ASF Standards · Ambulatory Clinic · Standard 3

Standard 3 — Environment & Shared Spaces

6 criteria · 4 non-negotiable · 2 core · Version 3.0

Criteria in this standard

3.1 — Water Supply Is Safe and Monitored
3.2 — Medical Equipment Is Maintained on Schedule
3.3 — Shared Spaces Are Genuinely Clean
3.4 — Facility Risks Are Tracked in One Integrated Register
3.5 — Diagnostic Equipment On-Site Is Calibrated, Not Just Maintained
3.6 — Point-of-Care Testing Has Real Quality Control, Not Just a Working Device

3.1

Water Supply Is Safe and Monitored

Non-Negotiable

Water quality is tested on a defined schedule and a contingency plan exists for interruption — not an assumption that municipal supply is automatically safe.

In plain terms: You test your water on a set schedule, keep the results, and have a plan for what to do if the supply fails or is contaminated.

Facility category	Crisis	Transition	Small	Standard
Applicability	Adapted	Full	Full	Full

Why this matters

Clinics use water for everything — drinking, hand hygiene, sterilisation, dialysis, cleaning wounds. If it is contaminated, every one of those becomes a route for infection. Municipal supply is not automatically safe: pipes corrode, tanks grow biofilm, pressure drops draw in groundwater. Legionella, Pseudomonas, and faecal contamination are found in clinic water systems every year, and outbreaks kill patients who were already weak. Testing costs little. Not testing and finding out through an outbreak costs lives, closures, and lawsuits. The second half — a contingency plan — matters because supply interruptions happen, and a clinic without water for six hours is a clinic in crisis.

What good looks like

Testing happens on a defined schedule with consistent records.
A specific, actionable contingency plan exists.
Concerning results trigger a known, followed response process.

Common failure modes

No regular testing beyond an assumption of municipal safety.
No contingency plan exists.
Results, when they exist, are filed without review.

Worked example

In practice

A 18-room clinic on municipal supply with a rooftop storage tank.

BeforeNo one had tested the water in living memory. The rooftop tank had not been cleaned in four years. Staff assumed municipal water was safe. When asked what would happen if supply stopped, the facilities manager said they would 'call the water company.' There was no stored reserve for clinical use.

ActionThe Coordinator arranged quarterly microbiological testing at a certified laboratory and had the tank drained, cleaned, and inspected. A written contingency plan named who calls whom, where the 48-hour bottled reserve is stored, which services stop first, and how hand hygiene continues (alcohol rub stock). Results and the plan were filed in the risk register.

AfterThe Monitor reviewed two quarters of test results (both within limits), the tank cleaning certificate, and the contingency plan. Asked a treatment area nurse what she would do if the taps stopped; she pointed to the alcohol rub and the plan on the noticeboard. Verified.

If you are starting from zero — do this first

Find out when your water was last tested and by whom. If nobody knows, the answer is never.
Book a microbiological test at a certified lab this week.
Look at your storage tank — when was it last cleaned?
Write one page: if the water stops, who does what, and where is the reserve?

The most common mistake: Trusting the municipal supply certificate and never testing what actually comes out of the clinic's own taps.

Self-assessment questions

1. Is water quality tested on a defined, regular schedule, with records kept? — An assumption is not a verified fact.
Evidence: Water testing records

2. Is there a documented contingency plan for water supply interruption? — A plan written during an actual interruption is not a contingency plan.
Evidence: Contingency plan document

3. Are test results reviewed and acted on, not just filed? — A concerning result nobody reads is no better than not testing.
Evidence: Review and action record

Common reasons for a PARTIAL answer

Testing happens but with gaps during busy periods. — Routine tasks without strong enforcement are often the first thing skipped.
A contingency plan exists but has never been reviewed since written. — An untested plan may not reflect current capacity.
Results are reviewed informally with no documented follow-up.

Implementation plan

When	What
Week 1	Review current testing frequency for gaps.
Week 2	Establish a specific contingency plan for interruption.
Week 3	Define a clear response process for concerning results.
Ongoing	Review testing consistency on a fixed schedule.

How the Monitor verifies this

Method	What	Detail
DOCUMENT	Testing record review	Reviews water testing records for consistency and whether the schedule is followed.
DOCUMENT	Contingency plan check	Reviews the plan for a real, specific backup arrangement.
ASK	Response protocol interview	Asks staff what actually happens if a test result is concerning.

