Abstract
In Croatian medical laboratories (ML), external quality assessment (EQA) has a long tradition of almost half of a century. At national level, EQA is provided by Croatian Centre for Quality Assessment in Laboratory Medicine (CROQALM) which is a part of Croatian Society of Medical Biochemistry and Laboratory Medicine. This case study aimed to summarize the main challenges, which are set to CROQALM and their possible solutions. CROQALM has 10 schemes, covering majority of analysis for which medical biochemistry laboratories in Croatia are authorized for, including pre-analytical and post-analytical phase of laboratory work. Assessment scheme has three exercises per year. One sample per scheme and exercise is distributed to participants depending on their application. All data transfer and evaluation of the results are done using web interface and statistical software for evaluation of quality in laboratory medicine. Since CROQALM has relatively small number of participating laboratories (N = 197) with lot of different manufacturers of instruments used for analysis in all schemes, constant challenges are present in the evaluation of the results (commutability problems, statistical analysis etc.). Further, number of participating medical laboratories is even lower for highly specific parameters, which are in the scope of clinical laboratories only. Despite the obstacles we are faced to, EQA at national level is useful tool regarding standardization and harmonization aspects in total testing process within the country. Furthermore, it gives participating laboratories recognition and proof for meeting expected quality criteria in the community they serve.
Highlights
External quality assessment (EQA) is a widely accepted tool for monitoring and improving method performance in the medical laboratory (ML).Croatian Centre for Quality Assessment in Laboratory Medicine (CROQALM) is a part of the Croatian Society of Medical Biochemistry and Laboratory Medicine (CSMBLM) and serves as a quality evaluation scheme in laboratory medicine at national level
Participation in CROQALM is mandatory for every ML in Croatia
Peer group consensus value is the basis for laboratories evaluation throughout whole Croatian EQA scheme
Summary
External quality assessment (EQA) is a widely accepted tool for monitoring and improving method performance in the medical laboratory (ML).Croatian Centre for Quality Assessment in Laboratory Medicine (CROQALM) is a part of the Croatian Society of Medical Biochemistry and Laboratory Medicine (CSMBLM) and serves as a quality evaluation scheme in laboratory medicine at national level. Each laboratory receives report showing calculated percentage deviation of the result from corresponding peer group mean and z-score in absolute number showing positioning of the individual result regarding target value and standard deviation after outlier exclusion. Category 1 EQA scheme is the most challenging one, requiring distribution of commutable, replicate samples with values assigned by reference method.
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