Department of pathology and laboratory medicine at Jigme Dorji Wangchuck National Referral Hospital striving for quality: external quality assessment scheme in hematology

2016 ◽  
Vol 2 (1) ◽  
pp. 5-10
Author(s):  
Kuenzang Dorji ◽  
Rixin Jamtsho ◽  
Puja D. Samal ◽  
Partab Rai ◽  
Dorji Wangchuk
Keyword(s):  
Quality Assessment ◽  
External Quality Assessment ◽  
Internal Quality ◽  
External Quality ◽  
External Quality Assessment Scheme ◽  
Gradual Improvement ◽  
Laboratory Services ◽  
Effective System ◽  
Corrective Actions

Introduction: Quality Assurance comprising External Quality Assessment Scheme (EQAS) and Internal Quality Control (IQC) is an indispensible part of the laboratory analytical process to ensure reliable results from the laboratories. However, due to various challenges in many developing countries such as limitations in resources and manpower, EQAS samples are often given less importance at laboratories. The objective of this study is to assess performance on hematology EQAS samples received from Pacific Paramedical Training Center- External Quality Assesment Scheme (PPTC-EQAS) and International External Quality Assesment Scheme-United Kingdom (IEQAS-UK)since 2007 and 2008 respectively. The findings from this study will be helpful to establish an effective system to ensure timely follow up and corrective actions to improve the quality of laboratory services. Methods:The feedback of the EQAS results submitted thrice a year to the PPTC-EQAS and six times a year to the IEQAS-UK since 2007 and 2008 respectively were reviewed to assess the laboratory’s performance and to determine the effectiveness of EQAS participation for improving the performance of laboratory hematology in Bhutan. Results:For PPTC-EQAS, the average yearly scores were 69.00%, 75.00%, 87.66%, 87.50%, 70.00%, 80.33%, 80.50%, 85.00% for the years 2007-2014. For IEQAS-UK, the average yearly scores were 76.66%, 75.95%, 77.91%, 85.83%, 92.50%, 63.88% and 98.14% for the years 2008-2014. Our results show inconsistent performances on both EQAS samples despite gradual improvement over the last seven years. Conclusions:We conclude that, strengthening the system for regular follow up and implementing corrective actions for the outlying results in addition to replacement of the equipment could improve the trend and ensure consistency of the performance.

Quality assurance in laboratory haematology

1993 ◽  
Vol 101 ◽  
pp. 283-310
Author(s):  
S. M. Lewis
Keyword(s):  
Quality Control ◽  
Quality Assurance ◽  
Quality Assessment ◽  
Blood Count ◽  
External Quality Assessment ◽  
Blood Film ◽  
Test Reliability ◽  
Internal Quality ◽  
External Quality ◽  
External Quality Assessment Scheme

SynopsisQuality assurance in laboratory haematology includes (a) constant checking of test reliability by internal quality control, (b) external quality assessment by an independent agency to check performance of a number of laboratories at intervals in order to obtain a retrospective indication of their ability and (c) proficiency control by supervision of the pre-test and post-test phases of laboratory work, from specimen collection to delivery of the report to the clinician.The procedures which comprise quality control are described; these include use of control preparations with control charts, CUSUM analysis, constancy of daily means of the blood count indices of ‘absolute values’, duplicate testing, clinical correlation and the important role of the blood film to check the instrument-derived blood count measurements.A description of the functions of an external quality assessment scheme is based on the UK National Scheme (UK NEQAS). The blood count and other tests of general haematology have been used as models to describe the procedures for qualitative and quantitative tests, low results are analysed and performance is assessed. The tribulations and triumphs of NEQAS are described and it is concluded that NEQAS has a vital role in ensuring good laboratory practice in general, and the reliability of the individual laboratories who participate in the scheme. NEQAS, in turn, must ensure its own ability to provide stable materials which are suitable for each test in the programme, and to analyse data correctly. There is also need to take account of the continued expansion of laboratory services as new techniques are introduced and to develop appropriate EQA procedures and materials in order to incorporate these in a comprehensive scheme.

Combi scheme: new combined internal/external quality-assessment scheme in The Netherlands

1991 ◽  
Vol 37 (7) ◽  
pp. 1196-1204 ◽  
Author(s):  
Herman Steigstra ◽  
Rob T Jansen ◽  
Henk Baadenhuijsen
Keyword(s):  
The Netherlands ◽  
Quality Assessment ◽  
Internal Control ◽  
External Quality Assessment ◽  
Clinical Chemistry ◽  
Laboratory Data ◽  
Data Communication ◽  
Professional Organization ◽  
Internal Quality ◽  
External Quality

Abstract The Dutch Foundation for Quality Assessment in Clinical Chemistry (SKZL) is the professional organization that conducts external quality-assessment schemes in The Netherlands. However, such schemes in fact assess the performance of the internal quality-control systems of the participating laboratories. In this paper we describe a new concept, relating the data for internal control materials with those for external samples and thereby leading to a combined external/internal scheme (Combi). The statistical principles underlying the Combi scheme are discussed and examples of the graphical presentation of the results are shown. Because the laboratory data are transmitted over the public telephone system to the computers of the SKZL, we also describe the principles of the data communication. At two-month intervals a statistical presentation is sent to all participants. The central database is updated daily with the received results, making possible an on-line consultation regarding the statistics of the accumulated findings of the control materials in use.