Supervisor tips

Ask for actual test records, not a general assurance. — Dated records are the only real evidence of a consistent schedule.
Ask what happened the last time a result was concerning. — A real example reveals more than a policy description.

Evidence base

[10] World Health Organization, UNICEF. Water, sanitation and hygiene in health care facilities: practical steps to achieve universal access to quality care. Geneva: WHO; 2019.

Train your team: AMB-03 · Environment & Shared Spaces on GMJ Academy →

This course teaches practical implementation of this standard. Free to enroll. ASF certificate on completion.

3.2

Medical Equipment Is Maintained on Schedule

Non-Negotiable

A maintenance programme covers all clinical equipment on a defined schedule, and faulty equipment is genuinely removed from use, not kept in service pending eventual repair.

In plain terms: Every piece of clinical equipment is on a maintenance schedule, gets serviced on time, and anything broken is taken out of use immediately — not left in service 'until the technician comes.'

Facility category	Crisis	Transition	Small	Standard
Applicability	Adapted	Full	Full	Full

Why this matters

A ventilator that has not been serviced fails at 3am. An infusion pump that drifts delivers the wrong dose. A defibrillator with a flat battery is a box. Equipment failure is a leading cause of preventable patient harm and is almost entirely predictable — machines fail on schedules, which is why manufacturers publish service intervals. The harder discipline is removing faulty equipment from use. It is tempting to keep a monitor with an intermittent fault in service because there is no spare. That is how a known fault becomes a death. Tag it, remove it, find a workaround. Equipment that is 'mostly working' is not working.

What good looks like

A comprehensive schedule is consistently followed.
Faulty equipment is physically removed from use immediately.
A named person owns the programme confidently.

Common failure modes

Maintenance happens reactively, only after failure.
Faulty equipment remains available and sometimes used.
Nobody can identify who is responsible.

Worked example

In practice

A 10-room clinic with 400 items of clinical equipment and one biomedical technician.

BeforeThere was no equipment inventory. Servicing happened when something broke. Three infusion pumps with known faults were still in use on the treatment areas because there were no replacements. A ventilator in ICU was 14 months overdue for service. Staff had no way to report a fault except to tell the technician verbally.

ActionThe Coordinator and technician built a spreadsheet inventory of every clinical item with its service interval and next due date. Overdue items were prioritised by risk — ventilators and pumps first. A red 'DO NOT USE' tag system was introduced; any staff member could tag and remove a faulty item and log it. The three faulty pumps were tagged and removed the same day; two were repaired, one condemned.

AfterThe Monitor sampled 20 items from the inventory: all had a service record and none were overdue. Found one tagged monitor in the equipment store with a logged fault. Asked two nurses how they would report a fault; both described the tag system. Verified.

If you are starting from zero — do this first

Walk the treatment areas and count clinical equipment. If you have no inventory, start one today.
Ask staff: is any equipment in use that you know has a fault? Remove it now.
Find the service interval for your highest-risk items (ventilators, pumps, defibrillators) and check when they were last done.
Give every treatment area a stack of 'DO NOT USE' tags and tell staff they have authority to use them.

The most common mistake: Keeping equipment with a known fault in service because there is no replacement — a known fault is worse than no equipment, because staff rely on it.

Self-assessment questions

1. Is there a documented maintenance schedule covering all clinical equipment? — A defined, proactive schedule, not reactive maintenance.
Evidence: Maintenance schedule and log

2. Is faulty equipment actually removed from use, not kept accessible awaiting repair? — A tag alone isn't sufficient if the equipment remains physically accessible.
Evidence: Removal-from-service record

3. Is there a named person responsible for the maintenance programme? — Diffuse responsibility usually means inconsistency.
Evidence: Role assignment record

Common reasons for a PARTIAL answer

A schedule exists for major equipment but not smaller items. — Coverage often reflects value or visibility rather than actual risk.
Faulty equipment is tagged but not physically relocated. — A tag depends on every staff member noticing it every time.
Responsibility sits with someone who has since changed roles informally.

Implementation plan

When	What
Week 1	Audit equipment against the maintenance schedule for gaps.
Week 2	Establish a process for physically removing faulty equipment.
Week 3	Name a specific owner of the programme.
Ongoing	Review maintenance log currency against the schedule.

How the Monitor verifies this

Method	What	Detail
DOCUMENT	Maintenance schedule review	Reviews the schedule and log for completeness and consistency.
OBSERVE	Faulty equipment check	Checks whether flagged equipment remains physically accessible.
ASK	Responsible person interview	Asks whoever is responsible to describe the actual process.

