Dan Edson and the American Proficiency Institute provide ways to assess the accuracy of lab tests

May 1, 2012

Dan Edson, President,
American Proficiency Institute

American Proficiency Institute President since 1991;
Prior to that, Surveys (Proficiency Testing) Manager for the College of American Pathologists
MS, Michigan State University
BS, Medical Technology, from Central Michigan University
“My most important community work has been the 17 years spent as Board President of a free medical clinic for the uninsured in the Traverse City [Michigan] area. I am also on the Board of Trustees at Munson Medical Center, a 350-bed regional referral hospital in Traverse City. I also enjoy bicycling, cross country skiing, and spending time with my grandsons.”

New approaches and technologies for assessing the accuracy of laboratory tests. The novel proficiency testing samples we developed (e.g., liquid chemistry, CBC with automated differential, blood cell photographs) are now used by all proficiency testing providers and have made for a fairer evaluation of a laboratory's performance. Many new laboratory tests such as BNP, Troponin, and D-dimer have come on the scene in the past 20 years. API has developed proficiency testing samples to meet the demands of the laboratories performing these and many other assays.

The newest focus for API is being able to offer proficiency testing to hospital laboratories because of our approval by the College of American Pathologists' Laboratory Accreditation Program. That change has led to an additional 2,000 hospital labs using our service. Our medical technologists meet the demands of 200- and 300-bed hospital labs while still offering a high level of service to physician offices.

As customer demands changed, API has met the challenges. When API began in 1991, we offered only proficiency testing for point-of-care sites—Blood Gas and Activated Clotting Time. When proficiency testing programs were mandated for all clinical laboratories in 1994, due to CLIA' 88 [Clinical Laboratory Improvement Amendments], our enrollment grew from 700 laboratories to 4,000 in one year. Today, API offers a full array of proficiency testing options for more than 17,000 hospital, clinic, and physician office laboratories across the country.

Early on, API focused on the needs of physician office laboratories and strove to help those labs understand all aspects of the new CLIA regulations. In many cases, the people performing the tests were not medical technologists, so our staff had to wear several hats as they communicated with less sophisticated analysts, along with laboratory inspectors and technical service groups at instrument manufacturers. We also realized there were a number of hospitals that oversaw other labs, so we created special management reports that allowed them to assess proficiency testing results for all labs in their system. API now has over 350 “systems” that range in size from four labs to 86 labs. The systems have been a big part of our recent growth because we listened to their needs and developed special computer software that saves them time in overseeing multiple labs. Our newest feature allows laboratories not only to enter results over the Internet but also to review performance reports and statistical trends and to get free continuing education credits.

Benefits of the collaboration with ASCP and the Joint Commission. API, the American Society of Clinical Pathologists, and the Joint Commission have a collaborative relationship known as LabAdvantage, a combined package of laboratory accreditation, customized proficiency testing, and technological and scientific educational services. LabAdvantage offers facilities the opportunity to integrate menu-driven, web-based API proficiency testing that meets Joint Commission accreditation requirements and participate in cutting-edge ASCP technological and scientific educational programs that are uniquely designed for customer needs. Through this collaborative effort, the expertise of pathologists, skilled medical technologist surveyors, and an experienced proficiency testing provider will be integrated into the Joint Commission survey process. The Joint Commission, API, and ASCP together will provide an opportunity for customers to obtain needed survey, proficiency testing, and education products in a one-step, no-hassle fashion.

By providing this opportunity, we hope to enhance the value of accreditation and related services and, more importantly, reduce costs, improve service, provide new educational opportunities, and enhance the breadth of survey expertise for our members and customers.

New programs and test options for 2012. For 2012, API added more sophisticated blood bank programs such as Antibody Titers and Antigen Typing, added more analytes to our Urine Drug Screen program, and created a new Proficiency Testing (PT) option for Cystatin C. As larger hospitals utilize our service, we continue to evaluate the addition of more esoteric analytes to our menu.

Medical laboratory science scholarship program administered by API. The nationwide shortage of medical technologists will impact the future of laboratory medicine. API recognized this issue and decided in 2008 to initiate a scholarship program for junior and senior level college students enrolled in clinical laboratory science programs. Each year we offer five $2,000 scholarships with the hope that this money will offset a portion of the college expense for the winners and perhaps not only attract visionary leaders to the profession, but also help in some small way to alleviate the nationwide shortage of laboratorians.

Giving back to the local, national, and global community. API works with the clinical laboratory science faculty at a nearby university to enrich their experience by providing surplus PT samples for them to analyze in their simulated laboratory. I personally travel there each fall and give a presentation to their junior and senior level students about careers in laboratory medicine. Locally I am involved with a high school science program and speak to its students each year about laboratory science and careers in the medical field.

Globally, API is partnered with AMPATH—a program led by Indiana University in response to providing life-saving care in the face of the HIV pandemic. AMPATH now treats more than 140,000 HIV-positive persons at more than 60 urban and rural sites in western Kenya. API provides all of the needed proficiency testing samples at no charge for their core laboratory in Eldoret, Kenya. I have traveled to Eldoret to meet with laboratory staff and speak with them about all aspects of quality assurance.

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