Establishing an Accuracy Basis for the Vitamin D External Quality Assessment Scheme (DEQAS)

2017 ◽  
Vol 100 (5) ◽  
pp. 1277-1287 ◽  
Author(s):  
Carolyn Q Burdette ◽  
Johanna E Camara ◽  
Federica Nalin ◽  
Jeanita Pritchett ◽  
Lane C Sander ◽  
...  
Keyword(s):  
Vitamin D ◽  
Quality Assessment ◽  
External Quality Assessment ◽  
Measurement Procedure ◽  
Binding Assays ◽  
External Quality ◽  
External Quality Assessment Scheme ◽  
Hydroxyvitamin D ◽  
Target Values ◽  
High Concentrations

Abstract Until recently, the Vitamin D External Quality Assessment Scheme (DEQAS) assessed the performance of various assays for the determination of serum total 25-hydroxyvitamin D [25(OH)D] by using a consensus mean based on the all-laboratory trimmed mean (ALTM) of the approximately 1000 participants' results. Since October 2012, the National Institute of Standardsand Technology (NIST), as part of the Vitamin D Standardization Program, has participated in DEQAS by analyzing the quarterly serum sample sets using an isotope dilution LC-tandem MS (ID LC-MS/MS) reference measurement procedure to assign an accuracy-based target value for serum total 25(OH)D. NIST has analyzed90 DEQAS samples (18 exercises × 5 samples/exercise) to assign target values. The NIST-assigned values are compared with the ALTM and the biases assessed for various assays used by the participants, e.g., LC-MS/MS, HPLC, and several ligand-binding assays. The NIST-value assignment process and the resultsof the analyses of the 90 DEQAS samples are summarized. The absolute mean bias between the NIST-assignedvalues and the ALTM was 5.6%, with 10% of the samples having biases >10%. Benefits of the accuracy-based target values are presented, including for sample sets with high concentrations of 25(OH)D2 and 3-epi-25(OH)D3.

Correlates of External Quality Assessment and Improvement Programs in Internal Auditing: A Study of 68 Countries

2016 ◽  
Vol 15 (2) ◽  
pp. 53-71 ◽  
Author(s):  
Steven M. DeSimone ◽  
Mohammad Abdolmohammadi
Keyword(s):  
Quality Assessment ◽  
Audit Committee ◽  
External Quality Assessment ◽  
Internal Audit ◽  
Data Availability ◽  
Internal Quality ◽  
External Quality ◽  
Improvement Programs ◽  
Quality Assessment And Improvement ◽  
Committee Involvement

ABSTRACT We use survey responses from 1,053 chief audit executives (CAEs) of public companies located in 68 countries to investigate the theoretical correlates of the use of external quality assessment and improvement programs (ExternalQAIP) for the Internal Audit Function (IAF). Our test variables are (1) internal quality assessment and improvement programs (InternalQAIP) and its related components and IAF performance measures, (2) chief audit executive competence, (3) audit committee involvement with the internal audit, (4) IAF age, (5) IAF outsourcing status (in-house or outsourced), and (6) the nature of the IAF's work (work performed by IAF). We find support for our hypothesized associations between various measures of InternalQAIP and ExternalQAIP. We also find significant and positive results for associations between audit committee involvement and IAF age and ExternalQAIP. However, we do not find significant results for in-house or outsourcing of internal audit activities, CAE competence, or control variables. Our results should be of interest to management, CAEs, corporate boards, regulators, and external auditors. Data Availability: Please contact The Institute of Internal Auditors Research Foundation (IIARF) that owns the CBOK (2010) database used in this study.

Precision and accuracy of commercial assays for vancomycin therapeutic drug monitoring: evaluation based on external quality assessment scheme

2020 ◽  
Author(s):  
Chao-Yang Chen ◽  
Meng-Ya Li ◽  
Ling-Yun Ma ◽  
Xing-Yu Zhai ◽  
Dao-Huang Luo ◽  
...  
Keyword(s):  
Serum Concentration ◽  
Quality Assessment ◽  
Bacterial Infections ◽  
External Quality Assessment ◽  
Detection Methods ◽  
Therapeutic Drug ◽  
External Quality ◽  
External Quality Assessment Scheme ◽  
Percentage Difference ◽  
Precision And Accuracy

Abstract Background Vancomycin remains a mainstay of the treatment of Gram-positive bacterial infections. It is crucial to accurately determine vancomycin serum concentration for adequate dose adjustment. Objectives To evaluate the precision and accuracy of commercial assay techniques for vancomycin concentration and to assess the comparability of vancomycin detection methods in Chinese laboratories. Methods Human serum samples spiked with known concentrations of vancomycin were provided to laboratories participating in the external quality assessment scheme (EQAS). Assay methods included chemiluminescence, enzyme immunoassay (EIA) and so on. The dispersion of the measurements was analysed and the robust coefficient of variation (rCV), relative percentage difference (RPD) and satisfactory rate for method groups were calculated. Moreover, performance of the Chinese laboratories was assessed. Results A total of 657 results from 75 laboratories were collected, including 84 samples from 10 Chinese laboratories. The median rCV, median RPD and satisfactory rates classified by methods ranged from 1.85% to 15.87%, −14.75% to 13.34% and 94.59% to 100.00%, respectively. Significant differences were seen in precision, between kinetic interaction of microparticles in solution (KIMS) and other methods, and in accuracy, between enzyme-multiplied immunoassay technique (EMIT), fluorescence polarization immunoassay (FPIA) and other techniques. Vancomycin detection in China mainly depended on the chemiluminescence and EMIT methods, which tended to result in lower measurements. Conclusions Although almost all assays in this study achieved an acceptable performance for vancomycin serum concentration monitoring, obvious inconsistencies between methods were still observed. Chinese laboratories were more likely to underestimate vancomycin concentrations. Thus, recognizing inconsistencies between methods and regular participation in vancomycin EQAS are essential.

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