“…Also, the individual laboratory may be confronted with contradictory federal and local guidelines or receive reimbursements that do not cover the costs of quality assurance according to guidelines. 4,9,13,14,27,30,39,42,44 Some of the variations in TQM practices that were discussed at the consensus conference are outlined below. In the United States, laboratories have the option of subscribing to a peer review organization, like the College of American Pathologists (CAP) or JCAHO or can opt for regional-, state-or nationallevel inspections by the Health Care Financing Agency (HCFA).…”