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Gram stain is a commonly performed bacterial stain in clinical microbiology laboratories. It is often the starting point guiding microbiological workup and initial clinical diagnosis and therapy. It is important for technologists who read Gram stains to provide an accurate interpretation based on reaction type and microscopic morphology in order to provide presumptive identifications and quantification of bacteria and fungi in clinical specimens.


This study will help assess the effectiveness of educational and practical experience policies and procedures dedicated to the laboratory’s efforts in maintaining technologist skills in the morphological assessment of Gram stains. Participation in this study will help management assess the technologist’s ability to evaluate Gram stains using online, whole slide images. These cases provide a standardized review and evaluation for each technologist. The study will help management meet applicable CLIA, CAP Laboratory Accreditation, and The Joint Commission laboratory requirements for personnel competency requirements and consistency of reporting amongst staff.*

Data Collection

A series of online, whole slide images of Gram stained smears using DigitalScope technology will be provided to each participating institution to assess technologists’ ability to detect various microorganisms. Technologists will provide information about their work experience related to Gram stains, continuing education, and professional background. Information will be collected from each laboratory site to provide information about their continuing education requirements in microbiology, and relevant laboratory procedures and policies related to Gram stain assessment.

Performance Indicators

  • Individual technologist score (%) for each Gram stain case, and overall based on a standardized competency assessment method
  • Overall laboratory score based on the facility’s individual technologist performance(s)

Reports are provided at institution and technologist levels. A summary of responses to the general questions will be provided for participants.

Program Information

To meet your staff technical competency assessment requirements:

  • Result forms for up to 10 technologists (QPD10)
  • Result forms for up to 25 technologists (QPD25)
  • Multiple kits may be purchased to accommodate quantity needed

Shipping Schedule

D Mailing: August 5, 2024

Additional Information

*Participation in this study helps laboratories meet:

  • CLIA personnel requirements (Subpart M, 42 CFR §493.1)
  • CAP Laboratory Accreditation Program Microbiology Checklist statement MIC.11060, Culture Result Reporting: Personnel performing Gram stains for this purpose are subject to competency assessment
  • CAP Laboratory Accreditation Program Microbiology Checklist statement MIC.11350, Morphologic Observation Evaluation: The laboratory evaluates consistency of morphologic observation among personnel performing Gram, trichrome and other organism stains at least annually
  • CAP Laboratory Accreditation Program Checklist statement GEN.55500, Competency Assessment of Testing Personnel
  • The Joint Commission standards HR. 01.05.03, 01.06.01, 01.07.01 and LD.04.05.03 and 04.05.05 regarding in-service training, continuing education, competency, and evaluation of hospital personnel
Select Q-PROBES and Q-TRACKS studies to support your quality improvement initiatives.
Anatomic Pathology
Clinical Pathology
Turnaround Time
Patient Safety
Transfusion Medicine
Chemistry/ Hematology
Customer Satisfaction
Non-Physician Care Team Satisfaction With Clinical Laboratory Services (QP231)
Technical Competency Assessment of Body Fluid Review (QPB10)
Technical Competency Assessment of Peripheral Blood Smears (QPC10/QPC25)
Technical Competency Assessment of Gram Stains (QPD10/QPD25)
Patient Identification Accuracy (QT1)
Blood Culture Contamination (QT2)
Laboratory Specimen Acceptability (QT3)
In-Date Blood Product Wastage (QT4)
Gynecologic Cytology Outcomes: Biopsy Correlation Performance (QT5)
Satisfaction with Outpatient Specimen Collection (QT7)
Stat Test Turnaround Time Outliers (QT8)
Critical Values Reporting (QT10)
Troponin Turnaround Times (QT15)
Corrected Results (QT16)
Outpatient Order Entry Errors (QT17)

*The CAP requires accredited laboratories to have a quality management plan that covers all areas of the laboratory and includes benchmarking key measures of laboratory performance (GEN.13806, GEN.20316, COM.04000). The Joint Commission requires accredited hospitals to regularly collect and analyze performance data (PI.01.01.01, PI.02.01.01). CLIA requires laboratories to monitor, assess, and correct problems identified in preanalytic, analytic, and postanalytic systems (§493.1249, §493.1289, §493.1299).

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