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Grant Maxie, DVM, PhD, Diplomate ACVP

Murray Hazlett, DVM, DVSc, Diplomate ACVP

Josepha DeLay, DVM, DVSc, Diplomate ACVPAnimal Health Laboratory, Laboratory Services Division, University of Guelph

CAHLN-RCTLSA annual meetingSt. Hyacinthe, PQ, May 27, 2013

Quality assurance by and for

veterinary pathologists

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Services provided by the AHL• Anatomic Pathology – Guelph and Kemptville• Bacteriology/Mycoplasmology• Clinical Pathology• Immunology/Serology• Molecular Biology • Parasitology• Toxicology/Soil & Nutrient• Virology• Surveillance

• 16 veterinarians on staff, all with advanced training in various disciplines

• over 1,000 tests available in-house• central support for QA, IT, HR, Finance/Marketing

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Avian, 10,210, 1% Bovine, 87,602,

11%Canine,

44,261, 5%

Caprine, 7,121, 1%

Chicken, 224,231, 27%

Equine, 24,858, 3%

Feline, 10,201, 1%

Ovine, 7,228, 1%

Porcine, 67,752, 8%

Turkey, 302,441, 37%

Other, 38,267, 5%

Annual AHL procedures by species 2008-2012

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AHL caseload distribution

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2008-2012, AHL, annual averages:

63,000 cases

825,000 procedures

~1,000,000 tests

Avian, 1,504, 2%

Bovine, 10,346, 17%

Canine, 20,155, 32%

Caprine, 811, 1%

Chicken, 4,581, 7%

Equine, 9,102, 15%

Feline, 4,928, 8%

Ovine, 1,251, 2%

Porcine, 4,464, 7%

Turkey, 3,271, 5%

Other, 2,623, 4%

Annual AHL cases by species 2008 to 2012

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AHL function and structure

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Client service

Laboratory testing

Quality program

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AHL accreditations, registrations

1. ISO/IEC 17025 General Requirements for the Competence of Testing and Calibration Laboratories o auditors – SCC, CALA o ~30 AHL tests – Toxicology, scrapie PrP genotyping, 7

Mammalian Virology tests + flexible scope?

2. AAVLD Requirements for an Accredited Veterinary Medical Diagnostic Laboratory, v 6.0o auditor – AAVLDo 5 yrs, all species, full-service

3. Various – CFIA for EIAV ELISA, etc.

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Within the AAVLD standard, which is patterned on ISO 17025, element 5.2.1 states that: “The laboratory shall ensure the initial and ongoing competence of all laboratory personnel to do their assigned work.”

Ensuring competence?

AHL quality program• recruitment, hiring, monitor, retention• electronic document control system (Omni-

Assistant)• quality manual, v.20 (quiz)• standard operating procedures (SOPs)• training records

• ongoing quality assurance• documented• auditable• contribute to continuous improvement

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AHL anatomic pathology QA• 10 anatomic pathologists, all with advanced

training (7 Diplomates ACVP)• 2 clinical pathologists (I Diplomate ACVP)• semi-weekly gross rounds and histopathology

rounds (histopathology record book, avian/wildlife books, cytopathology book)

• reviews of random cases by Director in individuals’ quarterly updates, recorded

• bi-weekly group peer review of random cases• circulate glass slides, documentation in LIMS• link G and Kv by teleconference• record comments, continuous improvement• 2-3 cases/pathologist/year

• external QA – VLA, etc.

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Gross pathology rounds• Tuesdays and Fridays, 0830 to 0900 h

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AHL histopathology rounds• Tuesdays and Fridays – 0900 to 1000 h

Rounds record book

Andrew/Jan

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Bi-weekly QA pathology case review

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1. Veterinary Laboratory Association (VLA) for:• histopathology• hematology• cytopathology

2. Animal Health and Veterinary Laboratories Agency (AH-VLA VETQAS - UK)• cellular antigen immunohistochemistry (IHC)

3. National Veterinary Services Laboratory (NVSL - USDA)• infectious antigen IHC

Third-party proficiency testing

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Veterinary Laboratory Association

• the VLA administers the Veterinary Quality Assurance Program (VQAP)• http://www.vetlabassoc.com/qap/

• provided by the Atlantic Veterinary College (AVC) in conjunction with Catachem Diagnostics Inc.

• range of disciplines, including pathology• Cytology - 4 virtual images from diagnostic cases per year for

cytological evaluations.• Hematology – 4 or 8 whole blood samples and 4 Wright-Giemsa

stained slides for analysis and differentials• Histopathology – 4 virtual images from diagnostic veterinary cases

per year for morphological interpretation

• $270 USD for 1 year histopathology

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Sample VLAreport

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Animal Health - Veterinary Laboratories Agency (AH-VLA)

• VLA is an executive agency of the UK Department for Environment, Food & Rural Affairs (DEFRA)

• http://www.defra.gov.uk/ahvla-scientific/services/vetqas/• proficiency testing / external quality assessment

schemes, e.g., VETQAS• offers a wide range of PT/EQA schemes, & issues

over 20,000 samples a year to laboratories around the world

• accredited proficiency testing provider (ISO Guide 43, ILAC G13).

• IHC, 2 markers per assessment, 6 times per year, £556

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IHC cell markers (cont’d)

• In-house run control slides and test slides provided by the program are stained at the participating lab and evaluated externally

• Stained slides are returned to the participating lab with the assessment

• Assessment is more in-depth than for infectious antigen proficiency panel

• Includes:• staining color / intensity• background• accuracy (inappropriate staining, uneven

staining, inappropriate antibody)• counterstain (nuclear stain intensity and color)• method comparison among participating labs

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Example of VETQAS IHCreport

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Example of VETQAS IHCreport:

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