GLI GLI Quality Tool
GLI Quality Tool — Version 2.0

Building A Monthly Quality Report For TB Laboratories

A monthly quality report turns routine laboratory data into a manageable view of performance, risk and improvement. For a tuberculosis service, the document should show whether testing is timely, technically reliable and safe, while making it easy to identify problems that need action.

A useful report is more than a collection of percentages. It gives laboratory managers, quality officers and clinical partners a shared picture of what happened during the month, why results changed and which corrective actions are still open. The format should work for a metropolitan service in Sydney or Melbourne as well as a small laboratory supporting remote communities in the Northern Territory or Western Australia.

The GLI Quality Tool provides a practical framework for this work through its four-phase roadmap and twelve Quality Systems Essentials. A monthly indicator report can reflect those essentials by linking results to equipment, personnel, documents, assessment, safety and continual improvement rather than treating quality as a separate administrative task.

The template should be simple enough to complete consistently and detailed enough to support decisions. Clear definitions, named data owners and stable calculation methods matter more than visual complexity. When the same information is reviewed every month, trends become visible before they develop into serious failures.

Define The Report’s Purpose And Audience

Begin by writing a short purpose statement at the top of the template. It might explain that the report monitors TB laboratory quality indicators, highlights risks, documents improvement actions and supports review by the laboratory leadership team. This keeps the report focused on service performance rather than turning it into a general activity summary.

Identify who will read the report and what each audience needs. A bench scientist may need specimen rejection details, contamination rates and equipment downtime. A laboratory manager may focus on turnaround time, staffing and unresolved incidents. A public health programme may need testing volume and result reporting timelines, while a NATA assessment team may look for evidence that monitoring leads to documented improvement.

Use a reporting period that is easy to compare, such as the first to last day of each calendar month. Australian laboratories that operate across state or territory networks should record the site, testing platform and reporting month clearly. If a service covers several locations, show both site-level results and a combined view so that a strong aggregate figure does not conceal a problem in a smaller regional facility.

Select Indicators That Reflect The Workflow

Choose indicators across the full testing pathway: pre-analytical, analytical and post-analytical. Pre-analytical measures can include rejected specimens, missing clinical information, unsuitable containers and transport delays. Analytical measures may cover internal quality control, contamination, invalid molecular tests, smear quality and equipment interruptions. Post-analytical measures can include result turnaround time, amended reports and critical results communicated within the required timeframe.

Each indicator needs a precise definition. “Turnaround time” should state whether the clock starts at specimen receipt, accessioning or collection, and whether it ends when the result is authorised or communicated. “Rejected specimen” should specify the reasons included. Without these rules, two laboratories may report different results while using the same label.

Keep the initial set manageable. A laboratory may begin with eight to twelve indicators, then add measures as the reporting process becomes reliable. Include a mixture of outcome measures, such as contamination, and process measures, such as the percentage of staff completing competency assessment on schedule.

A balanced indicator set can include:

For smear microscopy services, indicator definitions should distinguish technical quality from workload. A high number of slides does not demonstrate good performance by itself. A structured stained smear programme can support consistent review of staining, reading and documentation.

Design A Template That Supports Decisions

Place the reporting period, laboratory name, reporting officer and date of review at the top. A summary panel can then show the current result, target, previous month’s result and status. Use words such as “within target,” “watch” and “action required” alongside colour, because colour alone may not be accessible or meaningful when reports are printed or circulated in grayscale.

Create a separate row for each indicator. Recommended columns include indicator name, definition, numerator, denominator, result, target, previous result, data source, responsible person and comments. Showing the numerator and denominator makes the calculation auditable. A rejection rate of 4 out of 100 specimens tells a different story from 40 out of 1,000, even though both equal 4 per cent.

Add a section for significant events and a separate action register. The action register should record the issue, immediate containment, root cause or contributing factors, assigned owner, due date, status and evidence of completion. A failed external quality assessment result should lead to documented follow-up; the guidance on a corrective action plan can help structure that response.

