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Tuesday, October 19, 2010

Selecting PT Challenges

We are in CMPT Annual Meeting Challenge (more on this later) and one of the important tasks that needs to be accomplished is the selection of challenges for the next programmatic year.  Since our program year starts in May, the challenges we selected now go through to April 2012.
Selecting challenges for Clinical Microbiology Proficiency Testing is really interesting exercise that does not get easier with experience.  It gets harder.

Each year our group of committe participants, all knowledgeable and experienced, some laboratory physicians, some laboratory scientists, and some technologists meet with an empty slide.  By the time we finish we have 12 gram stains, two paper challenges, a variety of wound samples, blood culutres, CSF samples, urine samples, throat swabs, and enteric samples, all selected to address variety, complexity, cover the full laboratory tesing cycle, avoid repetition but allow for sequential testing, susceptibility testing, and try to increase the probability of having samples that will discriminate between strong and weak performers. And making sure that to the extent possible all will have gradable results.  And it needs to get done in under 4 hours, which includes the process of deciding on what the correct answer is going to be.  The fact that every year we get this done is no assurance that we will always be successful.

You would probably not be surprised to know that this is rarely a process that goes smoothly.  There is a lot of discussion, and lot of debate, and a lot of opinion and controversy.  But in the end we always come to a position of consensus, although rarely would it be total and absolute. Not everybody is happy, but at least everyone can live with and support the selection.  I can say that when we get up and leave the table every participant agrees that laboratories will be better having received and processed these samples, and worked through the critiques. 

But for those of you that are participators, and users of the information, I am sure you appreciate that selecting the menu is only the beginning.  Now we have to make sure we have the organisms, and ensure they will function as we expect them to.  We need to create the  mixtures of background flora to go with the challenge target, verify the growth patterns, validate the associated history, and then go through the process of quality control including all the transport issues.  All-in-all there is not a lot of time left over once we have worked through all these steps, so that we can ship them out on-time and go through the process of receiving and grading the results.

So why do we do all this.  First and foremost, laboratories and their accreditation bodies as well as the other quality partners expect that the samples are well thought out and will work to provide quality answers.  Second, if we don't produce quality samples, it becomes really hard to convince programs to continue to support us.  And third, it is actually a fun intellectual exercise that many would like to participate in, if ever they get the chance. 

For those of you that have the interest in promoting quality laboratory practice, working with your local PT program can be a positive and satisfying activity.

And for those in our neighbourhood, we will be doing this again next October. 

And then we go through the same exercise for our Mycology and Enteric Parasitology, and Water Bacteriology programs

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1 comment:

  1. If anyone does not currently belong to a scheme, Randox operate the largest PT scheme in the world - RIQAS. It is used by 16,000 laboratories worldwide, participating in a variety of programmes. RIQAS is also accredited to a number of internationally recognised standards. http://www.riqas.com/

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