Participant responses to blood gas proficiency testing reports

There is scant objective information regarding the effect of proficiency testing for blood gases or other analytes on characterizing poor or good performers or changing laboratory behavior. Following the institution of a percentile ranking system for participants in the American Thoracic Society--California Thoracic Society Blood Gas Proficiency Testing Programs, a telephone survey disclosed characteristics of three equally sized groups of participants as follows: (1) FAIL (failed rating); (2) LOW (lowest percentile rankings without a failed rating); and HIGH (highest percentile rankings). The FAIL and LOW groups often had isolated instruments, instruments which were infrequently operated, and/or instruments operated by nontechnicians, whereas these characteristics were not found in the HIGH group. Those in the LOW group who understood their ranking and those in the FAIL group always found defects or errors and took some corrective action. This study appears to show that it is harder to maintain good performance with isolated, underutilized, or nontechnician-operated blood gas instruments, and blood gas proficiency testing is economical and valuable in assessing performance and changing behavior.