JACO Officially listed i-STATs as a Blood Analyzer

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See new standard below:
We are planning on using our Cal/Ver data, which we perform on every i-STAT biannually, and compare them against each other. Then do our method comparisons on a subset of meters. For us this would show the devices compare against each other and that the subset compares against the other methods. How is everyone satisfying this new requirement from JACO?

New Blood Analyzer Requirement from CMS for Laboratories
Joint Commission recently received notification from the US Centers for Medicare & Medicaid Services (CMS) about the classification of the Abbott i-STAT system, which includes the i-STAT 1 blood analyzer device and testing cartridges. Effective immediately, Joint Commission–accredited laboratories must incorporate the i-STAT 1 device into their correlation process every six months, in accordance with Quality System Assessment for Nonwaived Testing (QSA) standard QSA.02.08.01. This includes correlation between all i-STAT 1 devices within each Clinical Laboratory Improvement Amendments certificate.
Historically, only the testing cartridges were subject to correlation every six months to evaluate the results of the same test performed with different methodologies or instruments or at different locations. However, based on the most current information available, the i-STAT 1 device is categorized as a blood analyzer, not a reader.
Joint Commission surveyors will evaluate compliance with this requirement during your next survey.

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We have been looking at this change from all angles and were told by TJC that we also need to re-evaluate our IQCP and perform monthly QC on every device. Now that they are considered chemistry analyzers, we have to treat them as such in every way. We have been considering using our monthly data to complete our 6 month correlations. 

We only have one i-Stat in my facility, and only perform the ABG's on that analyzer, so we have never performed correlations.  We did, at one point, many moons ago, perform the 6 mth cal verify.  During one of our JC inspections, an inspector stated the cal verify was not necessary.  Does this change reimplement the need for the cal verify at 6 mths?

many thanks

I'm also trying to figure out how others are interpreting this requirement. We currently perform cal/ver on all iSTAT every 6mo, have an established IQCP, perform weekly blood gas QC, and complete method comparison studies against our GEM analyzers every 6mo on a subset of iSTAT. We have about 28 iSTATs across our health system so performing method comparisons on every analyzer every 6mo would be a pretty significant undertaking. My interpretation is that all iSTAT need to be included in the correlation process but it's not clear whether JC expects direct method comparison on every analyzer or if there is another acceptable way to demonstrate agreement across all devices. We're considering using our cal/ver data to show agreement between the iSTAT while continuing method comparison studies on a subset of analyzers against the central lab method
Our lab is CAP accredited while our hospital is JC accredited. Also curious whether anyone has heard if CAP plans to issue guidance on this topic.

We just had our JC inspection last month. The inspector told us that using QC data or Cal Ver data are not acceptable as correlation data. Basically, they are separate events. Instead, he suggested (but cannot tell us what to do) that we test 5 (at minimum) different pooled samples and average the results. Those averages are then compared to each other. I'm still working out if I want to designate a primary (the inspector didn't like the idea but my pathologist does) or use an average of all results to compare (possible with a trimmed average to remove outliers). IDK, I have all the data, just unsure how to best analyze it. 

We only need to correlate directly measured analytes (we were already doing this), and only to similar sample types (we no longer need to correlate plasma/serum methods to whole blood).

What?! Cannot use QC or Cal Ver data to crunch separately as correlation? I would highly recommend direct contact with JC again and request further investigation on this, find direct evidence in a regulation that states you cannot use QC or Cal Ver. I am not JC but the CAP does allow this. 

We contacted JC (SIG) in early May regarding these correlations. Their response stated that QC would be appropriate to use, and that JC nor CLIA regulations can't define either what are used as "samples," or the number of samples performed for the correlations. I agree with Erika, maybe reach out to JC/SIG directly.

My facility also does the Cal Ver and QC as well as patient sample comparison on the lab analyzers. We also get the AQSQ Quality Cross Check survey from CAP for our iSTATs twice per year which is done on all in use iSTATs.  I'm wondering if this will suffice for JC regulations.

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