QUALITY INDICATORS IN A HEMATOLOGY LABORATORY

 XXI međunarodna konvencija o kvalitetu JUSK ICQ – 29 – 31. maj 2025, Beograd, (158-165 str.)

 

АУТОР(И) / AUTHOR(S):  Danijela Ristovski-Kornic

 

Download Full Pdf   

DOI:  10.46793/XXIJUSK-ICQ.158RK

САЖЕТАК / ABSTRACT:

Quality indicators (QI) are an essential part of the quality management in health care systems that leads to monitor performance, process improvements and good decision-making. The aim of this study is to monitor and analyze seven common QI in a routine hematology laboratory that cover all phases of the laboratory process in order to achieve continuous improvement. This study included retrospective analysis of the recorded data over a period of one year. The following QI were examined: sample rejection rates, sample redo rates, turnaround time (TAT), critical reports, internal quality control failure (IQC), instrument breakdown, performance in External Quality Assurance Program (EQAS). The most frequent errors were in the pre-analytical phase 69.04%, followed by the post-analytical phase 27.66%, and the analytical phase 3.3%. The most common reasons for pre-analytical error were: clotted sample (50%), haemolysis (23.3%), incorrect sample volume (22.8%), unlabelled/mismatched sample (1.9%) and incorrect vacutainer (3.3%). In improving quality control procedures in clinical laboratories, modern adaptations of the Six Sigma methodology show great potential. The higher the Sigma level for a laboratory process, the better the system performance. Continuous monitoring of QI, with the use of appropriate corrective and preventive measures, can reduce errors in order to achieve the desired quality in all phases of the laboratory process.

КЉУЧНЕ РЕЧИ / KEYWORDS:

Quality indicator, Pre-analytical phase, analytical phase, post analytical phasе

ПРОЈЕКАТ / ACKNOWLEDGEMENT:

ЛИТЕРАТУРА / REFERENCES:

  • https://www.who.int/health-topics/quality-of-care#tab=tab_1
  • Kashyap A., Gurpreet K., Preeti T., Arijit S. Quality indicators in a hematology laboratory- a retrospective analysis.Int J Adv Med. 2020 Nov;7(11):1682-1686
  • Sciacovelli L, O’Kane M, Skaik AY, Caciagli P, Pellegrini C, Da Rin G, Ivanov A, Glys T, Plebani M. Quality Indicators in Laboratory Medicine: from theory to practice. Clin Chem Lab Med 2011; 49: 836–44.
  • Majkić-Singh N, Šumarac Z. Quality indicators of the pre-analytical phase. J Med Biochem 2012; 31 (3)
  • Garg M, Sharma N, Das S. Sigma Metrics Assessment as Quality Improvement Methodology in a Clinical Chemistry Laboratory. Indian J Med Biochem 2023;27(2):23–27.
  • Goel S, Nisal AR, Raj A, Nimbargi RC. Analysis of hematology quality control using six sigma metrics. Indian J Pathol Microbiol. 2024 Apr 1;67(2):332-335.
  • Dale JC, Novis DA. Outpatient phlebotomy success and reasons for specimen rejection. Arch Pathol Lab Med. 2002;126:416-9.
  • Shah P.,Vaghasiya K.,Kiran S.,Jarag M. N analysis of quality indicators in hematology laboratory at tertiary C re center. Glob. Sci. Res. 2024; 13(6): 168-170.
  • Rajashree K.,Anuradha S.,Deepti P.,Shashikala P. Assessing quality indicators in the hematology laboratory. Int J Med Pub Health. 2024;14(2): 674-676.
  • Goswami B.,Singh B.,Chawla R., Mallika V.Evaluation of errors in a clinical laboratory: a one-year experience. Clin Chem Lab Med. 2010;48(1): 63–66.
  • Codagnone T., Alencar S., Shcolnik W., Chaves S., Silva L., Henriques V.,Spitz L. The use of indicators in the preanalytical phase as a laboratory management tool. J Bras Patol Med Lab. 2014;50(2).
  • Sudarshan K, Das S., Hemalatha A., Raju K. Quality Audit of Haematology Laboratory: Challenges and Opportunities. Adv. hum. biol.2024;13 (Suppl 1):p S75-S79.
  • Sciacovelli L., Padoan A., Aita A., Basso D., Plebani M. Quality indicators in laboratory medicine: state-of-the-art, quality specifications and future strategies. Clin Chem Lab Med 2023; 61(4): 688–695
  • Kouser S., Abbas F., Ul Huda N., Pahore A., Kharrum S., Qureshi H.,Majeed M., Akram O., Rabbani W., Hassan S., Khan M.Review of Key Performance Indicator in a Hematology Laboratory: A Preventable Source of Error. J. Liaquat Univ. Med. Health Sci. 2023;22(01): 44–49.
  • Llopis MA, Trujillo G, Llovet MI, Tarrés E, Ibarz M, Biosca C, Ruiz R, Kirchner MJ, Alvarez V, Busquets G, Doménech MV, Figueres C, Minchinela J, Pastor RM, Perich C, Ricós C, Sansalvador M, Palmada MS. Quality indicators and specifications for key analytical-extranalytical processes in the clinical laboratory. Five years’ experience using the Six Sigma concept. Clin Chem Lab Med. 2011 Mar;49(3):463-70.
  • Quinn Mary A, Mary A K, Das S, Chaudhary N, Raju K. Analysis of the six sigma principles in the preanalytical quality of hematology samples. Cureus. 2023 Jul 25;15(7):e42434
  • Robiul F.Using six sigma to assess analytical performance of a hematology analyser. Indones. J. Clin. Pathol. Med. Lab.2019; 25(04):165