College of Physicians

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OntarioYours to Discover Anne Raby, EQA Julie
Coffey, OLA
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Provincial Roundup 2007Ontario

• Outline
• Introduction
• External Quality Assessment
• Ontario Laboratory Accreditation

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Provincial Roundup 2007Ontario

• Introduction
• 234 laboratories licensed by MOHLTC
• Mandatory participation in Quality Management
  Program Laboratory Services (QMP-LS)
• both EQA and OLA divisions
• Although all 234 laboratories undergo
  accreditation, the number that participate in EQA
  programs varies by scope of the licence
• Additional out-of-province laboratories
  participate in some surveys
• June 2006 Dr. Harold Richardson retired
• December 2006 Dr. Greg Flynn appointed as
  Managing Director

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Provincial Roundup 2007Ontario

• EQA - Outline
• Whats new
• New programs or services provided or coordinated
• New developments
• Highlights
• Accomplishments
• Laboratory performance
• Issues of concern
• Future Endeavors
• New plans

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Provincial Roundup 2007Ontario

• EQA
• Whats new
• 121 EQA surveys conducted in 2006
• 112 challenge surveys 6 patterns-of-practice 2
  questionnaires
• 1 new pilot survey C.difficile toxin detection
• Web-based surveys included
• morphology, bone marrow and flow cytometry
• Patterns-of-Practice surveys included
• QC limits, linearity studies, antibiotic
  reporting practices, POCT, disaster planning and
  massive transfusion protocols

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Provincial Roundup 2007Ontario

• EQA - Highlights
• Performance concerns
• Major causes identified by discordant finding
  investigation were due to method and
  technical-related problems
• EQA surveys moved to a new database (LEQA)
• Improved capability for analysis and reports
• Implemented robust statistics for quantitative
  surveys
• Compliant with ISO 13528 standard Statistical
  Methods in use for PT by Interlaboratory
  Comparison
• Contributed to development of following
  guidelines/standards
• CLSI GP27A Use of PT for Improvement of
  Laboratory Performance
• ISO/IEC 17043 General Requirements for the
  Competence of PT Providers
• Hosted 2-day Canadian Flow Cytometry workshop
• Participated/presented at 14 national/internationa
  l meetings and published/presented 8 papers

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Provincial Roundup 2007Ontario

• EQA - Future Endeavors
• 115 EQA surveys in 2007
• 107 challenge surveys 7 patterns-of-practice/ques
  tionnaire
• 1 new pilot survey Cytology - PAP stain
  assessment
• Patterns-of-Practice surveys include
• Quality indicators, method validation, fetal
  maternal hemorrhage protocols
• Continue survey revision to comply with ISO Guide
  43.1
• Prepare for internal audit by end of Feb 2008
• Replace error system of performance assessment
  with scoring system
• Move to direct EQA data entry by participants

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Provincial Roundup 2007Ontario

• OLA Outline
• Whats new
• New programs or services provided or coordinated
• New staff
• New developments
• Highlights
• Accomplishments
• Laboratory performance
• Issues of concern
• Future Endeavors
• New plans

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Provincial Roundup 2007Ontario

• OLA
• Whats new
• Initial peer assessments (to 234 licensed labs)
  will continue through mid-2008. To date, 177 labs
  have been assessed and 163 certificates issued.
• Average conformance 93.94
• 3 applications for voluntary accreditation
• One new staff technologist joined our team, so
  our staff compliment is 4 staff technologists, 1
  senior administrative assistant and a director.
• 29 new assessors trained, current number of
  trained, certified assessors 285
• Expanded electronic tools for assessments (mobile
  assessor)

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Provincial Roundup 2007Ontario

• OLA
• Highlights
• OLA operations comply with ISO 17011
• Internal audit to ISO 17011 in Oct 2006
• External audit to ISO 17011 in Jan-Feb 2007
• Number of assessments conducted last year 47
• Number of lab self-assessments reviewed last
  year 66
• Monthly Eye on OLA column introduced to QMP-LS
  News
• Database-driven operations (management of
  assessments, assessor records and requirements)
  electronic delivery of correspondence and
  documents to laboratories

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Provincial Roundup 2007Ontario

• OLA
• Future Endeavors
• Number of assessments in new year 45
• Number of self-assessment reviews in new year 50
• Biennial review of requirements, guidance
  information and reference sources to be completed
  in Dec 2007, with identified quality indicators
  for a patient care scorecard
• Shortening the accreditation cycle
• Expanded surveillance of proficiency testing/EQA
  in accredited labs
• Collaborate with Health Canada on oversight of
  blood transfusion services in Ontario
• Market our national volunteer accreditation
  program to ISO 15189, with Standards Council of
  Canada