CAP 15189 Accreditation Process

CAP 15189 Accreditation Program Process

A Personalized, Flexible Accreditation Process

Each laboratory’s quality improvement program is unique, so we offer a flexible preparation experience to help guide you through your initial accreditation journey. Your dedicated lead assessor supports you with Quality Management System (QMS) educational resources and unique CAP-developed tools—where and when you need them.

The CAP Laboratory Accreditation Program provides the foundation for our ISO 15189 program; therefore your laboratory must first be accredited by the CAP Laboratory Accreditation Program.

CAP 15189 Accreditation Process

CAP 15189 Accreditation Steps and Activities

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The laboratory completes the online application, includes requested documentation, and submits it to the CAP. After receiving the application, the CAP assigns a dedicated lead assessor who guides the laboratory through the subsequent steps to earn accreditation to ISO 15189.

The CAP lead assessor conducts an off-site review of the documents submitted by the laboratory. The purpose is to learn your QMS, look for major issues with the documentation, and evaluate the laboratory’s readiness for the accreditation assessment. Based on this review, the lead assessor may recommend CAP online courses, such as Internal Auditing and Root Cause Analysis.

The laboratory performs at least one internal audit of its QMS against the ISO 15189 standard. This must be done prior to the on-site accreditation assessment.

The CAP assessment team performs a detailed on-site assessment of the QMS and technical competency. This helps the laboratory identify gaps in the system and scope of work required for accreditation. The lead assessor discusses readiness for the accreditation assessment.

The laboratory updates QMS gaps as needed, including development or revision of policies and procedures and redesign of processes.

The CAP performs a detailed review of the laboratory’s QMS and technical competency. The output of the assessment is a report on the level of conformance, listing specific nonconformances, strengths, opportunities for improvement, and any vulnerabilities.

The laboratory performs root cause analysis on all nonconformances and submits corrective action responses to the CAP. The CAP reviews these responses, evaluating the root cause analysis conducted for each. Subsequently, the assessors make a recommendation to the CAP 15189 Accreditation Committee.

The CAP 15189 Accreditation Committee, which is comprised of pathologists and quality experts, reviews the assessors’ report, documentation, and corrective action reports prior to voting on whether or not to grant accreditation.

The CAP performs a review of the laboratory’s QMS focusing on ISO 15189 Section 4, Management Requirements. Progress on corrective action from prior assessments will be reviewed.

The CAP performs a review of the laboratory’s QMS focusing on ISO 15189 Section 5, Technical Requirements. Progress on corrective action from prior assessments will be reviewed.

The timeline for the initial accreditation cycle varies depending on the laboratory’s readiness, resources, and level of commitment. Gain further insight into each step in the accreditation process, then assess your readiness to apply.

Review CAP 15189 Accreditation Program Readiness Checklist  Arrow Right

Before You Apply, Make Sure that You Are Fully Prepared

Accreditation Pricing

The cost to obtain accreditation will vary depending on the size and scope of the organization seeking accreditation, and the organization’s readiness for assessment. Since each laboratory’s journey to accreditation is unique, the pre-accreditation fee schedule will include an application fee, annual base fee, and fees to reflect the assessors time for remote and on-site assessments plus travel expenses for on-site assessments.

Once accredited, over the three-year accreditation cycle, the fee schedule will include an annual base fee, and fees to reflect the assessors time for remote and on-site assessments plus travel expenses for on-site assessments.

Case Examples

Learn about the accreditation journey from CAP 15189 accredited laboratories.