[The pilot program in Mexican clinical laboratories. II. The characterization of the operating processes]

To evaluate a questionnaire for operating procedures in Mexican clinical laboratories.

A group of 18 hospital laboratories (described in the first paper of this series).

The questionnaire had 132 items exploring nine sections (bacteriology, clinical chemistry, general hematology, immunology, microbacteriology, mycology, parasitology and urine analysis) and it was filled by the participants and modified if necessary in an audit visit. The questions were scored in the range of zero to one, and the participants in a scale of zero to 100 points.

the answers had scores ranging from zero (N = 3) to one (N = 11) and a distribution with a clear shift to high scores. This led to a partition in three categories (low: < 0.3, medium: 03.-0.7, high: > 0.7) and to calculate a low/high ratio which enabled us to identify poor procedures in the sections. This ratio was also used to evaluate the type of procedure involved, i.e. management (N = 51), resources (N = 36), quality control (N = 23), and type and number of tests performed (N = 16). In the evaluation of the laboratories, the global score was 60. As expected, the private laboratories had the highest scores (73 to 84) as they were chosen because of their good resources. In the public ones only the State laboratories had more members above the mean score than below, whereas most of the Federal laboratories were below the global mean.

The questionnaire performed reasonably well in spite of some deficiencies, i.e. it should include more questions on the specialized sections and on procedures other than management. The specialized sections (immunology, microbacteriology, mycology and parasitology) had lower scores than the more traditional ones (chemistry, hematology and bacteriology). Resources and quality control had lower scores than management; and the laboratory scores of the auditors tended to be lower than the autoevaluation of the public hospitals.