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External Quality Assessments in Cambodia. Presented by Mom Chandara. EXTERNAL QUALITY ASSESSMENTS (EQA).
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External Quality Assessments in Cambodia Presented by Mom Chandara
EXTERNAL QUALITY ASSESSMENTS(EQA) EQA refers to a system in which laboratory results are scrutinized objectively by an outside agency in order to get a general impression of the standard of laboratory practice and to achieve inter-laboratory comparability. (Sudarshan Kumari, et. al., 1998)
REQUIREMENT Of EQA PROGRAM EQA includes submission of samples to participating laboratories; analysis by them and returning of the results to the EQA organizer who performs the statistical analysis and sends feedback to participants so that they may judge their individual performances. (Sudarshan Kumari, et. al., 1998)
Purpose of an EQA Program • To assure that quality laboratory results are provided to the public (MD’s, patients) • To assess and compare the quality of laboratory performance on a national and/or international scale. • To identify common errors and recommend corrective measures.
Purpose of an EQA Program • To encourage the use of standardized procedures, good quality reagents and good working practices • To encourage the continuous application of measures for IQC. • An educational tool for the laboratory involved in the program.
EQA Programs in NLPH • Until 2002 National Laboratory of Public Health did not participate in any External Quality Assessment program • 2002 NLPH linked to “QC OnCall” (Biorad) to assess the QC data of Hematology and Biochemistry • 2003 NLPH connected to EQAS network at NRL, Melbourne, Australia for Serology
EQA Programs in NLPH • 2004 NLPH started EQAS program for Hematology with Royal College of Pathologists of Australia (RCPA) • 2004NLPH subscribed for BioRad’s EQAS program for Biochemistry.
QC OnCall Program for NLPH (1) • QC data for Hematology and Biochemistry of NLPH are compared with other laboratories in this program. • QC data are reported monthly to QC OnCall program • Receipt of QC result report 4 weeks later - Laboratory performance overview - Laboratory comparison - Laboratory histogram • Review of the report by technical group of NLPH
EQAS Program in NLPH (2) SEROLOGY (NRL, Australia): Serum panels 2 times/year: - HIV1/2 - HBs-Ag - HCV-Ab HEMATOLOGY(RCPA): 2 blood samples/month for 6 parameters: WBC, Hb, RBC, HCT, PLT, and MCV
EQAS Program in NLPH (3) BIOCHEMISTRY (BioRad) Clinical Chemistry samples of 17 parameters are run 2x/month and the results are reported directly to BioRad EQAS
Problems experienced in Cambodia with EQAS • High costs • Delay of specimen reception in Cambodia - not in time - storage in customs - unclear responsibilities • Delay of EQAS result reports
Future EQAS programs in NLPH • Subscription to EQAS program for Flow Cytometry (CD4/CD8) established (July 2004) • EQAS program for Microbiology planned for next year