By Fred Rodriguez, Jr., MD, President, NAACLS Board of Directors

Competence: the ability to do something well (http://www.merriam-webster.com/dictionary/competence)

In my last posting, I commented on “quality” (i.e., a high level of value or excellence). “Competence” may seem synonymous with “quality,” but “the ability to do something well” may (or may not) result in a “high level of value or excellence.” You can possibly be assessed as being “competent” (depending on the standards used) and not have “quality,” but you certainly cannot achieve “quality” without being “competent” (as assessed by an appropriate set of standards).

Evaluating and documenting “competence” of laboratory personnel is required by CLIA ’88, and the Centers for Medicare and Medicaid Services (CMMS) (and the “deemed status” accrediting agencies) mandate the assessment semi-annually for the first year of patient testing, and annually thereafter. Also mandated are the required methods for assessing “competence” (42 CFR 493:1413). These methods include:

• Direct observation of test performance
• Monitoring test result recording and reporting
• Review of worksheets, QC, PT, and maintenance records
• Direct observation of instrument maintenance
• Assessment of test performance (PT/blind samples)
• Assessment of problem solving skills

Studies have shown that testing personnel who are “competent,” as assessed by these methods to meet appropriate standards of performance, produce a higher “quality” of laboratory results with fewer laboratory errors that could have a potential adverse patient impact.

So what does this have to do with NAACLS and the accreditation of clinical laboratory science programs?

In order to produce “competent” clinical laboratory personnel, training programs have an obligation to be “competent” themselves. The NAACLS Standards, and the process by which NAACLS evaluates programs, assesses the “competence” of educational programs. The intent of NAACLS is to assure the “competence” and “quality” of the students that graduate. The NAACLS Standards and the NAACLS process of program evaluation are analogous to the CMMS requirements for the assessment of the competence individual laboratory personnel.

Graduates of NAACLS accredited programs manifest their “competence” and “quality” by higher rates of first time passage of certification examinations, and their success in securing employment. Certification test examinees from non-NAACLS accredited programs and from other exam qualification routes do not have the same first time pass rate.

So, the message is clear. To produce “quality” students (i.e., students with a high level of value or excellence), educational programs should pursue NAACLS accreditation in order to document the “competence” of the program (i.e., the ability to do something well), as well as to document the “quality” of the program ((i.e., that the program has a high level of value or excellence). “Competent” faculty and resources, that meet NAACLS Standards, will have a higher probability of “competent” and high “quality” graduates.

I hope you agree that the “juice” (i.e., being accredited by NAACLS) is worth the “squeeze.” NAACLS accreditation is a key element in substantiating the “competence” and “quality” of a program.