The elephant in the room (and how to lead it out): In-clinic laboratory quality challenges

Over 30 yr of technological evolution have resulted in sophisticated instrumentation for in-clinic laboratories, yet there is no regulatory oversight of diagnostic testing quality. Long overdue, the veterinary profession must address quality assurance (QA) of diagnostic testing. Each practice must weigh the responsibility for laboratory instrumentation test results that are often a combination of in-clinic and send-out testing. Challenges faced by clinic staff maintaining in-clinic laboratories include lack of training in QA and quality control (QC), lack of emphasis placed on QA/QC by instrument suppliers, QC financial and time costs, and a general lack of laboratory QA/QC support resources in the veterinary community. Possible solutions include increased continuing education opportunities and the provision of guidelines and other resources by national veterinary organizations; specialty certification of veterinary technicians; an increasing role of veterinary clinical pathologists as QA/QC consultants; and development of external quality assessment programs aimed at veterinary practices. The potential exists for animal health companies to lead in this effort by innovating instrument design, providing QC services, and exploiting instrument connectivity to monitor performance. Veterinary laboratory QA/QC is a neglected aspect of the profession. In coming years, veterinarians will hopefully find increased support for this core practice component.