Lot verification practices in Ontario clinical chemistry laboratories - Results of a patterns-of-practice survey. 2022

Angela C Rutledge, and Anna Johnston, and Ronald A Booth, and Kika Veljkovic, and Dana Bailey, and Hilde Vandenberghe, and Gayle Waite, and Lynn C Allen, and Andrew Don-Wauchope, and Pak Cheung Chan, and Julia Stemp, and Pamela Edmond, and Victor Leung, and Berna Aslan
Institute for Quality Management in Healthcare (IQMH) Endocrinology and Immunology Scientific Committee, Toronto, Ontario, Canada.

Verifying new reagent or calibrator lots is crucial for maintaining consistent test performance. The Institute for Quality Management in Healthcare (IQMH) conducted a patterns-of-practice survey and follow-up case study to collect information on lot verification practices in Ontario. The survey had 17 multiple-choice questions and was distributed to 183 licensed laboratories. Participants provided information on materials used and approval/rejection criteria for their lot verification procedures for eight classes of testing systems. The case study provided a set of lot comparison data and was distributed to 132 laboratories. Responses were reviewed by IQMH scientific committees. Of the 175 laboratories that responded regarding reagent lot verifications, 74% verified all tests, 11% some, and 15% none. Of the 171 laboratories that responded regarding calibrator lot verifications, 39% verified all calibrators, 4% some, and 57% none. Reasons for not performing verifications ranged from difficulty performing parallel testing to high reagent cost. For automated chemistry assays and immunoassays, 23% of laboratories did not include patient-derived materials in reagent lot verifications and 42% included five to six patient materials; 58% of laboratories did not include patient-derived materials in calibrator lot verifications and 23% included five to six patient materials. Different combinations of test-specific rules were used for acceptance criteria. For a failed lot, 98% of laboratories would investigate further and take corrective actions. Forty-three percent of laboratories would accept the new reagent lot in the case study. Responses to the survey and case study demonstrated variability in lot verification practices among laboratories.

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