Accreditation is just one aspect of an organization’s quality assurance program, which also should include proficiency testing where relevant, continuing education, and other programs to help the organization provide better overall services. In the case of laboratories, accreditation does not mean that accredited laboratories do not make mistakes, nor does it mean that a laboratory utilizes best practices in every case, but rather, it means that the laboratory adheres to an established set of standards of quality and relies on acceptable practices within these requirements. An accredited laboratory has in place a management system that defines the various processes by which it operates on a daily basis, monitors that activity, and responds to deviations from the acceptable practices using a routine and thoughtful method. This cannot be a self-assessing program. Oversight must come from outside the participating laboratory to ensure that standards are not self-serving and superficial and to remove the option of taking shortcuts when other demands compete with quality assurance. In addition, accreditation serves as a mechanism to strengthen professional community ties, transmit best practices, and expose laboratory employees directly to the perspectives and expectations of other leaders in the profession.
An example of a strong accreditation system is that required through the Clinical Laboratory Improvement Amendments of 1988 (CLIA).6 Through this legislation, the Centers for Medicare & Medicaid Services (CMS) regulates all clinical laboratory testing (except research) performed on humans in the United States. In total, CLIA covers approximately 189,000 laboratory entities (see Box 7-1).
Some key elements of CLIA and of other accreditation programs that might be incorporated into a mandatory accreditation system for forensic science include:
a national organization that can mediate the accreditation process;
an application process with criteria by which organizations are eligible to apply;
a process of self-evaluation;
an external evaluation process, including site visits by external evaluators;
an appeals process;
a repeat cycle of evaluation and external evaluation, and;
a set of standards by which entities can be evaluated.7