The American Association for Laboratory Accreditation

 The American Association for Laboratory Accreditation (A2LA) marks its 20th year of existence. Its major aim as a non-profit, public service organization is to promote laboratory quality and competence. In terms of the number of current accreditations, A2LA is the largest multidiscipline laboratory accreditation body in the United States and the fourth largest in the world. An overview of current activities and status is provided.     

The Slovak National Accreditation System

 After the split of the Czechoslovak Federation, the Slovak National Accreditation System was established in November 1993, being the only system in this country executing accreditation and certification. This system is strictly based on EN 45 000 and covers testing laboratories from both the mandatory and voluntary areas of metrological laboratories, products testing and certification, quality systems, and good laboratory practice. It seeks to reach the level of compatibility accepted and recognized by EU member countries. The development and basic features of the Slovak National Accreditation System, its basic principles, and the structure and competence of accreditation bodies are described in this article.     

Update on the activities of the National Cooperation for Laboratory Accreditation

 The efforts to form a laboratory accreditation cooperation in the United States and North America are described, including activities of the Laboratory Accreditation Working Group and the interim board of the National Cooperation for Laboratory Accreditation. The vision, mission, and guiding principles developed by the two groups are presented, along with the operational documents, such as bylaws, the recognition document, guidance documents and the quality manual drafted by the interim board. Received: 8 June 1998 · Accepted: 16 June 1998     

NATA: 50 years experience with accreditation

 Laboratory accreditation is becoming increasingly accepted around the world as a means of identifying technically competent laboratories. It is also being used as a mechanism for the acceptance of test data both nationally and internationally. The concept and mechanisms of accreditation have been developed over the past 50 years. The first national laboratory accreditation system appeared in Australia in 1947. This organisation, known as the National Association of Testing Authorities (NATA), has since taken a leading role in developing accreditation practices that are now used world-wide in evaluating testing, measurement and calibration laboratories. This paper examines the development of the world's first and largest laboratory accreditation system, and looks at the difficulties and triumphs in gaining acceptance and recognition by government and industry of the benefits of laboratory accreditation. Received: 24 June 1996 Accepted: 25 June 1996     

The development of a National Accreditation System in South and Southern Africa

 In South African industry there is a strong appreciation of Quality Assurance. More than 1400 companies have been certified as complying with ISO 9000, and this, of course, has resulted in a strong demand for accredited calibration and test facilities. Work on the development of a national calibration service started in 1976, and the South African National Calibration Service (SANCS) was inaugurated in 1980 with 13 calibration laboratories. The early maturity of the SANCS can be judged by the fact that by 1984 it had the technical capability to establish a mutual recognition agreement with a European country. It now has a total of some 191 accredited laboratories, 139 calibration laboratories and 52 testing laboratories. In 1993, the SANCS signed mutual recognition agreements with the CNLA (Taiwan) and the European Co-operation for the Accreditation of Laboratories (EAL). In 1994 it entered the field of testing laboratory accreditation and is already experiencing a strong influence therefrom, and in 1997 it changed its name to National Laboratory Accreditation Service (NLA). In May 1995, the NLA was appointed by the Department of Trade and Industry to establish a South African National Accreditation System (SANAS). Progress with this work up to the present time has been substantial.     

Introduction of Japan Chemical Laboratory Accreditation

 Japan Chemical Laboratory Accreditation (JCLA), a new accreditation body in chemical fields was established and the activities and organization of JCLA are outlined.     

Development of laboratory accreditation in the United States

 Laboratory accreditation in the United States is an old profession. Users and regulators have, it seems, been concerned about the quality of test data they obtain from laboratories for well over half a century. These users have developed many different systems to meet their needs. As a result, there is much duplication of effort and overlapping in accreditation requirements and many laboratories have to maintain current accreditation from a number of organizations. A number of attempts have been made over the years to reduce this duplication, but it still remains. In the meantime, rapid progress has been made internationally to recognize laboratory accreditation systems in different countries. This paper describes this situation and speculates on the future, considering the international thrust to simplify and consolidate conformity assessment procedures. Received: 26 May 1998 · Accepted: 6 June 1998     

The College of American Pathologists laboratory accreditation program

The College of American Pathologists (CAP) operates voluntary programs in proficiency testing (PT) and quality monitors, which are briefly described. Additionally, a peer-based laboratory accreditation program covers over 6,100 clinical laboratories. Participation requires successful PT and on-site inspections using a series of 18 checklists structured along traditional subdisciplines of laboratory medicine and anatomic pathology. The laboratory general checklist contains over 250 questions covering broad issues affecting all disciplines. Among these are three items within the computer services section that specifically probe the laboratory’s use of autoverification. Data autoverification is defined as the process by which the computer performs the initial verification of test results; any data that fall outside of set parameters should be reviewed by the human operator. Central to these questions is the role of the laboratory director in approving the rules and validation. CAP does not define the specific technical details, recognizing the uniqueness of each laboratory setting and the patients it serves. Received: 8 August 2002 Accepted: 10 August 2002 Presented at the European Conference on Quality in the Spotlight in Medical Laboratories, 7–9 October 2001, Antwerp, Belgium Correspondence to A. Rabinovitch     