Collect And Validate The Data

Assign every indicator to a data owner. Depending on the measure, the owner may use the laboratory information system, specimen reception log, instrument records, quality control sheets, incident forms or staff training files. Record the source in the template so that another person can reproduce the result without relying on memory.

Set a cut-off date and a short verification process. The quality officer can check that the denominator matches the reporting period, duplicate specimens have not been counted twice and missing values are explained. A sudden fall in testing volume may reflect a genuine service change, a public holiday, instrument downtime or incomplete data entry.

Australian services should account for operational patterns that affect interpretation. Public holidays and Christmas-New Year staffing can alter turnaround times, while specimens transported from rural or remote areas may experience delays outside the testing laboratory’s direct control. Report these factors as context rather than silently excluding the affected data.

Data checks before sign-off:

The template can be maintained in a controlled spreadsheet or quality management system, provided access, version control and backups are managed. Downloadable quality resources may help laboratories adapt checklists and supporting documents without creating uncontrolled copies.

Interpret Trends Instead Of Isolated Results

A monthly result should be read alongside at least the previous three to six months. A single high contamination rate may be caused by a short-term event, while a gradual increase may indicate changes in specimen quality, workflow or staff practice. Use a simple run chart where possible, with the target or alert threshold marked visibly.

Targets should be realistic and linked to the laboratory’s service, method and risk profile. National or local requirements may provide a starting point, but targets should not be copied without checking their relevance. A remote laboratory with a small monthly workload may need to use counts and longer review periods because one event can create a large percentage change.

Distinguish between a performance failure and a signal that warrants review. A result outside target should trigger investigation, not automatic blame. Consider workload, staffing, reagent supply, instrument maintenance, referral transport, changes in clinical demand and interruptions to information systems.

Turn Findings Into Corrective Action

The report should show what happened after an indicator moved outside its limit. Immediate containment might include repeating a control, isolating affected results, contacting a referral laboratory or checking recent runs. Longer-term action could involve refresher training, revised specimen collection instructions, preventive maintenance or a change to the workflow.

Use a risk-based priority. A delayed result for a clinically urgent specimen, a failed control or a biosafety incident may require immediate escalation. A minor documentation omission can be managed through routine follow-up, provided it is tracked and does not recur. Assign one accountable owner for each action, even when several people contribute.

Review open actions at every monthly meeting. Mark them as open, overdue, completed or ineffective. Completion should mean that the planned work occurred and evidence was reviewed. If an action did not solve the problem, record the next step rather than closing the item to improve the appearance of the report.

Make Review Part Of Routine Governance

Set a regular review meeting with a fixed agenda: confirm the previous actions, review current indicators, discuss exceptions, agree on owners and record decisions. Keep minutes or a signed review record with the report. This creates a traceable link between measurement and management action.

Share only the level of information appropriate for the audience. Patient identifiers should not appear in a routine quality report. If an incident requires case-level investigation, keep those details in a controlled record and refer to the record number in the monthly summary.

Connect the report to the laboratory’s broader quality management system. Indicators can provide evidence for internal audits, management review, staff competency activities, equipment planning and continual improvement. In Australia, alignment with local public health laboratory arrangements, state or territory reporting expectations and workplace health and safety procedures will help the template fit existing governance rather than creating a parallel process.

Improve The Template Over Time

Review the template after three reporting cycles. Remove indicators that are never used, clarify definitions that produce repeated questions and add measures that address important risks not currently visible. Changes should be version-controlled, approved and communicated to everyone who enters or reviews data.

Avoid excessive automation at the beginning. A reliable spreadsheet with protected formulas may be more useful than a complex dashboard populated with inconsistent data. Once definitions and data flows are stable, automated extraction from the laboratory information system can reduce transcription errors and free staff time for interpretation.

A strong monthly report should make the next action obvious. It should show whether the laboratory is meeting its standards, where variation is occurring, who is responsible for follow-up and whether previous interventions worked. Build the template around that purpose, test it with the people who will use it, and place the approved version within the laboratory’s controlled document system.