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Rethink quality control processes

Ambulatory Safety Monitor, November 10, 2005

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When Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standard PC.16.50 took effect January 1, it led ambulatory organizations that perform instrument-based screenings to reevaluate their procedures for quality control checks, says Rebecca S. Jessie, BA, assistant director of quality and patient safety at Rockingham Memorial Hospital in Harrisonburg, VA.

The standard "requires organizations to maintain policies and procedures that address quality controls and documentation showing that quality controls were conducted," she says. This requirement has stumped several ambulatory surgery centers (ASC), according to the JCAHO, which reports it as the second most troublesome standard in 2004.

Making the grade
Ensure that your organization meets compliance by including at least two levels of control, if available, and perform quality control tests on each instrument at least once each patient testing day.

For example, sometimes only one or two patients per day come in for a screening. It wouldn't be cost-effective to run quality control for such a small number of users. To meet compliance and still provide this service, some centers stopped offering open screenings and instead designated screening days to see a large number of patients in one day to make the quality controls worthwhile.

Don't forget the new EP
Element of performance 5 is also new this year. It says ASCs must document controls based on

• how the test is done
• the reagent stability
• manufacturer's recommendations
• the hospital's experience with the test
• currently accepted guidelines

Consider all of these issues as they relate to what test you're doing and for what patient population. Ask yourself: Will the quality controls in place give you the information you need to ensure that you receive the results you need?

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