College of American Pathologists
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  One laboratory's story: How jazz CDs helped
  smooth the way to accreditation


June 2001
Originally published in CAP TODAY

Erlo Roth, MD

Cesar A. B. Sanches, technical director of the Brazilian laboratory Laboratório Previlab, had set a goal to make his laboratory the first in Latin America to be accredited by the CAP. In 1986 he succeeded.

Sanches, while serving as a medical technologist for Previlab, decided in 1979 to attend the School of Medical Technology at Hinsdale (Ill.) Hospital. Despite having to adapt to a new culture, Sanches placed near the top of his class, and he came away from the experience with a deep appreciation for the value of laboratory accreditation.

When Sanches returned to Brazil, he began putting into practice what he had learned. First Sanches had to convince the two pathologists who owned Previlab that accreditation was worthwhile. Then he had to overcome the trade barriers of a closed market. This was a problem because Surveys materials were shipped via express mail. Sanches had the difficult task of convincing the customs officer at the local post office to deliver the Surveys material he needed. Sanches learned that the customs officer enjoyed jazz so he periodically ordered jazz CDs to bribe the official into releasing the proficiency testing materials before they spoiled or the laboratory missed the reporting deadlines.

On the operational side, Sanches had to build his own safety hoods because none were available in Brazil. Also unavailable were QC materials for coagulation, so Sanches had to improvise and use plasma from medical technologists.

such obstacles, Sanches and his colleagues were not deterred. "We are convinced that the CAPLaboratory Accreditation Program is the most powerful tool available for managing quality in a clinical laboratory," he says.

The first CAP inspection of Previlab turned up more than 100 deficiencies, but all Phase II deficiencies were corrected within the allotted time, and the laboratory received a certificate of accreditation in September 1986.

Since that time, says Alcione M. Aprilante, MD, medical director for Previlab, "we have been able to observe a significant improvement in the services we provide, as indicated by the growth in our customer base and in the respect and credibility attained with the medical community. This is, to a large extent, the result of the accreditation program."