Supervisor tips

Look for equipment that should be flagged but isn't. — The absence of any flagged equipment is itself worth questioning.
Check whether tagged equipment is still physically reachable. — A tag alone doesn't prevent use if it sits in its normal location.

Evidence base

[11] Biomedical equipment maintenance frameworks consistently identify scheduled preventive maintenance, combined with clear removal-from-service protocols, as the primary control against equipment-related patient harm.

Train your team: AMB-03 · Environment & Shared Spaces on GMJ Academy →

This course teaches practical implementation of this standard. Free to enroll. ASF certificate on completion.

3.3

Shared Spaces Are Genuinely Clean

Core

Shared clinical and waiting areas are cleaned on a documented schedule, with cleanliness verified by more than a visual check on the day of assessment.

In plain terms: Shared areas are cleaned on a documented schedule, and you can prove cleanliness with more than 'it looks clean today.'

Facility category	Crisis	Transition	Small	Standard
Applicability	Adapted	Full	Full	Full

Why this matters

Surfaces look clean long after they stop being clean. A waiting-room chair wiped once a week harbours what every patient who sat on it left behind. Infection spreads on door handles, bed rails, and toilet flush handles that appear spotless. The standard asks for two things: a schedule — who cleans what, how often, with what — and verification that goes beyond the eye. That can be as simple as a supervisor sign-off checklist, or as rigorous as ATP swab testing. Either way, 'we clean every day' is a claim; a log with signatures and a spot-check is evidence.

What good looks like

A documented, consistently followed schedule covers all shared spaces.
High-touch surfaces are specifically addressed.
Cleanliness is verified through a defined process.

Common failure modes

No documented schedule beyond good intentions.
High-touch surfaces show visible neglect.
Verification is undocumented and inconsistent.

Worked example

In practice

A 8-room clinic with an outsourced cleaning contractor.

BeforeThe contractor cleaned to their own plan, which nobody at the clinic had seen. There was no log. When the Coordinator asked which surfaces were cleaned in the waiting area and how often, no one could say. A visual check on the day looked fine. An ATP swab of the main waiting-room door handle returned a reading four times the acceptable threshold.

ActionThe Coordinator obtained the contractor's schedule, revised it with infection control to specify high-touch surfaces and frequency, and required a signed daily log per area. The treatment area sister spot-checked one area per day with a 10-point checklist. Monthly ATP swabs of five high-touch points were added, with results recorded.

AfterThe Monitor reviewed three months of daily logs and ATP results (all within threshold after month one). Observed a cleaner following the schedule and a supervisor checking the log. Verified.

If you are starting from zero — do this first

Ask who cleans your main waiting area, how often, and where it is written down.
Get the cleaning schedule — if there isn't one, that is the first gap.
Add a signed daily log for each area, kept where the supervisor can see it.
Start spot-checking: one area a day, ten points, initialled.

The most common mistake: Relying on a visual inspection on the assessment day, which proves nothing about the other 364.

Self-assessment questions

1. Is there a documented cleaning schedule with records kept? — A specific, dated schedule, not a general statement.
Evidence: Cleaning schedule and log

2. Is cleaning verified through more than a visual check? — Visual cleanliness and actual microbial cleanliness aren't the same thing.
Evidence: Verification or audit record

3. Are high-touch surfaces specifically included? — Door handles and switches are easy to overlook relative to visible surfaces.
Evidence: High-touch surface schedule

Common reasons for a PARTIAL answer

A schedule exists for the waiting room but not less-visited areas. — Peripheral areas often receive less consistent attention.
Cleaning happens but high-touch surfaces aren't specifically called out. — A general routine can miss the surfaces that matter most.
Verification exists informally with no documentation.

Implementation plan

When	What
Week 1	Review current schedules for coverage gaps.
Week 2	Add specific high-touch surface cleaning to the schedule.
Week 3	Establish a simple verification step.
Ongoing	Audit cleaning log completeness periodically.

How the Monitor verifies this

Method	What	Detail
DOCUMENT	Cleaning schedule review	Reviews the schedule against completion records.
OBSERVE	High-touch surface check	Checks whether high-touch surfaces are specifically addressed.
ASK	Verification process interview	Asks staff how cleanliness is actually verified.

Supervisor tips

Check high-touch surfaces specifically. — Door handles and switches reveal more than open floor areas.
Ask for the log, not a general assurance. — Dated records are the only real evidence.

