External Quality Assessment Scheme (IEQAS) in Haematology at National Institute of Health, Islamabad, Pakistan

Objective: To document overall performance and improvement, if any, gained through participation in an International External Quality Assessment Scheme (IEQAS). Study Design: Descriptive study. Place and Duration of Study: The Haematology Department, Public Health Laboratories Division, National Institute of Health, Islamabad, Pakistan, from January 1996 to December 2006. Methodology: Overall performance of blood parameters and parasite identification were analysed. Individual values were assessed against consensus value (mean +/- SD) and deviation index (DI) from the mean, whereas coefficients of variation (CV) were calculated for years 1996 to 2006. The results are expressed as percentage of accurate versus inaccurate results, deviation index (DI) and coefficient of variation (%CV). Results: The laboratory achieved 87.74% of values within acceptable limits for haemoglobin, 72.03% for white blood count, 69.49% for platelet and 77.03% for reticulocyte estimation. Results were satisfactory, having DI values less than 3 for all four parameters. %CV values was found to be dependent on the type of test performed and varied among different parameters. Difficulty has been observed in identifying Plasmodium malariae and ovale. Conclusion: Participation in External Quality Assessment Schemes is extremely beneficial for the improvement of laboratory performance and quality of care. Evaluation of the survey results on a regular basis serves as a useful guide to assess overall performance of the laboratory. Standardization of analytical procedures, equipments and reagents, continuous monitoring of personnel competency and thorough investigation of discordant results significantly contributes to the delivery of quality diagnostic services.