Performance Qualification Template: Insert Logo Here
Performance Qualification Template: Insert Logo Here
Quality representative signs to confirm document complies with quality management system
Authorised by: Job title: Signature: Date:
Contents
1. Introduction ......................................................................................................................3
2. Scope .................................................................................................................................3
2.1. Exclusions .................................................................................................................................3
3. Responsibilities .................................................................................................................3
3.1. Preparer ....................................................................................................................................3
3.2. Verifier ......................................................................................................................................3
3.3. Quality Approval ........................................................................................................................3
4. Qualification Description ..................................................................................................3
4.1. Equipment/System Details ..........................................................................................................3
4.2. Qualification Details ...................................................................................................................4
4.3. Justifications .............................................................................................................................4
5. Test Section Details ..........................................................................................................4
6. Qualification Instructions .................................................................................................5
6.1. Data Collection ..........................................................................................................................5
6.2. Interim Progression ...................................................................................................................5
7. Deviations & Deficiencies..................................................................................................5
8. Protocol Approval Requirements ......................................................................................6
8.1. Acceptance Criteria ....................................................................................................................6
8.2. Reporting ..................................................................................................................................6
9. Referenced Documents .....................................................................................................6
10. Definitions .........................................................................................................................6
11. Test Section 1 – Signature Register..................................................................................7
12. Test Section 2 – Test Instrument Details .........................................................................8
13. Test Section 3 – Performance Testing ..............................................................................9
14. Test Section 4 – Exception Reports ................................................................................10
15. Test Section 5 – Progression Approval ...........................................................................11
16. Test Section 6 – Attachments .........................................................................................13
1. Introduction
This Performance Qualification (PQ) protocol describes in detail the activities required to
execute the PQ phase of qualification of the Performance Qualification Template at
Company Name’s [Company Address] manufacturing facility. It defines testing and
documentation required to ensure that the equipment performs in accordance with
process, company and regulatory requirements.
2. Scope
This protocol applies to the Performance Qualification Template. It considers
equipment/system performance under normal operating conditions.
2.1. Exclusions
List only items specific to the scope which could reasonably expect to part of the testing.
Refer to the alternative testing documentation or state justification if not tested.
3. Responsibilities
Personnel executing and/or assisting with the execution of the Performance Qualification
are recorded in the Signature Register in Test Section 1. Persons signing the front page of
this protocol are confirming compliance with the information below:
3.1. Preparer
The preparer shall be the primary author of the document, or a delegate with an
appropriate level of understanding of the technical content of the document. The preparer
signs to confirm that, to their knowledge, the document is complete, complies with the
validation plan and is free from errors.
3.2. Verifier
The verifier shall be the system owner or a delegate with an appropriate level of
understanding of the functionality of the equipment/system The verifier signs to confirm
that, to their knowledge, the document fulfils all relevant testing requirements, is logical
and executable and is free from errors.
4. Qualification Description
4.3. Justifications
Acceptance criteria for most qualification tests have been established in accordance with
regulatory requirements, internal policy standards and established industry standards.
In some cases, it is necessary to define criteria without these established references. Any
instances of these criteria in this protocol are explained below:
6. Attachments Mandatory
6. Qualification Instructions
8.2. Reporting
When the qualification protocol is complete, including the completion and approval of all
exception reports, the results shall be summarised in a Validation Summary Report (VSR).
It shall summarise the results of the executed protocol relative to acceptance criteria,
detail exceptions; discuss relevant issues arising from the execution and make a
concluding statement regarding the success of the qualification exercise. The report shall
have an equivalent level of approval to the protocol.
The report may combine the results of multiple qualifications from the same project.
9. Referenced Documents
Ensure the following documents are read and understood before executing this protocol
10. Definitions
Term/abbreviation Definition
Complete table for each person involved in performing or documenting the qualification, including reviewers.
Acceptance Criterion: All personnel involved have been identified and acknowledged their role.
Comments:
Acceptance Criteria Met Related Exception Reports Initial and Date Checked by Initial and Date
Y/N
Document is current if front page has “Controlled copy” stamped Page 7 of 14
Document ID: <PQ001>
Insert logo here
Revision No.: <nn>
Performance Qualification Template
Complete the table for all reference instruments used to confirm PQ test results, and confirm calibration status before use.
Acceptance Criteria: All identified test instruments have current calibration at the time of use.
2.1 U34
2.2 N/A
2.3
2.4
2.5
2.6
Comments:
Acceptance Criteria Met Related Exception Reports Initial and Date Checked by Initial and Date
Y/N
Document is current if front page has “Controlled copy” stamped Page 8 of 14
Document ID: <PQ001>
Insert logo here
Revision No.: <nn>
Performance Qualification Template
Execute the performance tests to ensure that system/equipment operates in accordance with specifications and regulatory requirements. Where additional
raw data is generated, attach it to the qualification protocol and list is Test Section 6. Where multiple trials are performed, copy this section as required.
Acceptance Criteria: Refer to individual tests.
Test Spe Test Description/Procedure Acceptance Criteria Actual Result Pass/ Initial & Date
No. c Fail
Ref.
3.1 U22
3.2 U27
3.3 N/A
3.4
Comments:
Acceptance Criteria Met Related Exception Reports Initial and Date Checked by Initial and Date
Y/N
Document is current if front page has “Controlled copy” stamped Page 9 of 14
Document ID: <PQ001>
Insert logo here
Revision No.: <nn>
Performance Qualification Template
List all exception reports generated during this qualification. Provide a brief summary of the information in the full reports.
Closed
Exception Brief Description of Initial &
Brief Description of Exception Brief Description of Cause (Yes/No
Report No. Resolution Date
)
This progression approval lists the minimum requirements for progression to the next phase of use for the equipment/system. Confirm that the progression
requirement has been met, or non-compliance has been adequately justified within an approved exception report. Provide justification for why progression
is acceptable prior to completion of all sections.
On completion of all tests and exceptions, completion the Final Disposition section of the certificate.
If all tests and exceptions are completed prior to progression, strike out the progression justification and approvals section.
Instructions
This progression approval lists the minimum requirements for progression to the next phase of use for the equipment/system. Confirm that the progression
requirement has been met, or non-compliance has been adequately justified within an approved exception report. Provide justification for why progression
is acceptable prior to completion of all sections.
On completion of all tests and exceptions, completion the Final Disposition section of the certificate.
If all tests and exceptions are completed prior to progression, strike out the progression justification and approvals section.
Progression Justification
Document Information
Revision History
Revision Modified by Change Description of Change
Control No.
01
Complete the above fields for each revision of this document. Ensure that there is
sufficient description of changes so that the change history of this document can
be followed. Additional columns can be added to include document/change
tracking numbers generated by your company’s systems if required (eg. change
control).
List all controlled procedural documents referenced in this document (for example,
policies, procedures, forms, lists, work/operator instructions
Associated records
Doc. No. Document Title
List all other referenced records in this document. For example, regulatory
documents, in-house controlled documents (such as batch record forms, reports,
methods, protocols), compliance standards etc.