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Using Probing Questions for Effective Laboratory Inspections, Summaries of Laboratory Practices and Management

Insights into the use of probing questions during laboratory inspections. Probing questions are open-ended queries that elicit detailed information about a specific topic, helping inspectors to understand the laboratory's processes and practices more thoroughly. The benefits of using probing questions, provides examples, and suggests a list of questions for various topics such as proficiency testing, quality control, specimen collection, safety, and analytic measurement range. By asking probing questions, inspectors can gain a comprehensive understanding of a laboratory's operations and ensure compliance with regulations.

What you will learn

  • What are some benefits of using probing questions during laboratory inspections?
  • Can you provide examples of probing questions for various topics in laboratory inspections?
  • How do probing questions differ from checklist questions during laboratory inspections?

Typology: Summaries

2021/2022

Uploaded on 09/27/2022

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Using Probing Questions when Performing an Inspection
Asking a probing question is a way for the inspector to establish a dialogue with the
laboratory being inspected, and often leads to a beneficial discussion of the laboratory
processes. The inspector must assess “how” a laboratory complies with the intention of a
checklist section, such as quality control or proficiency testing, and should avoid simply
asking the checklist questions verbatim one after the other in a linear fashion. That
technique often leads to “yes” or “no” answers that yield limited amounts of information.
Probing questions are not meant to replace or be used instead of the inspection
checklist(s). Rather, probing questions can be used as a tool to elicit a large amount of
general information concerning an area of laboratory practice. One would ask a probing
question initially, then proceed to ask the individual checklist items concerning that topic
to get more specific information.
What is a Probing Question?
A probing question is a question that elicits a large amount of general
information concerning an area of laboratory practice.
What is an Example of a Probing Question?
“How do you ensure that all testing personnel perform proficiency testing?”
When Do I Use Probing Questions?
Experienced inspectors use probing questions as a lead-in to a major topic or
group of checklist requirements, such as quality control.
Ask a probing question initially and then proceed to ask individual checklist
items concerning that topic to get more specific information.
Why Use Probing Questions?
Probing questions are efficient and establish an open-ended dialogue that may
answer 5-10 checklist questions at one time.
Probing questions eliminate the need to ask individual checklist questions in a
linear fashion.
Do Probing Questions Replace Asking the Checklist Questions?
No. They are used in addition to the checklist.
How Do Probing Questions Differ from Checklist Questions?
Checklists contain very specific questions and are used as a recording tool.
Probing questions allow the inspector to get a general idea of compliance, and
may point to individual checklist questions that should be focused on.
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Using Probing Questions when Performing an Inspection

Asking a probing question is a way for the inspector to establish a dialogue with the

laboratory being inspected, and often leads to a beneficial discussion of the laboratory

processes. The inspector must assess “how” a laboratory complies with the intention of a

checklist section, such as quality control or proficiency testing, and should avoid simply

asking the checklist questions verbatim one after the other in a linear fashion. That

technique often leads to “yes” or “no” answers that yield limited amounts of information.

Probing questions are not meant to replace or be used instead of the inspection

checklist(s). Rather, probing questions can be used as a tool to elicit a large amount of

general information concerning an area of laboratory practice. One would ask a probing

question initially, then proceed to ask the individual checklist items concerning that topic

to get more specific information.

What is a Probing Question?

• A probing question is a question that elicits a large amount of general

information concerning an area of laboratory practice.

What is an Example of a Probing Question?

• “How do you ensure that all testing personnel perform proficiency testing?”

When Do I Use Probing Questions?

• Experienced inspectors use probing questions as a lead-in to a major topic or

group of checklist requirements, such as quality control.

• Ask a probing question initially and then proceed to ask individual checklist

items concerning that topic to ge t more specific information.

Why Use Probing Questions?

• Probing questions are efficient and establish an open-ended dialogue that may

answer 5-10 checklist questions at one time.

• Probing questions eliminate the need to ask individual checklist questions in a

linear fashion.

Do Probing Questions Replace Asking the Checklist Questions?

• No. They are used in addition to the checklist.

How Do Probing Questions Differ from Checklist Questions?

• Checklists contain very specific questions and are used as a recording tool.

• Probing questions allow the inspector to get a general idea of compliance, and

may point to individual checklist questions that should be focused on.

USING PROBING QUESTIONS AS AN INSPECTION TECHNIQUE

Question Reason for asking the question

Proficiency Testing

  1. Please explain the Proficiency Testing Program for the laboratory.
  2. How does the laboratory ensure that all members of the staff perform proficiency testing?
  3. How does the laboratory handle proficiency testing samples?

Alternate Proficiency Testing

  1. What is done if you are testing an analyte that does not have commercially available proficiency testing material?
  2. How often is this system of alternate PT utilized, and who is responsible?

Quality Control

  1. How is the bench technologist involved in the QC program for the laboratory?
  2. How do you know your QC results are within range?
  3. Please explain your normal procedure for what is done when QC results are out of range.

Specimen Collection and Accessioning

  1. Please explain the procedure for performing venipunctures.
  2. How are both inpatients and outpatients identified before performing the venipuncture?
  3. How are “send outs” handled?
  4. How do you know what tests the physician orders and how the specimens are accessioned?

Safety

  1. What would you do if you spilled (Name a chemical)?
  2. In the event of an emergency evacuation what are your responsibilities?
  3. When is it acceptable for you to recap needles?
  4. Where are your fire extinguishers, alarms, and emergency eye wash stations located?

Asking this group of questions may aid the inspector in determining how the laboratory’s proficiency testing program functions and how proficiency samples are handled.

Asking this group of questions may result in information about the process the laboratory utilizes when commercially provided PT material is not available.

Posing this group of questions may allow for the assessment of the laboratory’s quality control program, including the bench technologist’s role, identifying out of range controls and any corrective action for out of range controls.

Using this group of questions may reveal how the laboratory performs specimen collection and how patients are identified before collection. This may also help the inspector assess whether the requisition and accessioning systems are adequate and determine if an acceptable process for processing specimens sent to another laboratory has been successfully developed.

Posing this group of questions may help the inspector determine the safety processes of the laboratory. This may lead to a discussion of the Chemical Hygiene Plan, needle safety, and location of safety equipment, and may aid in determining training and persons responsible for the safety program.

  1. How does the bench technologist contribute to the laboratory QI plan?
  2. How are Quality Improvement monitors determined?
  3. How does the laboratory determine if improvement has been made and the QI plan is effective?

Laboratory Information System

  1. If you are using an LIS, what are the criteria you use before releasing (approving) patient results?
  2. How does the laboratory ensure that data are accurately transmitted from point of origin to final reporting?

General Technical Questions

  1. How does the laboratory ensure that all staff members who are making morphologic observations for urine sediment, body fluid and blood cell differentials are consistent?
  2. Who is responsible for procedure review and how often is this done?
  3. What type of water is used for the laboratory’s testing procedures and what testing is performed on the water to ensure it is of proper quality?

Reagent Issues

  1. How does the laboratory label new reagents?
  2. How does the laboratory ensure that reagents are maintained at proper storage conditions?
  3. How does the laboratory check new reagent lots against old reagent lots, and what kind of samples are used for this process?

Inquiring with this group of questions can aid the inspector in assessing processes used by the laboratory to ensure proper results are reported through the LIS.

Asking this group of questions may aid the inspector in determining how the laboratory manages general technical issues that can affect patient testing in the laboratory.

Posing his group of questions may aid the inspector in assessing how the laboratory labels reagents and ensures that they are stored at the proper conditions. This may also help in assessing how reagents are validated before being placed in service.