Evaluation of the Quality Indicators in Laboratories at National AIDS Research Institute, Pune, India
Keywords:
Quality indicator, Pre-analytical, analytical, post-analytical, quality controlAbstract
Introduction: Quality indicators in a clinical laboratory are considered as useful tools for continual improvement of the laboratory services.
Aim: The aim of this study was to assess timely performance of the NARI service laboratories in three phases of testing - pre-analytical, analytical and post-analytical, in an effort to improve their performance.
Methodology: The study included an assessment of different quality indicators from six laboratories - Clinical Biochemistry, Hematology, Serology, Microbiology, Virology and Immunology at the NARI central laboratory which provide service for the patient care.
Results: Data obtained from a total of 39139 clinical samples collected over a period of two years was used in the study. The overall error rate was found to be 2.72%. The commonly observed indicators were revision of the laboratory requisition form (0.49%) and sample rejection (0.31%) during the pre-analytical phase, equipment breakdown (0.12%) and failure of the controls (0.03%) during the analytical phase, turnaround time (1.55%) and revision of the report form (0.15%) during the post- analytical phase.
Conclusions: Quality indicators are important tools in improving the quality system in a clinical laboratory and patient care.
References
World Health Organization’s Regional Office for Africa. Resolution AFR/RC58/R2: Strengthening Public Health Laboratories in the WHO African Region: a critical need for disease control. In: Final Report: 58th Session of the WHO Regional Committee for Africa. Yaounde, Republic of Cam-eroon: World Health Organization’s Regional Office for Af-rica, 2008; p11-13
Agarwal R, Chaturvedi S, Chhillar N, Goyal R, Pant I, Tripa-thi CB. Role of Intervention on Laboratory Performance: Evaluation of Quality Indicators in a Tertiary Care Hospital. Indian J of Clin Biochem. 2012; 27: 61-68.
Carraro P, Plebani M. Errors in a stat laboratory: types and frequencies 10 years later. Clin Chem. 2007; 53:1338-42.
Codagnone F, Alencar S , Shcolnik W , Chaves S ,Silva L , Henriques V, Spitz L. The use of indicators in the pre-analytical phase as a laboratory management tool. J Bras Patol Med Lab 2014; 50: 100-104
Plebani M, Sciacovelli L, Aita A, Padoan A, Chiozza ML. Quality indicators to detect pre-analytical errors in labora-tory testing. Clin Chim Acta. 2014; 15; 432:44-8.
Furtado V , Shusaku S , Mendes M , Massakazu N . Useful-ness of quality indicators in the management of clinical la-boratories. J Bras Patol Med Lab 2011;47:201-210
Phlebani M. Quality specifications: self pleasure for clinical laboratories or added value for patient management? Clin Chem Lab Med 2007; 45:462–6
McCay L, Lemer C, Wu AW. Laboratory safety and the WHO World Alliance for Patient Safety. Clin Chim Acta 2009 ; 404:6-11
International Organization for standardization ISO 15189: 2012-Medical laboratories requirements for quality and competence. Geneva, Switzerland. 2012. http://www.iso. org
Bureau of Indian Standards. Indian Standards Medical La-boratories- Particular Requirements for quality and compe-tence. First Revision. New Delhi: Bureau of Indian Stand-ards; 2010
Chawla R, Goswami B, Singh B, Chawla A, Gupta VK, Mal-lika V. Evaluating laboratory performance with quality in-dicators. Lab medicine. 2000;41:297–300
Goswami B, Singh B, Chawla R, Venkatesan M. Evaluation of errors in a clinical laboratory: a one-year experience. Evaluation of errors in a clinical laboratory: a one year ex-perience, Clin Chem Lab Med; 2010; 48: 63-66
Gupta V, Negi G, Harsh M, Harish C, Agarwal A, Shrivasta-va V. Utility of sample rejection rate as a quality indicator in developing countries. The journal of national accredita-tion board for hospitals & health care providers 2015;2(1):30-35
Chawala R, Goswami B, Tayal B, Mallika B. Identification of the types of Pre-analytical Errors in Clinical Chemistry La-boratory: 1-Year Study at G.B Pant Hospital. Lab Medicine 2010;41:89-93
Soni S, Katara R, Nanera A, Goswami H, Vegad M. Sample rejection as a quality indicator for continual improvement of Laboratory Services, Tertiary Care Hospital. NJIRM; 2014:5: 72-75
Chhillar N, Khurana S, Agarwal R, Singh NK. Effect of pre-analytical errors on quality of laboratory medicine at a neu-ropsychiatry institute in north India. Indian J Clin Biochem 2011;26:46-9
Kirchner MJ, Funes VA, Adzet CB, Clar MV, Escuer MI, Gi-rona JM et al. Quality indicators and specifications for key processes in clinical laboratories: a preliminary experience. Clin Chem Lab Med. 2007;45:672-7
Stark A, Jones BA, Chapman D, Well K, Krajenta R, Meier FA et al. Clinical laboratory specimen rejection: Association with the site of patient care and patients′ characteristics: Findings from a single health care organization. Arch Pathol Lab Med 2007; 131:588-92.
Guimarães AC, Wolfart M, Brisolara ML, Dani C. Causes of rejection of blood samples handled in the clinical laboratory of a University Hospital in Porto Alegre. Clin Biochem. 2012 ;45:123-6
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The authors retain the copyright of their article, with first publication rights granted to Medsci Publications.
