For half a century, IQMH has played a crucial role in actively advocating for and supporting quality laboratory services. IQMH promotes laboratory competence and enables the active detection of underlying and emerging issues. The internationally-recognized Proficiency Testing programs at IQMH allow health care providers to have confidence in accurate laboratory results enabling them to deliver safe, high-quality care.
In 1974, responding to the request of the Ontario Minister of Health, the Ontario Medical Association (OMA) established the Laboratory Proficiency Testing Program (LPTP) to assess the proficiency of laboratory tests. Over the years, LPTP gained international recognition as a benchmark for excellence, and in September 2000, the government expressed its intention to create a quality management program for laboratory services. The OMA was tasked to develop and implement it, leveraging its extensive experience with LPTP. As a result of this shift in mandate, LPTP transitioned to the Quality Management Program — Laboratory Services (QMP–LS) in the fall of 2000.
Leveraging a core foundation rooted in quality
In 1974, the Laboratory and Specimen Collection Centre Licensing Act paved the way for the establishment of LPTP through a contractual agreement between the OMA and the Ministry. Initially, LPTP conducted testing in eight classes, covering clinical chemistry, bacteriology, hematology, immunohematology, genetic cell culture, cytology, serology, and radioisotopic assays. Early surveys were conducted every month or every other month. In contrast, by 1999, LPTP expanded its scope to assess performance in 20 classes of tests, distributing 93 challenge surveys, 12 patterns-of-practice surveys, and six questionnaires.
The evolution of the quality management program
QMP–LS
In the fall of 2000, LPTP underwent a name change and became the Quality Management Program — Laboratory Services (QMP–LS). On September 15, 2000, the Minister declared the ministry's commitment to advancing an enhanced quality management program (QMP) for Ontario's medical laboratories. The QMP served as a vital component of the ministry’s broader plans for laboratory reform, aiming to enhance access and offer the public assurance of the highest standards in laboratory services. Once fully developed, the QMP was designed to encompass accreditation and standards of practice guidelines, ensuring that all laboratories adhere to consistent high-quality standards.
The new agreement forged between the Ministry and the OMA tasked QMP–LS with developing and implementing a comprehensive quality management program. This program encompassed the examination and evaluation of test performance in laboratories, the establishment and execution of an accreditation program, the development of standards of practice for testing in laboratories, and the creation of standards for utilization management.
QMP–LS had two components:
- Ontario Laboratory Accreditation (OLA)
OLA would develop processes and procedures for peer group laboratory accreditation, leveraging a limited staff and a diverse group of consultants. A pilot accreditation of selected laboratory service providers would then take place, enabling feedback and adjustments to the logistics and other program components. The full rollout, including the accreditation of all providers, would be scheduled for years four and five.
OLA would additionally disseminate accreditation requirements and actively seek input from a broad array of stakeholders. To gather feedback and secure endorsement, focus groups would be employed as a valuable means of engagement in this process.
In early 2001, the first standards-of-practice guidelines addressing gynecological cytology quality assurance requirements were released. These guidelines were collaboratively developed in association with Cancer Care Ontario.
In response to the Minister's directive, the establishment of a test review committee would be initiated. This standing committee within QMP–LS would play a key role in advising the Ministry on the quality requirements for tests not presently listed in the Schedule of Benefits for laboratory services. The Committee's efforts would be bolstered by a rotating panel of experts possessing the requisite knowledge and expertise relevant to the specific test under consideration. The Ministry's laboratories branch would refer tests requiring the committee's advice for thorough examination and assessment.
2. External Quality Assessment (EQA)
EQA would continue to carry out the work previously undertaken by LPTP but with some refinements. It will continue to:
- Assess laboratories using challenge and patterns-of-practice surveys.
- Provide educational support programs under the guidance of the present consultant technologists and the existing scientific committees.
- Augment the scope of assessment (a new committee in anatomical pathology has already been created).
QMP–LS demonstrated its competence through the attainment of international recognition for its programs. OLA underwent international peer evaluation, leading to its status as a signatory to the Mutual Recognition Arrangement (MRA) of the International Laboratory Accreditation Cooperation (ILAC) and its regional counterpart, the Asia Pacific Accreditation Cooperation (APAC). Additionally, EQA received accreditation from the American Association for Laboratory Accreditation (A2LA) in alignment with the globally acknowledged international standard ISO/IEC 17043:2010 Conformity assessment — General requirements for proficiency testing.
IQMH
In 2009, QMP–LS changed its name to IQMH (Institute for Quality Management in Healthcare as the result of the organization’s new strategic direction to expand services outside of Ontario and Canada. IQMH continued to operate as a wholly owned subsidiary of the OMA.
As a result of the name change, IQMH’s accreditation, proficiency testing, and education services would be under three Centres of Excellence:
- Centre for Accreditation (formerly known as OLA [Ontario Laboratory Accreditation])
- Centre for Proficiency Testing (formerly known as EQA [External Quality Assessment])
- Centre for Education
The organization’s new tagline was “Elevating confidence in the system”, which reinforced IQMH’s commitment to elevate the integrity of the medical diagnostics testing system by providing rigorous, objective, third-party evaluation according to international standards.
Accreditation Canada and IQMH join forces
In 2019, Accreditation Canada and IQMH joined forces ensuring everyone has universal access to safe, accurate, and reliable test results. This partnership emphasized the demonstration of quality and competence in adherence to ISO standards, which effectively brought together the longest-standing health care accreditation body in Canada and the country's largest provider of medical laboratory accreditation and proficiency testing.
The combined forces solidified their position as leaders in improving health outcomes for patients and citizens around the world. Accreditation Canada and IQMH will continue to provide rigorous, evidence-based, third-party evaluations, spanning a full spectrum of health and social services aligned with international leading practices and world class standards.
IQMH’s Centre for Accreditation became Accreditation Canada Diagnostics within Accreditation Canada, and the Education and Echocardiography services also became part of this transfer. IQMH’s Centre for Proficiency Testing remained within IQMH as an affiliate of Accreditation Canada.
Commitment to quality and patient safety
The partnership between Accreditation Canada and IQMH underscores a shared vision to ensure the delivery of high-quality medical diagnostic testing. Recognizing the essential role of such testing in a well-functioning health system, our joint efforts contribute to maintaining and advancing standards that promote the quality, accuracy, and reliability of medical diagnostic services.
Today, the Proficiency Testing program offers over 69 surveys, through eight disciplines, and educational resources including committee comments, consensus practice recommendations, reviews, and actively contributes to scientific literature.
At the core of IQMH’s mission is a central objective: to ensure that all physicians and their patients have access to high-quality and efficient laboratory services providing accurate, timely and clinically relevant results to promote safer care and a healthier world.