From the President’s Desk: Lab quality in times of COVID-19

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Patrick Godbey, MD

March 2021—I inspected my first lab as a pathology resident in 1988. Robert Baisden, MD, head of clinical pathology at Medical College of Georgia at the time, handed me a checklist one day and said we were going to do a laboratory inspection. Like that of so many pathologists, my introduction to the CAP came through the Laboratory Accreditation Program.

The Laboratory Improvement Program, LIP, is an essential component in the CAP’s efforts to ensure laboratory quality. Our inspection program is considered the gold standard around the world, and rightly so. Our checklists are the best textbooks on laboratory quality in existence. If you understand and put into place the elements spelled out in the checklists, you will have a quality lab. They are written and updated regularly by pathologists and other medical laboratory scientists, giving CAP members direct input into the process. After all, nobody knows a quality laboratory better than we do. The ultimate beneficiary of all of this is who it should be: the patient.

Dr. Godbey

CAP checklists are the same all over the world. I have inspected labs in Georgia, Florida, South Carolina, Saudi Arabia, and Singapore. The requirements are consistent across labs small and large. That’s why it means so much to be accredited by the CAP. I know my laboratory is a good one because it was inspected by the CAP and the CAP tells me so. Labs that do not go through CAP inspection might be good—might be—but if you are CAP inspected, then everyone knows you are, including you and those who work with you.

In the past year, our commitment to quality has been tested in new ways. I am so proud of how the CAP has handled laboratory inspections and proficiency testing during the COVID-19 pandemic. The CAP quickly developed proficiency products to help pathologists ensure they were running SARS-CoV-2 tests properly. Getting that out to the community so early in the pandemic helped labs produce accurate results at a time when low-quality results would have been devastating not only to patients but also to public health policy.

We also released, and frequently updated, an infographic designed to help pathologists understand exactly what they needed to do to verify or validate a new test. We put that and so much other critical information on the public part of the CAP website so it was available to the entire community, not just to CAP members and CAP-accredited laboratories. And since many laboratories had to bring up more than one SARS-CoV-2 test at once, we released Quality Cross Checks to help pathologists test concordance in detecting the same analyte across methods and platforms. We also updated our checklists to include new criteria about how labs had to report both negative and positive results for state and federal compliance.