Monitoring of Quality Indicators in Pre Analytical Phase of Testing in the Clinical Biochemistry Laboratoryof A Tertiary Care Hospital Attached with Government Medical College.

Abstract

Introduction: Quality indicators (QIs) are fundamental tools enabling users to quantify the quality of laboratory services. Pre-analytical errors account for more than 70% of the total number of laboratory errors. Objective: To quantify performancein the pre analytical phase of testing in Clinical Biochemistry Laboratory, using quality indicators and compare our results with those in the literature to assess the quality of our laboratory services. Methods:For preanalytical phase there are various QIs defined by International Federation of Clinical Chemistry (IFCC) and Laboratory Medicine Working Group on Laboratory Errors and Patient Safety (WG-LEPS),among them we monitored four QIs. (1)Sample lost (QI-8) (2) Sample with inappropriate anticoagulant (QI-9) (3) Hemolyzed sample (QI-10) and (4)Sample with insufficient Quantity(QI-12).The data pertaining to these QIs was collected and QI scores were calculated between 1 st January to31 st October, 2015. We then compared the QI scores with the quality specifications laid down in IFCC (WG-LEPS).We also calculated the Six sigma value for QIs. Results: During the 10 months period, a total of 138262 samples were received in Clinical Biochemistry Laboratory. In this period 2012 preanalytical errors associated with these four QIs were recorded, accounting for 1.4 %(2012/138262) of thetotal number of samples received. Among total preanalytical errors,1.5 %(31/2012) were (QI-8), 0.9% (19/2012) were (QI-9), 12.9 %(261/2012) were (QI-10) and 84% (1701/2012) were (QI-12) When these results were compared with specifications of IFCC (WG-LEPS), QI-8, QI-9 and QI 10 were found to be within optimal level whereas QI-12 was within desirable range. Sigma value for (QI-8), (QI-9), (QI-10) and (QI-12)QIs were 5.0,5.2, 4.5 and 3.8respectively. Conclusion: The preanalytical performance of our laboratoryis favorable and complies with international qualityspecifications.