat or a high-carbohydrate meal on the plasma levels of lipids, apolipoproteins, and coagulation and anticoagulation factors.
Methods: In a randomized cross-over study, 12 young non-obese women were served isocaloric meals, predominantly fat (69 E% fat) or carbohydrate (91 E% carbohydrates), on two separate days, and blood samples were taken before and 2.5 and 5.5 h after the meal.
Results: After consuming a high-fat meal, there were significant increases in triglycerides, small dense LDL (sdLDL) cholesterol, and factor VII activity. However, levels of total, LDL, and HDL cholesterol, and apolipoproteins decreased; and levels of total protein S antigen and its activity, free protein S antigen, protein C antigen, and fibrinogen remained unchanged. On the other hand, all these parameters, except for apoC-II and total protein S antigen, decreased after eating a high-carbohydrate meal. Insulin increased postprandially, while glucose levels remained unchanged. Strong positive relationships between triglycerides and the levels of sdLDL cholesterol and apoC-II were observed both at fasting and after consuming meals. However, no correlation was found between triglycerides and coagulation and anticoagulation factors such as factor VII activity and total protein S antigen and its activity.
Conclusions: Consuming a high-fat meal increased factor VII activity during the postprandial elevation of triglycerides and sdLDL cholesterol. However, the activated protein C-dependent anticoagulant system may not regulate this postprandial hypercoagulable state.

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