Laboratory Accreditation

For the first time at the NHS, a team of nine laboratory accreditation surveyors from Ontario Laboratory Accreditation (OLA) visited our six NHS medical laboratory testing sites to conduct a peer assessment. Planning for the survey in late October 2007 was an intense effort by Laboratory Medicine Program.

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The outcome?

Photo of lab staffIn the words of the surveyors, 'the results of the survey are an incredibly good news story". Each of the six laboratories was evaluated on up to 451 individual requirements or standards, divided into eleven categories, and each of our sites scored in excess of 95% compliance. Joanne Bishop, lead surveyor for OLA, stated that "there is no other multi-site hospital organization that has consistently scored greater than 95% compliance across all sites in Ontario". It is important to note that in the sections of quality management and post analytical reporting, the NHS scored 100% compliance. This validates that the clinical and technical services provided by the laboratory to our patients is of extremely high caliber. The surveyors described the survey as a 'dream assessment'.

The surveyors had high praise for the level of knowledge and expertise of all levels of the laboratory medical and professional staff, commenting that "the staff are participating at a level of quality improvement not normally seen by the surveyors and there is strong communication within the laboratory".

Our compliance with 450 standards ranged from 95% to a high of 98%, a remarkable accomplishment, the surveyors noted. The laboratory staff has worked for many months and countless hours preparing for this survey, which involved development and implementation of our Quality Management system and standardization of practices across all laboratory sites.

The Laboratory Medicine Program has successfully obtained a five-year Ontario Laboratory Accreditation (OLA) award. OLA is operated by the Quality Management Program Laboratory Services, a division of the Ontario Medical Association and funded by Ontario's Ministry of Health and Long Term Care. Accreditation is required of all Ontario-licensed laboratories. The peer assessment visit is a process to ensure laboratories meet explicit criteria in order to give formal recognition that the laboratory is competent. The program was assessed for the following sections:

  1. Organizational Structure, Personnel Policies, Training and Laboratory Management
  2. Quality Management System
  3. Physical Facilities
  4. Equipment/Reagents/Supplies
  5. Pre-analytical process
  6. Analytical Process
  7. Quality Assurance
  8. Post analytical (reporting)
  9. Laboratory Information System
  10. Safety
  11. Point of Care Testing

The surveyors shared with us that most laboratories are struggling to meet the standards. Because the NHS chose to prepare for the survey using a more aggressive set of standards, the ISO 15189 - Medical Laboratories standards, the NHS is way ahead of most laboratories and will be well prepared when OLA revises the standards in January to 2008 to mirror the ISO 15189 standards.

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