Evidence base

[12] Environmental cleanliness in shared healthcare spaces is a recognised contributing factor to healthcare-associated infection transmission risk, distinct from direct clinical contact precautions.

Train your team: AMB-03 · Environment & Shared Spaces on GMJ Academy →

This course teaches practical implementation of this standard. Free to enroll. ASF certificate on completion.

3.4

Facility Risks Are Tracked in One Integrated Register

Non-Negotiable

Water safety, fire safety, and equipment maintenance data feed into one integrated risk register, not separate untracked lists.

In plain terms: All facility risks — water, fire, equipment, building — are listed in one risk register that someone reviews regularly, instead of scattered across separate checklists nobody connects.

Facility category	Crisis	Transition	Small	Standard
Applicability	Adapted	Full	Adapted	Full

Why this matters

A clinic has dozens of risks that each live in someone's drawer: the fire officer's checklist, the water test folder, the equipment log, the building survey. Nobody sees them together. So nobody notices that the emergency generator (equipment) sits in a room with a leaking pipe (building) below the fire alarm panel (fire). A single register forces the question: what are our top ten risks right now, and who owns each? It turns a pile of compliance paperwork into a management tool. It also protects the Director — a reviewed register is evidence that risks were known and managed, not ignored.

What good looks like

Facility risks feed into one integrated register.
The register is reviewed on a defined schedule.
Risks are prioritised, with highest-risk items addressed first.

Common failure modes

Records exist as entirely separate, unconnected logs.
No defined review schedule exists.
All items are treated with equal, undifferentiated priority.

Worked example

In practice

A 16-room clinic with fire, water, equipment, and building risks tracked by four different people.

BeforeEach department kept its own list. The Director had never seen them together. When the Coordinator collected them, she found the backup generator was overdue for service, the fuel store had a fire-rating issue, and the fire officer had flagged the generator room as a risk — three findings, three files, no connection, no action.

ActionThe Coordinator built one register: risk, likelihood, impact, owner, current controls, next action, review date. She populated it from the four existing lists, scored each, and sorted by priority. The top ten went to the management meeting monthly. The generator issue was resolved in three weeks once all three findings were seen together.

AfterThe Monitor reviewed the register: 34 risks, each with an owner and a dated review. Minutes of two management meetings showed the top ten discussed and actions closed. Verified.

If you are starting from zero — do this first

Collect every existing risk list, checklist, and audit finding from every department into one folder.
Put them in one table: risk, how likely, how bad, who owns it, what's being done.
Score and sort — what are your top ten?
Put the top ten on the next management meeting agenda and set a review date.

The most common mistake: Building the register once for accreditation and never reviewing it — a register with a review date two years old is a historical document.

Self-assessment questions

1. Do water safety, fire safety, and equipment data feed into one register? — A single place to see the whole risk picture, not scattered logs.
Evidence: Integrated risk register document

2. Is the register reviewed on a defined schedule by clinic leadership? — Review at a level that can act across domains.
Evidence: Review meeting record

3. Does the register prioritise risks, not just list them? — A genuine tool ranks what needs attention first.
Evidence: Risk prioritisation criteria

Common reasons for a PARTIAL answer

Individual domain tracking is strong but nothing integrates them. — Good individual records don't automatically produce a combined view.
A register exists but review happens irregularly. — An ad hoc pattern risks the register becoming stale.
The register lists risks without ranking them.

Implementation plan

When	What
Week 1	Inventory current safety tracking across domains.
Week 2	Consolidate into one integrated register.
Week 3	Establish a defined review schedule.
Ongoing	Review and reprioritise on schedule.

How the Monitor verifies this

Method	What	Detail
DOCUMENT	Register completeness review	Reviews integration across safety domains.
DOCUMENT	Review schedule check	Checks for evidence of defined-schedule review.
ASK	Prioritisation interview	Asks how risks are prioritised, not just logged.

Supervisor tips

Ask to see the register itself, not descriptions of individual tracking. — Integration itself is what this checks.
Ask who reviews it and how often, specifically. — A specific process is the real evidence of active use.

Evidence base

[13] Integrated environment-of-care risk management, tying individual facility safety domains into one reviewed register, is an established approach in international facility safety frameworks.

Train your team: AMB-03 · Environment & Shared Spaces on GMJ Academy →

This course teaches practical implementation of this standard. Free to enroll. ASF certificate on completion.

