title: Quality management and accreditation in a mixed research and clinical hair testing analytical laboratory setting-a review.
abstract: BACKGROUND
  Quality management and accreditation in the analytical laboratory setting are developing rapidly and becoming the standard worldwide. Quality management refers to all the activities used by organizations to ensure product or service consistency. Accreditation is a formal recognition by an authoritative regulatory body that a laboratory is competent to perform examinations and report results. The Motherisk Drug Testing Laboratory is licensed to operate at the Hospital for Sick Children in Toronto, Ontario. The laboratory performs toxicology tests of hair and meconium samples for research and clinical purposes. Most of the samples are involved in a chain of custody cases.
  
  
  OBJECTIVE
  Establishing a quality management system and achieving accreditation became mandatory by legislation for all Ontario clinical laboratories since 2003. The Ontario Laboratory Accreditation program is based on International Organization for Standardization 15189-Medical laboratories-Particular requirements for quality and competence, an international standard that has been adopted as a national standard in Canada.
  
  
  METHODS
  The implementation of a quality management system involves management commitment, planning and staff education, documentation of the system, validation of processes, and assessment against the requirements. The maintenance of a quality management system requires control and monitoring of the entire laboratory path of workflow.
  
  
  RESULTS
  The process of transformation of a research/clinical laboratory into an accredited laboratory, and the benefits of maintaining an effective quality management system, are presented in this article.
authors.affiliation: Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, Canada. netta.fulga@sickkids.ca
authors.forename: Netta
authors.initials: N
authors.lastname: Fulga
mesh_terms: D000068:Accreditation; D019411:Clinical Laboratory Techniques / Q000592:standards*; D006197:Hair / Q000737:chemistry; D006776:Hospitals, Pediatric / Q000592:standards; D006801:Humans; D008470:Meconium / Q000737:chemistry; D009864:Ontario; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D011786:Quality Control; D058996:Quality Improvement / Q000458:organization & administration; D017749:Total Quality Management / Q000458:organization & administration*; D057188:Workflow