Quality Management Program - Laboratory Services

 IN THIS ISSUE

  No. 126        May 2008

A new EQA Program: Immunohistochemistry for Breast Cancer Tumour Markers

Eye on OLA: Contract Review

Knowledge Transfer: Quality Management in Action - Call for submissions

NORONT's 30th birthday in March 2008 a resounding success

Quali-TIP

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Contract Review

Version 4 of the Ontario Laboratory Accreditation (OLA) Requirements and Guidance Information, effective September 2008, includes new requirements for contract review never before assessed (Table 1). Primarily, these requirements are for laboratories providing a referral testing service—the flip side of II.G Referral Laboratories, laboratories accessing a referral testing service.

Laboratories that are subcontracted by another laboratory to provide testing services are required to have documented policies and procedures to address the review of any contract it enters into. Procedures should include provisions to ensure that contract requirements are met—the availability of competent staff, adequate space, equipment and resources to meet the obligations and that selected test methodologies are validated and appropriate for use. In some laboratories, different kinds of contracts may exist (e.g. agreements to provide physicians with services) to which these requirements will apply.

Whenever any further subcontracting is utilized, the existing contract is amended or if conditions of the original contract
can no longer be met, the laboratory must ensure that the contract review procedure is re-initiated and a record of this review is kept.

Assessors will expect to see records of review anytime a laboratory enters into a contract to provide medical laboratory services.

 Table 1:   New Requirements for Contract Review

II.H Contract Review

II.H.1 Where a laboratory enters into a contract to provide medical laboratory services, it shall establish and maintain procedures for review of contracts. The policies and procedures for these reviews leading to a change in the arrangements for examinations or contracts shall ensure that:

a) requirements, including the methods to be used are adequately defined,
     documented and understood;
b) the laboratory has the capability and resources to meet the requirements, and;
c) appropriate methods selected are able to meet the contract requirements and
    clinical needs

II.H.1.1 Records of review shall be maintained
II.H.1.2 The contract review shall also cover any work referred by the laboratory.
II.E.13  Clients (e.g., clinicians, health care bodies, health insurance companies, pharmaceutical companies) shall be informed of any deviation from the contract.
II.H.1.4 If a contract needs to be amended after work has commenced, the same contract review process shall be repeated and any amendments shall be communicated.

NORONT’s 30th birthday in March 2008 a resounding success

by Linda Crawford

NORONT is Ontario's best kept laboratory secret!

March 4–6, 2008 marked the 30th NORONT medical laboratory conference (Timmins). 

NORONT was conceived to provide education for front-line technologists throughout northern Ontario. First held in Cochrane in 1978, a dedicated group of technologists have continued the tradition with the generous support of loyal vendors. Chair Aline Letourneau (Timmins) noted that NORONT organizers have never charged a registration fee, due to sponsorship of exhibitors. Several "frequent fliers" (attendees and presenters from central and southern Ontario) were mentioned. John Lafferty called NORONT the best kept laboratory secret in Ontario. NORONT provides an intimate, congenial environment for laboratory technologists to learn and talk with suppliers.

Figure 1. NORONT's mascot, the cuddly polar bear and Linda Crawford, Director, Ontario Laboratory Accreditation, QMP-LS

If NORONT’s mascot, the cuddly polar bear (Figure 1), could talk it would certainly have stories to tell about the activities of past conferences:

• Technologist vs. vendor Olympics
• Kinnette’s charity casino night
• Hospitality suites
• Sleigh rides
• Wine and cheese mixers
• Pizza night

In the fun comradeship category, this year was no exception. Co-chair Judy Austin (Kapuskasing) provided the ever-popular JELL-O® shooters (http://en.wikipedia.org/wiki/Jell-O). Joe Bottos (Beckman Coulter, Mississauga) opened the first ever "Nortini Bar" (Figure 2). The question on everyone’s mind was, "Does he have a standard operating procedure (SOP) for those?" and indeed a contest to guess the ingredients produced one!

This year’s scientific program was a credit to the organizers and presenters alike. During my keynote address we took a look back over the past 30 years of major events occurring in our ever-changing world, and contrasted them against activities and new trends occurring in the medical laboratory as we improved technology and became more safety conscious. Denyse Tremblay (Canadian Blood Services, Ottawa) explained the new Buffy Coat production method introduced at Canadian Blood Services—a different way of making platelets from whole blood, stressing the implications for hospital transfusion services. Sandy Gillespie (LifeLabs, Etobicoke) led us through an interactive workshop titled Workplace Dynamics—Dealing with Difficult People. Following the banquet, speaker Dr. Edward Cormode (Orillia) entertained and amazed us with tales of working in the Baffin Island territory of Nunavut, where he has practiced pediatric medicine. He honoured us all when he said that he wanted to be a lab tech when he grew up, but the passion he demonstrated for respecting not only the inhabitants but their lifestyle was a tribute to those working and living in the far northern reaches of Canada. Dr. Roger Sandre (Regional Infection Control Network, Sudbury) spoke on new antibiotic therapy and treatment in the management of Clostridium difficile associated disease (CDAD), and made us all think carefully about protecting ourselves and others against hospital-acquired infections. Dr. Marciano Reis (Sunnybrook and University Health Network, Toronto) reviewed the newly implemented digital slide service installed for the Timmins cluster hospitals. This telepathology project will facilitate diagnostic consultative services, remote access by physicians, integrated reporting and teaching opportunities. Currently two scanners are installed at Timmins and District Hospital. He showed some blood films, cerebral spinal fluid cytospins, and bone marrow slide images available in a teaching databank, and all attendees were impressed by the quality of the 40x magnification images. Dr. Reis also discussed the use of flow cytometry in the immunophenotypic diagnosis of primary or secondary leukemias, lymphoproliferative disorders, chronic myelogenous leukemia (CML) in blast crisis, and leukemia/lymphoma, which was classified, but not previously immunophenotyped, and recommended indications based on Bethesda Consensus (2007). He stressed the importance of clinical history and morphologic assessment in conjunction with flow cytometry as a diagnostic tool.

In addition to this stimulating scientific program, the 50 attendees were treated to a number of lucky draw prizes from the NORONT committee and vendors.

Hat’s off to the NORONT 2008 committee! NORONT has not only come of age, it has become a conference known for excellence in education, supplier information and fun.

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Knowledge Transfer: Quality Management in Action—Call for submissions

Knowledge Transfer: Quality Management in Action is a column in QMP–LS News featuring a series of quality-related articles to showcase examples where laboratory individuals or teams have successfully used quality management principles to lead projects outside the walls of their laboratories in pursuit of integrated health care. The articles are intended to inspire and assist laboratory personnel in becoming leaders within their workplaces in the quest for quality services.

The success stories used in this series are all reprinted with permission from the author(s).

Submit Your Own Success Story

You and your laboratory team can now submit your quality-related success stories by e-mailing with your copy (Microsoft Word attachments preferred). Your article should include the following headings: Opportunity for improvement/achievement, Roadblocks and timeframe for completion, Tips for success, Future plans.

Include the following information in your e-mail: name, laboratory name, position title, telephone number, e-mail address.

You will receive a reprint permission form once your story is chosen to be published in QMP–LS News.

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