3.5

Diagnostic Equipment On-Site Is Calibrated, Not Just Maintained

Core

Any diagnostic equipment on-site — X-ray, ultrasound, ECG — is calibrated against a defined schedule, verified for accuracy, not just confirmed to be running.

In plain terms: X-ray, ultrasound, ECG and other diagnostic equipment is calibrated on a schedule and checked for accuracy — not just confirmed to switch on.

Facility category	Crisis	Transition	Small	Standard
Applicability	Adapted	Full	Full	Full

Why this matters

An ECG machine that is running but miscalibrated produces a trace that looks normal and misses an arrhythmia. An ultrasound with a degraded probe misses a mass. An X-ray unit delivering more dose than displayed exposes every patient to unnecessary radiation. Maintenance keeps the machine running; calibration keeps it accurate. They are different things done by different people on different schedules. A clinic that cannot show when its diagnostic equipment was last calibrated does not know whether its results are true.

What good looks like

Equipment is calibrated on a defined schedule by a qualified source.
Calibration certificates are current and retained.
Miscalibrated equipment is genuinely removed from use until corrected.

Common failure modes

No calibration schedule exists beyond general maintenance.
Calibration, if claimed, has no verifiable certificate.
Equipment continues in use despite known calibration issues.

Worked example

In practice

A 14-room clinic with an ECG, a portable ultrasound, and a dental X-ray unit.

BeforeThe ECG had been 'serviced' two years earlier — a cleaning and a new cable. It had never been calibrated against a reference signal. The ultrasound probe had a dead zone the operator had learned to work around. The X-ray unit had no dose verification record. All three were 'working.'

ActionThe Coordinator identified the manufacturer's calibration interval for each device and arranged a calibration visit from a certified biomedical engineer. The ECG was found 8% out; the ultrasound probe was replaced; the X-ray unit's dose was verified within tolerance. A calibration schedule with next-due dates was added to the equipment inventory, separate from the maintenance schedule.

AfterThe Monitor reviewed calibration certificates for all three devices and the schedule showing next due dates. Verified.

If you are starting from zero — do this first

List every diagnostic device you own.
For each, find the manufacturer's recommended calibration interval.
Find the last calibration certificate. If there is none, that is the gap.
Book a certified calibration visit and add the next-due date to your inventory.

The most common mistake: Treating an annual service as calibration — the technician who cleaned the machine did not verify its accuracy.

Self-assessment questions

1. Is diagnostic equipment calibrated against a defined schedule, not just confirmed to be running? — Calibration verifies accuracy; maintenance only verifies function.
Evidence: Calibration schedule and log

2. Is calibration performed or verified by a qualified, external or certified source? — Self-assessed calibration by untrained staff doesn't meet this.
Evidence: Calibration certificate

3. Is equipment found out of calibration removed from use until corrected? — Continuing to use miscalibrated equipment defeats the purpose of checking at all.
Evidence: Removal-from-service record

Common reasons for a PARTIAL answer

Calibration happens for the primary diagnostic device but not secondary equipment. — Attention often concentrates on the most visible or expensive equipment.
Calibration certificates exist but are past their valid period. — An expired certificate provides no current assurance.
Miscalibration is noted but correction is delayed without removing the equipment from use.

Implementation plan

When	What
Week 1	Inventory all diagnostic equipment and current calibration status.
Week 2	Schedule calibration with a qualified source for any equipment overdue.
Week 3	Establish a removal-from-service rule for miscalibrated equipment.
Ongoing	Track calibration certificate expiry proactively.

How the Monitor verifies this

Method	What	Detail
DOCUMENT	Calibration record review	Reviews calibration certificates and schedule adherence.
DOCUMENT	Qualified source check	Confirms calibration is performed by a qualified, certified source.
OBSERVE	Out-of-calibration handling check	Checks whether equipment found miscalibrated is genuinely removed from use.

Supervisor tips

Ask for the calibration certificate itself, not a statement that equipment works. — A certificate from a qualified source is the only real evidence of genuine calibration.
Check certificate dates against the actual current date. — An expired certificate is a common, specific gap worth checking directly.

Evidence base

[14] Calibration verification, distinct from general equipment maintenance, is an established requirement in diagnostic equipment quality frameworks specifically because functional equipment can still produce inaccurate output.

Train your team: AMB-03 · Environment & Shared Spaces on GMJ Academy →

This course teaches practical implementation of this standard. Free to enroll. ASF certificate on completion.

