System for laboratory proficiency testing in bacteriology: organisation and impact on microbiology laboratories in health care facilities funded by the Ontario Government.

The Ministry of Health requires that all medical laboratories in the Province of Ontario participate in a laboratory proficiency testing program (LPTP). In bacteriology compliance has been excellent. Eighty-six laboratories, for various reasons over the period under review, have surrendered their licence or, because of poor performance on LPTP test surveys, have had their licence withdrawn by the Ministry. The highest percentage of withdrawals occurred in small hospitals in isolated areas. In April 1979 there were 249 participating laboratories. Participants' results are first analysed by computer, and, subsequently, approximately 20% of participants' reports are reviewed by the Committee. Various Committee actions ensue: correspondence with the laboratory director regarding errors; an offer of a visit; and possibly a report via a senior LPTP committee to the Ministry that a laboratory is non-proficient and, in LPTP's terms of reference, non-remediable. Subsequent Ministry action might be the withdrawal of a laboratory's licence. However, this last recourse only occurs when educational efforts have proved ineffectual. Overall, performance in LPTP bacteriology surveys has improved over the period 1975-8, with 68% of 263 laboratories achieving a score of 70% or higher and 26% of 263 laboratories scoring less than 60%.