scholarly journals Application of Sigma Metrics Analysis for the Assessment and Modification of Quality Control Program in the Clinical Chemistry Laboratory of a Tertiary Care Hospital

2016 ◽  
Vol 32 (1) ◽  
pp. 106-109 ◽  
Author(s):  
Sahar Iqbal ◽  
Tazeen Mustansar
1969 ◽  
Vol 15 (11) ◽  
pp. 1039-1044 ◽  
Author(s):  
John R Allen ◽  
Rachel Earp ◽  
E Christis Farrell ◽  
H D Grümer

Abstract A quality control program utilizing both "known" and "blind" control specimens was analyzed in the routine clinical chemistry laboratory. The results obtained with the control samples of 18 automated and nonautomated procedures demonstrated the presence of analytical bias. Only through the evaluation of blind control samples tested at random times can a reliable measure of the proficiency of the laboratory be achieved.


2019 ◽  
Vol 6 (5) ◽  
pp. 1524
Author(s):  
Kavita Aggarwal ◽  
Saurav Patra ◽  
Viyatprajna Acharya ◽  
Mahesh Agrawal ◽  
Sri Krushna Mahapatra

Background: Six sigma is a powerful tool which can be used by laboratories for assessing the method quality, optimizing Quality Control (QC) procedure, change the number of rules applied, and frequency of controls run .The aim of this study was to quantify the defects or errors in the analytical phase of laboratory testing by sigma metrics and then represent the sigma value in Method Decision Chart.Methods: A retrospective study was conducted in a tertiary care hospital in Bhubaneswar, India. The clinical chemistry laboratory has been NABL accredited for the past 5 years and strictly quality checked.  Internal and external quality control data was collected for a period of six months from January - June 2018 for 20 biochemical analytes. Sigma metrics for each parameter was calculated and plotted on method decision chart.Results: The sigma metrics for level 2 indicated that 6 out of the 20 analytes qualified Six Sigma quality performance. Of these seven analytes failed to meet minimum sigma quality performance with metrics less than three and another seven analytes performance with sigma metrics was between three and six. For level 3, the data collected indicated that seven out of 20 analytes qualified Six Sigma quality performance, six analytes had sigma metrics less than 3 and seven analytes had sigma metrics between 3 and 6.Conclusion: In our study Sigma value was highest for amylase and lowest for potassium. Use of alternative methods and/ or change of reagents can be done for potassium to bring the sigma value within an acceptable range.


Author(s):  
Mohit Mehndiratta ◽  
Eram Hussain Pasha ◽  
Nilesh Chandra ◽  
Edelbert Anthonio Almeida

Abstract Objective The aim of this study was to study the incidence of preanalytical errors in the clinical chemistry laboratory attached to a tertiary care hospital. Design and Methods The study was conducted in a clinical chemistry laboratory using the samples and forms received for analysis. Five hundred random samples were analyzed using a predefined set of quality indicators (QIs) over a period of 3 months. The incidence of each preanalytical error was described as a percentage of the total samples analyzed in the study. Statistical Analysis Individual QIs were assigned values as 0 and 1 and were used to assess each sample; 0 if the error was present, and 1 if absent. The incidence of each preanalytical error was described as a percentage of the total samples analyzed in the study. Result Out of the 500 samples observed, 138 samples were error free, while 21 samples had the maximum number of errors, that is, 6. The error committed most often was the omission of provisional diagnosis being mentioned on the requisition form. No preanalytical error was observed for QIs: selecting the appropriate blood collection vial or storage of sample. Conclusion This study confirms that error rate in the preanalytical phase is high and vastly ignored. Errors committed here may be overlooked, given the large number of samples received in the clinical laboratory of a tertiary center. To reduce these errors, the laboratory should provide training to all workers involved in the preanalytical phase. Daily or weekly QI scores should be recorded to assess and rectify shortcomings, thereby improving patient care.


2018 ◽  
Vol 4 (1) ◽  
Author(s):  
Asim Qureshi ◽  
Nadira Mamoon ◽  
Imran Nazir Ahmad ◽  
Zafar Ali ◽  
Humaira Nasir ◽  
...  

Objective: The objective of this study was to evaluate the effectiveness of intradepartmental consultation conference (IDC) as a good quality control measure and problem-solving activity in a busy histopathology department.Methods: This study was done at the histopathology department of a tertiary care hospital over a period of 6 years from 2011 to 2016. IDC is routinely held at 2 pm daily on multi-header microscope. All the difficult and problematic cases are discussed. Discussed cases with the recommendations of IDC are recorded. The cases were extracted from the record of IDC being maintained since 2011. All the record sheets were analysed and the cases were divided organ and system wise.Results: A total of 5766 (6.5%) cases were discussed in this 6-year period of a total of 89,253 cases reported at our centre. Of these, 2198 (38%) were solved on first viewing, 1783 (31%) in the second viewing and 1691 (29%) in thethird viewing. In total, 98% of the cases were resolved until the third viewing, leaving only 94 (2%) cases in which further studies were recommended. A variable number of pathologists were present in the meeting, and an average of4 was present in majority of the occasions.Conclusion: IDC is a good quality control measure to ensure quality in a busy histopathology department and an effective problem-solving activity.Key words: Intradepartmental consultation, histopathology, cancer


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