3.6

Point-of-Care Testing Has Real Quality Control, Not Just a Working Device

Non-Negotiable

Any point-of-care test performed on-site — rapid strep, glucose, pregnancy, or similar — is run against a documented quality control process, not assumed accurate because the device powers on.

In plain terms: Every rapid test done in the clinic — glucose, strep, pregnancy, urine dip — has a quality control process with records, not just a device that turns on.

Facility category	Crisis	Transition	Small	Standard
Applicability	Adapted	Full	Full	Full

Why this matters

Point-of-care tests are trusted because they are simple. That trust is misplaced when the glucose meter has drifted, the strep kit is expired, or the strips were stored in a hot cupboard. A wrong result at the point of care is acted on immediately — insulin given, antibiotics started, a pregnancy missed — before anyone has a chance to question it. Quality control means running a control sample of known value at defined intervals (daily for meters, per lot for kits), recording the result, and not using the device or kit if the control fails. It takes two minutes. Without it, the clinic is guessing.

What good looks like

A documented quality control process runs consistently for every point-of-care test type.
Staff are specifically trained and assessed as competent for the tests they perform.
A quality control failure stops patient testing until resolved.

Common failure modes

No quality control process exists beyond the device appearing to work.
Staff perform tests with no specific training or competency assessment.
Quality control failures, if noticed, don't stop patient testing.

Worked example

In practice

A 10-room clinic running glucose, urine dipstick, rapid strep, and pregnancy tests daily.

BeforeNo QC was run on any test. Glucose strips were stored on a windowsill. One box of strep kits was six months past expiry. The Coordinator ran a control solution through the glucose meter: it read 15% high. Patients had been managed on that meter for months.

ActionA QC log was created per test type: glucose meter control run every morning before patient use; strep and pregnancy kits checked with the built-in control on every lot and daily visual check of expiry; urine dips stored per manufacturer and control strip run weekly. Any control failure stops use of that device or lot until resolved. Strips were moved to a cupboard away from heat.

AfterThe Monitor reviewed six weeks of QC logs: complete, with one glucose control failure documented and the meter replaced. All kits in date. Verified.

If you are starting from zero — do this first

List every rapid test you run.
Check every kit and strip box for expiry today.
Run a control solution through your glucose meter this morning.
Start a QC log per test — one line per day.

The most common mistake: Assuming a rapid test is accurate because it is simple — simple tests fail silently.

Self-assessment questions

1. Is a documented quality control process run for each point-of-care test type, not just assumed from the device working? — A specific control sample check, not confirmation the device turns on.
Evidence: Quality control log

2. Are staff performing point-of-care tests specifically trained and assessed as competent? — Training specific to the test, not general clinical competence.
Evidence: Staff training and competency record

3. Are quality control failures acted on before patient results are reported? — A failed control that doesn't stop patient testing provides no real protection.
Evidence: Quality control failure response record

Common reasons for a PARTIAL answer

Quality control is run for the most frequently used test but not less common ones. — Attention concentrates on high-volume tests, leaving others under-checked.
Staff were trained once at introduction but never reassessed. — Competency can drift without periodic reassessment.
A failed control is documented but patient testing continues regardless.

Implementation plan

When	What
Week 1	Inventory all point-of-care tests performed and current quality control practice.
Week 2	Establish a documented quality control process for every test type.
Week 3	Train and formally assess staff competency for each test performed.
Ongoing	Audit quality control log completeness periodically.

How the Monitor verifies this

Method	What	Detail
DOCUMENT	Quality control log review	Reviews the quality control log for consistency and completeness per test type.
DOCUMENT	Staff competency review	Reviews training and competency assessment records for staff performing point-of-care testing.
ASK	Failure response interview	Asks staff what happens when a quality control check fails.

Supervisor tips

Ask for the actual quality control log, not a description of the testing process. — Dated records are the only real evidence of a consistent process.
Ask what happens specifically when a control fails. — A real, specific answer reveals whether this is genuine practice or assumed.

Evidence base

[15] International Organization for Standardization. ISO 15189:2022 — Medical laboratories: requirements for quality and competence. Geneva: ISO; 2022 — establishes quality control requirements specifically applicable to point-of-care testing, distinct from centralised laboratory testing.

Train your team: AMB-03 · Environment & Shared Spaces on GMJ Academy →

This course teaches practical implementation of this standard. Free to enroll. ASF certificate on completion.

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