External quality assurance experience with Royal College of Pathologists of Australasia Program at an academic hospital in South Africa

Author:

Mokoka Ngwanatala Sophia1ORCID,Schapkaitz Elise1ORCID,Louw Susan1ORCID

Affiliation:

1. Department of Molecular Medicine and Hematology, Faculty of Health Sciences, University of Witwatersrand Medical School , Johannesburg , South Africa

Abstract

Abstract Introduction Laboratories use their performance in external quality assurance (EQA) to establish quality planning strategies and to assess whether testing processes require improvement. Methods The EQA performance of the hematology and coagulation test parameters on the Royal College of Pathologists of Australasia EQA program was evaluated over a 4-year cycle at an academic hospital in Johannesburg, South Africa. The test performance was determined from analytical quality specification (APS) and/or z-scores. Bias and imprecision were used to calculate sigma (σ) metric scores. Specifications from European Federation of Laboratory Medicine and/or biological variation were applied. Results The laboratory achieved a mean testing score of 98.7 ± 4.0%. There were 103 (10.7%) unacceptable results. On investigation, root causes included: presurvey issues (83%), transcription errors (9%), random errors (6%), and test performance errors (3%). All test parameters evaluated achieved an acceptable median APS during the study period. The mean z-scores, however, were >2 and unacceptable for mean cell hemoglobin concentration and hematocrit. On investigation, this was attributed to significant delay in transport and storage of full blood count samples. White cell count and d-dimer achieved a σ ≥ 6. Conclusion EQA participation assisted the laboratory in maintaining a quality system. Close monitoring is necessary for international laboratories to avoid sample delays that can affect result quality.

Publisher

Oxford University Press (OUP)

Reference26 articles.

1. Characterization and classification of external quality assessment schemes (EQA) according to objectives such as evaluation of method and participant bias and standard deviation. External Quality Assessment (EQA) Working Group A on Analytical Goals in Laboratory Medicine;Libeer;Eur J Clin Chem Clin Biochem.,1996

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