Recognition, certification, accreditation… The world of labels and acronyms is very varied and should indicate the quality and seriousness of institutions and products. Accreditation processes guarantee environmental, health and safety standards, while helping to improve the overall quality of products, be these anything from food products to washing machines. That is why 9 June is World Accreditation Day (WAD), jointly established by the International Acreditation Forum (IAF) and the International Laboratory Accreditation Cooperation (ILAC), to illustrate the contribution of accreditation to the organisation and safety of the economy and our daily lives. Each year, the day has a new slogan. The theme for WAD2022 is ACCREDITATION: Sustainability in Economic Growth and the Environment. This theme illustrates the contribution of accreditation processes to the protection of our ecosystem and our planet, and how accreditation supports the United Nations Sustainable Development Goals.

For the Laboratoire national de santé (LNS), accreditation of its work and laboratories plays an important role. Dr Patricia Borde is the spokesperson for the ” Codir Qualité” at the LNS, which coordinates the accreditation processes of the different laboratories. On the occasion of World Accreditation Day, we talk to her about her activities within the committee.

You are the spokesperson for the ” Codir Qualité ” at the LNS. What is your role in this function and how is quality organised at the LNS?

There is a great deal of heterogeneity in the missions at the LNS. As a result, not all departments have evolved at the same speed with regard to the accreditation process. Two ISO (International Organization for Standardization) standards that specify the competence and quality requirements for medical laboratories co-exist: 17025 and 15189:2012. Internal audits are constantly carried out by the Office Luxembourgeois d’Accréditation et de Surveillance (OLAS), according to the processes of each of the accredited departments. This situation is very burdensome for the support services, which are constantly called upon for these audits. We therefore wanted (and this was also a request from some auditors) to set up a central quality management system in order to avoid wasting time unnecessarily and to benefit from the experience of others, though the technical part of the accreditation remains the prerogative of the services.

There have been several quality managers at the LNS, but this solution did not work. I therefore suggested that all the heads of department should take on this function, which my colleagues approved. We took the plunge upon the green light of our Director, and I naturally gave the presentation to the Board of Directors. Since then, we have had weekly meetings with the heads of department and the quality referents to make progress (this is what we call the CODIR-Qualité). I became the spokesperson for this group from the start, but it’s a joint effort. It’s very collegial, with the experience of some helping others, but without imposing, taking into account the needs and ideas of everyone. That is why it is a long process, but I am confident that it’ll pay off.

What we are most concerned with at the moment is the implementation of document management and quality management software. Eventually, we hope to have one single OLAS audit for the whole of the LNS and one accreditation number per standard.

How does the accreditation process work at the LNS? How important is accreditation for an institution like the LNS?

Currently each service and/or department has an individual accreditation. Teams of auditors (quality and technical) visit each laboratory annually to deliver the accreditation or to monitor that everything remains under control. A cycle lasts five years, with an annual surveillance audit between two accreditation audits. I must admit that at first, I was not entirely convinced of the value of the approach in my department, as these processes are very time-consuming, and we felt that time would sometimes be better spent on our core work. However, I have changed my mind and I now realise that accreditation has enabled us to really progress in our practice and in our daily routine, because we are obliged to ask ourselves questions all the time: why we are doing this, could we do it better, what are the risks, etc. Accreditation forces us to constantly question ourselves, which makes us progress a lot, so that we can ultimately provide better care.

The first service at the LNS to be accredited was the Food Monitoring service, which was accredited in 2003 according to ISO 17025. The cytology service was accredited in 2012, the genetic identification service in 2013 (although the service opened in 2012), biological surveillance, bacteriology, and medical biology in 2017 and finally virology and analytical toxicology in 2022. Depending on the service, the number of accredited components varies between 60 and 100%. It should be borne in mind that for certain advanced or highly specialised techniques/methods of analysis, it is very difficult to accredit, so reaching 100% is in some cases almost impossible.

Accreditation is also an argument for us to prove to the general public that our work complies with the rules, that our skills are real, and that people can trust our results, because we do everything possible to ensure that this is the case.

The theme of World Accreditation Day 2022 is “Accreditation: Sustainability for Economic Growth and the Environment”. What role does this slogan play for accreditation at the LNS?

Our activities are unfortunately by definition polluting. Nevertheless, we try to limit our impact, for example in terms of waste (sorting, controlled disposal for solvents or radioactive products, infectious waste). Auditing bodies such as OLAS or the SuperDreckskëscht (SDK), the Luxembourg state body responsible for waste management, are there to check that we comply with environmental standards and laws. It is also a form of accreditation that validates the fact that we comply with environmental regulations. The accreditation processes therefore also play an important role in protecting our ecosystem.