April 2017
From the State Vet's Office

Diagnostic Laboratory Accreditation - Who Needs It?

Before I really get into this article, there is a word I need to define. The word is necropsy. Most of you will associate the word with autopsy. In the world of veterinary medicine, we use the word necropsy because when you break the word down it has two roots. The first root is "necr," meaning dead. The second is "opsy." It means to examine or observe. Thus necropsy means to examine the dead. If you look at the origin of the word auto, it comes from a Greek work meaning self. So when you break down the word autopsy, it means to observe or examine self. I think that is a pretty fair challenge if you are dead. Therefore, veterinarians use the word necropsy. Now, I can begin my article.

When I was in veterinary practice, it was not uncommon for me to perform a necropsy on a client’s animal that died from some unknown cause. Sometimes, I could make the diagnosis right there on the spot when a calf died from blackleg or a horse died from a twisted intestine. But there were other times that when looking at the deceased animal’s carcass didn’t yield a diagnosis, so I would collect tissues and send to the lab at Auburn for further testing. And while we didn’t always get a diagnosis, we usually ruled out several possibilities. Either way gave my clients valuable information and it was a learning experience for me. And did I mention that my laboratory was usually in the middle of somebody’s pasture?

I still believe in the value of a private practicing veterinarian performing necropsies on a farm. But there are at least a couple of reasons that using our diagnostic laboratories may, at least sometimes, be a better option. First, there is an economic aspect for the veterinarian. If I had to drive 30 minutes to your farm, do a necropsy that took an hour and drove another half hour back to my clinic, I would need to charge you a fair chunk of change for my two hours. Personally, I didn’t charge what the time was actually worth because usually one of my clients had lost economically and maybe emotionally, so I generally absorbed some loss myself. The second reason to use one of our diagnostic laboratories is that they are able to be consistent in not only performing necropsies but on all the tests they perform. The field necropsy still has a place in the food chain, but consistency is often a challenge. Often the pasture environment makes it easy to contaminate samples being taken for microbiological or virology testing. In addition, I might have performed the necropsy on your prize bull and then got four other farm calls before I could get back to the clinic to prepare the tissue samples for shipping to Auburn.

As I said, the field necropsy has its place in veterinary medicine and I encourage any veterinarian who wishes to do them to go right ahead. It has value to both you and your client. (Now, here’s the big transition in the article.) However, when someone uses one of our diagnostic laboratories, you should expect and we should provide a much higher standard. That is why, for the past few years, we have pursued and continue to pursue accreditation for our diagnostic laboratories.

In 2011, the lab at Auburn was granted accreditation by the American Association of Veterinary Laboratory Diagnosticians. That was the culmination of a vision Dr. Fred Hoerr had for the lab. It was the result of hours and hours of work by the lab personnel to ensure the quality and consistency of the work done by the laboratory. The AAVLD review committee makes sure the lab has a set of written Standard Operating Procedures for everything they do and that they adhere to those Procedures.

You have probably heard the definition of insanity is to continually do the same thing and to expect different results. We take a variation of that principle and say that if you do the exact same thing the exact same way every time, your results should be consistent. In other words, we try to take as many variables out of the equation as possible. That way, we have tremendous confidence that, if a test for a disease is negative, the disease is not present. And the same goes for positive results. In a state where animal agriculture and companion animal veterinary medicine is so important to our economy, we can’t afford to provide inconsistent results.

Maintaining accreditation requires not only consistency in every step of diagnostic process, from how we receive carcasses or tissue and serum samples to how we report the results, but also how we maintain equipment and handle reagents and chemicals. The whole process can be very tedious and the amount of recordkeeping is formidable, to say the least. But, in the end, we can stand behind the diagnostic information we provide to our clients.

This past November, the AAVLD accreditation committee reviewed the lab at Auburn and the branch lab at Boaz. Both were granted full accreditation. Because of some needed facility updates and recent changes in staff, our branch labs at Elba and Hanceville were not included in the November review. However, both of those labs are working toward accreditation as soon as possible. The accreditation at Auburn and Boaz was not something that could be done without all the personnel being onboard and dedicated to making it happen. It was almost like having two full-time jobs. One was to prepare for accreditation and the other was to continue to do the day-to-day work at our diagnostic laboratories.

Finally, I know some of you who are reading this article want to ask me about the long turnaround time experienced by some of our clients in the past. My answer is that we have been able to improve our turnaround times and continue to focus on getting our results back in the hands of our clients as soon as possible. Many of you may remember back in spring 2011 that we experienced some deep budget cuts. The Alabama Department of Agriculture and Industries lost about a fourth of our employees, with several of them being from our diagnostic laboratory system. We have been able to replace some of those positions and continue to work to add key personnel at the lab that will shorten the time from submission to when you get your final results. But, because of the accreditation process, you can know the results that come out of our laboratory system are backed up by a strict quality assurance program.

 

Dr. Tony Frazier is the State Veterinarian for Alabama. You can contact him at 334-240-7253.