The quest for comparability: Calibration 2000

 Most efforts in quality control have been focussed on the reduction of intralaboratory variation and the assessment of interlaboratory variation. Over the last few years, the importance of bias in interlaboratory variation and intralaboratory shifts has become clear. Small shifts can sometimes have a large impact on the number of treated patients, particularly in assays where cut off values are used. For example in cholesterol, HDL-cholesterol, HbA1c and TSH assays. There is an obvious need for adequate calibration material. However, the process of development of international primary reference materials and reference methods takes time, and even if reference materials exist and are used by in vitro diagnostics manufacturers, there still remains significant and clinically relevant interlaboratory variance and intralaboratory shifts, as is seen, e.g. in protein chemistry. The harmonization of inter laboratory and intralaboratory results needs an impulse from professional organizations to convince individual laboratories of the importance and significance of bias. This applies to all subdisciplines of laboratory medicine. On the occasion of the 25th anniversary of the Foundation for External Quality Assessment (SKZL), a large interdisciplinary harmonization project called Calibration 2000 was launched in The Netherlands The strategy and first results are reported in this paper. The project aims at harmonization of laboratory data of several disciplines, using secondary calibration materials, leading to common reference ranges throughout The Netherlands. Received: 15 April 2000 · Accepted: 15 April 2000     

Quality assurance programs for countries in need: a global view from the College of American Pathologists

Providing laboratory external quality assessment (EQA) programs for countries in need requires special considerations not ordinarily part of EQA for laboratories in industrialized countries. Cultural, professional, service and economic factors must be understood and accommodated in order to carry out successful programs. Coordination of worldwide efforts for countries in need requires more resources and planning than have thus far been devoted to the enterprise.     

Accreditation of types of tests

 DACH, the German accreditation body of chemistry, which was founded in 1992, has introduced a new model for the flexibilization of the scope of accreditation. This ensures that the accreditation of a laboratory also guarantees flexibility. Flexibilization of the scope of accreditation is of great importance, in particular if a great number of similar routine tests (standard methods) or non-routine tests are to be accredited. The main tool of flexibilization is the accreditation of types of tests. The accreditation of types of tests entitles laboratories to include additional test methods within the type of test accredited without informing the accreditation body immediately. Such information is provided at fixed surveillance intervals. The conditions for the accreditation of types of tests are described below.     

Accreditation of reference material producers

 The use of reference materials is the most pragmatic means by which the analyst can achieve comparability of data. Reference material producers therefore need to have adequate quality systems in place for ensuring the reliability of their materials. In order to provide guidance to both producers and assessors, ISO Guide 34 has recently been produced detailing the quality system requirements for the production of reference materials. CITAC, REMCO and ILAC are now collaborating in the revision of this guide to produce a free-standing document detailing the general requirements for the competence of reference material producers. This paper discusses some of the more important issues described in these documents. The possible formation of an international register containing details of a reference material producer's quality system status is also discussed.     

Accreditation of proficiency-testing schemes in The Netherlands

Proficiency testing by laboratories, national accreditation bodies, and other third parties is becoming more and more considered as a standard and integral part of the quality control system. Therefore, it is of utmost importance that the quality of the provided proficiency-testing (PT) service is outstanding. If PT-schemes are set up in order to help laboratories monitor and improve their quality, PT-schemes need not only be of high quality themselves, but the organizer also needs to be able to demonstrate this. In The Netherlands formal accreditation of the organization of proficiency testing schemes is used as a tool to guarantee high quality schemes and also to enable organizers to demonstrate their competence. Since 1996, the Dutch Council for Accreditation (RvA) has used the ISO-Guide 43–1 to assess PT-organizers in The Netherlands. From January 2000, the ISO-guide 43–1 was replaced by the ILAC G13 document for assessing organizers. Up till now, four institutes have been accredited by the RvA for the organization of PT-schemes.     

