Bench, supervisor and director review of QC

Review QC in three stages: bench acceptance, supervisor review, and a signed director review for each period, with reminders when one is due.

QC results are reviewed in three stages, each on its own tab. The same person may complete more than one stage if your lab works that way.

Bench review

Technologists review each analyte's results. The list shows every result nobody has reviewed yet, and its "Accepted" column shows the same Y or N as the analyte's data table: a green check when the result is accepted, a red mark when it is not.

The Westgard rules decide this automatically. A result that passes, or only triggers a warning, is accepted. A result that fails a reject rule is not, and neither are the other levels of that analyte in the same run, because the whole run is out of control. Rejects on a new lot during its changeover are advisory and stay accepted. Every result stays on the record and on the Levey-Jennings chart either way; only accepted results count toward the month and cumulative statistics.

On the chart, green points are accepted and in control, orange points are accepted with a warning, and red points are not accepted. Hover a point to see why.

To change the decision, select results and click "Toggle accepted". Accepting a result that failed a reject rule, or rejecting one that passed, overrides the rules, so Legion Diagnostics asks for a reason and for you to confirm that you have reviewed the results and any patient impact. The reason is shown when you hover the result and is kept in its audit trail. Toggling again returns the result to what the rules decided. Results excluded before Y/N replaced exclusion stay not accepted until someone sets them to Y.

Changing whether a result is accepted also marks it reviewed. Click "Toggle reviewed" for results you looked at without changing them. Reviewed results move on to supervisor review. A rejection can be followed up with a quality event.

To explain a rule violation or warning, open the analyte's "Data" tab, click "Edit Data", and type in the "Comments" column for that run, for example the action you took. Click "Save" to keep it. The same edit lets you correct a value, date, time or operator, and change a value's Y/N (with a comment saying why).

Supervisor review

A supervisor reviews the results after bench review and marks them reviewed with "Toggle supervisor reviewed". "Toggle accepted" works here as it does on bench review, so a supervisor can change a result's Y/N, with a reason when it goes against the Westgard rules. The info icon beside each action explains what it does. Director review follows.

Director review

A director review covers a period of QC for a whole site group, or one discipline within it. Click "New Review", pick the site group, discipline and dates, and work through the analytes in scope. Notes, tasks and quality events raised during the review are kept in its log.

For each analyte the review compares the previous period with this one: TEa, bias, CV, Sigma and rules. If Sigma has fallen into a tighter band, the review prompts you to look at the Westgard rules before signing. The first review for an analyte shows its design baseline instead.

When the review is complete, click "Finalize & Sign" to freeze it, and the final report is generated as a PDF. If something must change afterward, revoke the signature to unlock it.

If the lab director went over the review during a site visit, click "Add to site visit" on the review. It lists the open director visits at that site within 60 days of the review, so you can add the review to one, or click "Start a visit" to record a new one. See Recording lab director site visits.

Keeping reviews on schedule

The coverage view shows each site group and discipline with its last signed review and when the next is due. A review is marked:

• "Review due" when the set number of days have passed since the last signed review (30 by default, changeable in access control settings)
• "Overdue" when a month with QC results ended without a signed review

Due and overdue reviews also appear as reminders in My Queue.