Like many organizations, IQMH quickly pivoted to remote work with the COVID-19 pandemic. This was relatively easy as we were already connected remotely, accessing our network, portal and our quality management system (QMS) over the Internet.

We are very proud that IQMH’s Centre for Proficiency Testing was the first proficiency testing provider in Canada to be accredited to ISO/IEC 17043:2010 Conformity assessment — General requirements for proficiency testing in 2010 by the American Association for Laboratory Accreditation (A2LA). The accreditation process consists of external audits every four years and online annual reviews by A2LA. Conducting periodic internal audits are also a requirement of ISO 17043. A face-to-face internal audit was already on the agenda for 2020. After considering our options and resources, we decided to replace our face-to-face internal audit with the first remote internal audit.

IQMH has extensive experience maintaining and improving its quality management system (QMS), extending and adding scope of accreditation, conducting ongoing reviews of policies, processes and procedures, and our internal audits have involved all staff taking their expertise to a new level.

As the Centre for Proficiency Testing grows and evolves, so must the way we manage quality. Internal audits are one of our most important activities for improvement. It’s an opportunity to identify nonconformities, and to learn more about each other’s work and ask questions.

We approach internal audits at IQMH with meaning and purpose with the following goals in mind:

• To conduct an audit of the QMS every 12 months
• To verify that operations comply with requirements and appropriate International Standards
• To address all elements of the QMS and, in this remote audit, the operation of the proficiency testing scheme

Our employees develop internal auditing skills to help identify gaps in our QMS. Internal audits provide leaders and employees with the knowledge needed to continually improve the way we work.

IQMH internal audits are led by the Quality Manager who is responsible for the QMS and each audit requires a team of assessors assembled from employees who are objective, impartial and trained to conduct audits. It’s an opportunity to do a deep dive into our QMS and ready the service for an external audit by our accrediting body A2LA.

We asked Maritess Koerner, Quality Manager at IQMH why IQMH decided to proceed with the internal audit and how IQMH carried out its first remote internal audit.

Internal audits are a crucial part of our QMS. When we work so closely with our own processes, it can be difficult to shine an objective lens on what we do every day. This yearly check-up gives us an opportunity to have fresh and objective eyes scrutinize our processes from a different perspective. Especially during challenging times, as with this pandemic, internal audits are imperative in ensuring that we are still doing what we say and we say what we do, and we have sufficient, appropriate and acceptable evidence supporting our outputs.

What is a remote audit?

A remote audit is an audit which is conducted outside of the usual physical business premises of the facility or organization. One major characteristic of a remote audit is that the assessment is done using technology, e.g. Microsoft Teams, Zoom.

How did you plan and prepare for the remote audit?

For the most part, we were able to follow our current process for internal audit planning. The preparation process was different in that the agenda had to ensure we provided auditors and auditees enough time to complete their respective sessions, and to switch our sharing of information between everyone involved to a completely electronic platform.

When did you carry out this audit and how long did it take?

Keeping in mind that this was our first remote internal audit and to ensure that auditors and auditees had enough time to complete their respective sessions, the active assessment started June 1^st and ended July 31^st, wrapping up with the summation meeting the first week of August.

What were the challenges?

One of the most challenging parts of this audit was making sure everyone involved felt comfortable with the remote aspect. It meant that auditors and auditees alike had to gather and collate electronic materials for the audit, which in normal circumstances may have been as simple as getting a file from a survey’s folder. Naturally, there were also some concerns around the efficient use of technology and the best ways to tackle the sharing of information during the interviews.

We quickly learned the technological limitations of the tools we used and acted with flexibility to solve the issues. For example, file path character limitations in our share drive caused documents not to open; and varying internet speeds caused lag in VPN connectivity, making it difficult and slow to open and share documents on screen during Teams meetings. 

As much as we acted with flexibility, we also acted with patience and kindness. If something didn’t go smoothly or entirely to plan, we looked for a solution to keep moving forward.

How did the auditees prepare for the remote audit?

The auditees meticulously reviewed the agenda, requirements (checklist) and expectations in order to gather documentation and evidence needed for their sections of the audit. Each auditee was required to provide the auditors with all the information at least one week before their scheduled interview date. To no surprise, the staff were genuinely committed to this process and were eager to rise to the challenge.

Are remote audits as thorough as onsite audits?

Yes, absolutely! As long as your process in conducting remote audits covers all the aspects of your assessment requirements, the rest is up to your skilled and trained auditors to provide you with a detailed summary of their findings.

Lessons Learned

The challenges we identified during the remote audit will be reviewed and plans will be put in place to mitigate any risks impeding our remote internal audit process. Having effective IT support is key when dependence on technology during remote audits is high.

A big thank you to our auditors from the Centre for Accreditation: Terri Molloy (team lead), Aisha Ismail, Angela Situ, and Carol Julian.

Our incredible Centre for Proficiency team and Corporate Services staff were genuinely committed to this process and its success:

• Berna Aslan, Associate Director
• Wayne Ozanne, Manager, and Consultant Technologist, Pathology
• Tammy Ashfield, Consultant Technologist—Cytopathology and Genetics
• Anna Johnston, Consultant Technologist—Bone Marrow, Endocrinology, Hematology, Immunology, and Morphology
• Elaine Kerr, Consultant Technologist—Bacteriology, Mycology, and Parasitology
• Christine Fleming, Consultant Technologist—Bacteriology, Mycology, and Parasitology
• Sumedha Kulkarni, Consultant Technologist—Coagulation, Flow Cytometry, Hematology, and Red Cell Disorders
• Emily Lee, Receptionist and Logistics Administrator
• CK (Chang-Keun) Lee, Consultant Technologist—Point-of-Care Testing – HIV, Transfusion Medicine, and Virology
• Brittnee Ross, Team Lead, Client Relations and Operational Support
• Stefani Stanojevic, Senior Administrative Assistant
• Julia Stemp, Consultant Technologist—Chemistry-General, Cardiac Markers, Drug Monitoring, Enzymes, Lipids, and Point-of-Care Testing – Glucose Meters
• Jacob Aharon, Manager, Information Technology
• Jason Chard, Systems Analyst
• Neela Khatri Senior Systems Analyst
• Matthew Ramos-Manzano, Programmer Analyst
• Cathy Wong, Team Lead, Corporate & Office Services

Finally, thank you to our senior leadership, Jeff Sumner, President; Janice Nolan, Executive Director, Programs; and Mauro Pambianco, Chief Administrative Officer for their guidance and support during the entire process.

The IQMH Centre for Proficiency Testing is accredited by the American Association for Laboratory Accreditation (A2LA) in accordance with the recognized International Standard ISO/IEC 17043: 2010 Conformity assessment — General requirements for proficiency testing, and has over 40 years of experience delivering world-class and internationally-recognized proficiency testing services. Accreditation to this Standard demonstrates to our clients that IQMH is recognized for operating a management system and demonstrating technical competence in all aspects of proficiency testing schemes. Our A2LA accreditation certificate (A2LA Cert. No. 3059.01 10/15/2018) lists accredited programs.