The practical advantages of hospital quality systems such as NIAZ/PACE

 The Netherlands Institute for Accreditation of Hospitals (NIAZ) was established at the end of 1998. It was founded by the PACE foundation, the Society of University Hospitals, the Netherlands Association of General Hospitals and the Society of Medical Specialists in the Netherlands. Since then in the Netherlands 19 pilot accreditations have been performed based upon 35 NIAZ-PACE standards for hospital departments and functions, and the overall standard 'quality system'. The aims and methods of the accreditation system were inspired by examples from the other side of the Atlantic, especially from Canada. The characteristics are: voluntary-based, self-evaluation, peer-review and aiming at continuous improvement of quality of care. Received: 15 April 2000 · Accepted: 15 April 2000     

The European Eco-Management and Audit Scheme Accreditation – an overview

 Environmental quality is still deteriorating in the EU and worldwide despite all the Directives and Regulations in this field over the past 20 years. The European Community has devised a new approach to this problem with the introduction of the Eco-Management and Audit Scheme Regulation. This Regulation provides industry with an opportunity to demonstrate that it can achieve continuous improvement in its environmental performance through a voluntary scheme which is not based on the traditional command and control mechanisms of Directives. This paper gives an overview of the steps involved in implementing the European Eco-Management and Audit Scheme and the role of accreditation in supporting the scheme.     

Pathology laboratory accreditation: the Australian experience

 The National Associating of Testing Authorities, Australia (NATA) is a laboratory accreditation company that has been involved in the accreditation of pathology laboratories since 1982. This role is carried out in conjunction with the Royal College of Pathologists of Australasia (RCPA). The accreditation process is known as the NATA/RCPA scheme. The NATA/RCPA accreditation scheme originated from the desire to raise professionalstandards in pathology. The scheme aimed to achieve this through a peer review process in which education and voluntary participation were stressed. In 1986, the Australian Federal Government adopted the scheme as its measure of the competence of testing by pathology laboratories seeking payment from the Commonwealth Department of Human Services and Health reimbursement scheme, Medicare. This meant that NATA/RCPA accreditation became mandatory for such laboratories. The benefits of peer review as a means for establishing professional competence and the challenges a mandatory accreditation program poses to such a scheme will be discussed. Received: 6 May 1996 Accepted: 29 May 1996     

Accreditation and authorization in environmental analysis

 Since 1989 testing laboratories in Europe have had the possibility to confirm their competence in carrying out certain testing procedures by means of accreditation. Over the years an independent European Accreditation system has been developed, which many member states of the European Union have joined. The existing accreditation organizations joined to form the unified organization EA (European Cooperation for Accreditation) in 1997. Members of this organization are, inter alia, one representative of the accreditation authorities of each of the member states. The German accreditation system is different to the European system in that it is split. Here, we differentiate between the sector established by law and that which is not. Both sectors, however, pursue the same goal. Because of this double certification of competence and the resulting multiple reviews, German testing laboratories face a considerably greater load in comparison to their European colleagues. Several authorities are already working on the removal of this split accreditation system. The efforts must, however, be concentrated and brought into line. Efforts by the DAP and DACH for flexible accreditation and the creation of a standardized registration authority for testing laboratories in the field of workplace measures are examples of how the German accreditation system could develop in the future.     

Accreditation of calibration laboratories to normative documents: diversity or standardization

Calibration of measuring equipment is conducted by following some normative or applicable documents such as standards, manufacturer manuals and instructions, technical orders issued by defense organizations, or scientific papers. An accreditation body provides its recognition to the calibration laboratories by evaluating their technical competence and their compliance with the quality requirements of ISO/IEC 17025. The accreditation body must have defined criteria in order to evaluate different calibration methods which should ensure that the laboratories are performing the calibration in a technically competent manner when they are fully or even only partially based on the relevant reference documents. A discussion with different points of view about choosing the criteria, as well as the Israel Laboratory Accreditation Authority (ISRAC) policy on this issue, are presented.Presented at the 2nd International Conference on Metrology – Trends and Applications in Calibration and Testing Laboratories, November 4–6, 2003, Eilat, Israel.     

The measurement assurance concept in calibration and traceability at NBS/NIST

During the last quarter of the twentieth century, The United States National Bureau of Standards (NBS), later the National Institute of Standards and Technology (NIST), introduced a measurement quality control concept called ”measurement assurance,” and developed measurement assurance programs, or MAPs, for high-level calibration processes. The measurement assurance approach has, over time, become increasingly popular in the metrology community, and in recent years has become well accepted both inside and, to some extent, outside the United States as a rigorous way to ensure the quality of calibrations. The concept has also found application in defining traceability to national standards. This paper traces the history of the measurement assurance concept. Received: 23 October 2000 Accepted: 2 November 2000     

A framework for the application and materials in analytical chemistry

 Working group 5 of EuraChem Nederland has developed a framework for the implementation of reference materials in analytical chemistry. In this discussed paper, the framework is proposed as a tool for the development of standard operation procedures (SOPs) in laboratories. The implementation of (certified) reference materials in these SOPs is of major importance in establishing comparability and traceability in measurement results, which in turn play a crucial role in measurement in support of trade, environmental issues, and characterisation of materials. Recent developments in the field of uncertainty analysis require the application of reference materials. It is recognised that the calculation of the combined measurement uncertainty becomes almost impossible without the use of certified reference materials with a stated uncertainty. Received: 1 December 1995 Accepted: 20 December 1995