Sunday, July 18, 2010

Proficiency Testing - in all its guises.

I really enjoy being involved with medical laboratory proficiency testing.  It satisfies so many roles.

First and foremost it is a primary quality partner.  (Quality partners are those groups that provide the supports that a laboratory depends upon to improve its quality - standard development bodies, accreditation bodies, proficiency testing bodies, equipment and supplies providers, education bodies, professional organizations, and the public).  Every quarter, there are another set of samples that allow the laboratory to challenge its systems and challenge its procedures to prove to itself that it can achieve a correct answer.  Probably the worst thing that ever happened to proficiency testing was the intervention of "authorities" that jump in with all sense of nonsense rules when an error occurs. All this accomplished is promoting "gaming away" a very useful quality tool.  

Proficiency education is really about continuing education and continual improvement.  Our middle and smaller sized laboratories tell us that our critiques are the single most important source of continuing education material.  Not so for the bigger laboratories, but then they are the ones with enough money to buy books, buy guidelines, send folks to conferences, send folks for training, and on-and-on.  So they are not our first priority education target.

But there is another side to PT that most laboratories and laboratorians don't see, or if they do, it is less obvious.  Standards Development bodies, like ISO and WHO, raise the point that the proficiency testing samples should look like and act like real samples, otherwise they don't really measure proficiency.  That seems so obvious, until the laboratory receives vials of lyophilized powder.  There is a huge research and development component to PT.  How can you create samples that look like clinical samples, but are stable enough to transport over distances and still be acceptable when they get to the laboratory?  We spend a lot of time at that, as do many other programs.

This summer adds one more additional component that is very satisfying. Two months ago we had personnel in from a middle-East proficiency testing program learning how we make our samples, and more importantly,  how we go through the R&D.  Tomorrow we have another group from southern-Africa.  

So there is a big PT community in which we as Quality Laboratorians can play.

Memo to laboratorians.  Odds are that most of you will not be engaged in starting-up a PT program.  But everyone can have the opportunity to get engaged at a committee level, at a critique writing level, at a commentary level.  Don't limit your Quality activities time to only doing accreditation visits to other labs.  

Get involved.

At least that is what I think!

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