Charting the Future Direction of National Microbiological Reference Services in Canada

[Table of Contents]

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Themes

There was a high degree of consensus, at the conceptual level, on where microbiological reference services should focus and aim to be in the 21st century. Participants brought forward a convergence of concepts, with common visions of what defines an ideal microbiology reference services system.

Overall, participants called for more integrated microbiology reference services. Most participants envision a nationally cooperative and coordinated public health system, with greater synergy between the service providers and programs.

LCDC was identified in a central role, as the hub of a network with direct links to provincial, hospital, and diagnostics laboratories, as well as other external bureaus. Strong communication tools, networks, and information systems would be required to support the structure, and to enable the participants within it to thrive. The system should be able to accept and react to input from a broad base of stakeholders.

Participants shared the belief that the system should practice "real time" service delivery, meeting the expressed needs of the customer, and the strategically defined needs of the population. They defined an effective system as one that is externally driven, with strategically focused deliverables, objective evaluation measures, and public accountability for service outcomes and financial expenditures.

To this end, it was also suggested that public health funding could be linked to a strategic planning process, providing a means for financial accountability as well as facilitating funding stabilization for high priority services. The public health system of the future should have access to alternate funding mechanisms, including fee-for-service, research grants, and the pursuit of direct investment from the private sector, among others. However, this must be balanced with the ability of the system to meet the diverse needs of Canada's widespread population. The public health of the population, and individuals, must not be jeopardized by fiscal constraints and geographical challenges-rather the delivery of public health services must be enabled.

There was widespread support for stronger, national leadership within the system, and LCDC was recognized as a natural incumbent for that role. Participants also identified the need for an independent, high profile, national public health advocate. Together with the key players, these leaders must "sell" the benefits of effective public health initiatives, directly and through the media, to educate the customers and users of the system.

While it was acknowledged that all Canadian microbiology reference laboratories currently have quality control standards and procedures in place, there was a call for the establishment of national standards and procedures, as well as some coordination of proficiency testing. A level of national coordination and monitoring would not only ensure consistency in testing and reporting, but would also enable improved surveillance systems.

Existing provincial and international quality control programs could be evaluated as to their suitability for adoption nationally-given the breadth of programs and systems available, there is no need to "re-invent the wheel". Participants emphasized that improved information-exchange, data collection and communication tools would be required to support such nationally coordinated quality assurance efforts.

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