Alternative Proficiency Assessment?

Hi, you can do an i-STAT Chemistry-5 (verification) survey or do correlations between iSTAT and lab. Example run a few patient samples before they are spun and used in lab (or extra tube) that have chemistry and H&H ordered and compare iSTAT results to Lab chemistry and Hematology instruments.

We're supposed to "integrate all alternative performance assessment specimens within the routine laboratory workload, where applicable", so it seems like we should try to have testing personnel run the tests, if possible.

For my Hemochron INR: I ask the Cath Lab staff to pull a little extra from the line, run their testing, and transfer the rest into a blue top.  Then I have the lab staff run the PT/INR on the tube.  I just pick a day for them to do this.  If they don't get enough patients willing to participate in the study, I take the device to our busiest draw station and try to get patients willing to participate there.  I'm running the POC tests in the draw station, but I feel like I've done the best I can to meet the intent of the requirement.  All of this is in a policy signed by our medical director. 

HI
Who are you using for proficiency testing in the Core Lab?  You can have 2 platforms performing the same analyte but have different survey material.

This is a link to CMS proficiency testing guidelines:

https://www.cms.gov/regulations-and-guidance/legislation/clia/downloads/cliabrochure8.pdf

All of our labs are CAP accredited, and we use the CAP surveys for our PT.  I always thought alternative proficiency assessments were just for tests that don't have a survey available (ex. for the Medtronic HMS Plus heparin assay), but I was looking through the CAP Checklist Requirement Q&A's (in Accreditation Resources section of e-LAB Solutions Suite) and came across this:

This makes it sound like the POC analyzers would require APA.  If this is the case, those samples must be analyzed by testing personnel (vs. method comparison which can be tested by the POCC).  I sometimes wish there was a separate accreditation body just for POC...