Use of quality indicators by clinical bacteriology laboratories in Ontario, Canada—External quality assessment (EQA) survey by Quality Management Program—Laboratory Services (QMP-LS)

Results: The 104 labs reported monitoring a total of 947 QIs over the fi ve years (mean: 9; median: 9; range: 0-22). Specimen rejection rate (n=81), blood culture contamination rate (n=68), blood culture volume (n=45), transit times (n=31) and number of blood culture sets (n=19) were the most common pre-analytic QIs. Results review prior to report release (n=25) and correlation of Gram stain results with culture (n=9) were the most frequently reported analytic QIs. Report turnaround time (TAT) for CSF (n=29) and blood culture (n=20) Gram stains and review of reported results for transcription errors (n=16) were the most common post-analytic QIs. 125/947 (13%) of the QIs reported by labs were deemed to be erroneous QIs (e.g. quality control, temperature monitoring of equipment). Labs reported compiling data manually for most QIs. Not all labs had established target/threshold values for their QIs and some of the values reported were not well-defi ned (e.g. reduce specimen rejection). Only 6% of the threshold values reported had been revised over time. Corrective/remedial actions implemented as a result of monitoring QIs were variable and not all were appropriate. Conclusion: The use of QIs by bacteriology labs is widespread in Ontario. Nevertheless, this survey identifi ed a lack of understanding of QIs by some labs as evidenced by misidentifying basic QC as a QI, lack of targets or thresholds for some QIs and the need to revise targets over time in order to effect process improvement. QMP-LS released a summary of these fi ndings to Ontario labs along with educational commentary to assist labs in improving their quality systems. ABSTRACT P1374