EXTERNAL QUALITY ASSURANCE EQA

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• EXTERNAL QUALITY ASSURANCE (EQA)
• is a fundamental component of laboratory
• performance monitoring.
• helps identify potential areas of error within
• the laboratory that Internal QC may fail to
• highlight.
• is a valuable on-going teaching resource

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• The objectives of EQA are
• To establish inter-laboratory comparability
  (accuracy).
• To influence the reliability of future testing.
• To ensure credibility of the laboratory.
• In stimulating performance improvements.

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The Role of EQA in Laboratory Medicine
External Quality Assessment (EQA) is a service
where participating clinical laboratories are
sent samples on a regular basis which they test
as if they had come from patients.  Results are
returned to EQA centres which provide a report
that compares the participant's performance with
that of all laboratories and/or groups of
laboratories using the same test method(s).
EQA complements the Internal Quality Control
(IQC) procedures that laboratories use to monitor
within- and between-analytical run variability.
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EXTERNAL QUALITY ASSURANCE Quality ensures
right result at right time on the right
specimen from right patient using right
technique to test it.
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• The consequences of poorly performed /reported
  investigations can be very damaging
• Some of these consequences are
• It may lead to inappropriate action, e.g
  over-investigations, treatment or mistreatment.
• inappropriate inaction, e.g.,
• lack of investigations when required or
  non-treatment.

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• It may lead to delayed action due to lack of
  results or delayed results.
• .It may lead to loss of credibility of the
  laboratory.

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AVALIABLE EQA SCHEMES UK NEQAS United Kingdom
National External Quality Assessment
Service http//www.ukneqas.org.uk/ UK NEQAS
gives objective information and advice to
clinical laboratories throughout laboratory
medicine on the quality of their analytical and
interpretative performance, in order to help them
provide accurate and reliable test results and
advice to clinicians, which facilitates optimal
patient care.
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UK NEQAS Office Postal address P. O. Box 401
Sheffield S5 , 7YZ, United Kingdom
Electronic mail      General Information    
  office_at_ukneqas.org.uk                          
     Scheme design science
  queries_at_ukneqas.org.uk
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W.H.O. COLLABORATING CENTRE FOR EXTERNAL QUALITY
ASSESSMENT IN CLINICAL MICROBIOLOGY CONTACT
Prof. Em. Dr J. Vandepitte, Bacteriologie
Prof, Dr J. Verhaegen
Universitair Ziekenhuis St-Rafael
B-3000 Leuven Belgium
Tel [phone]
Fax [phone]
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W.H.O. / NHLS QUALITY ASSESSMENT PROGRAM RUN BY
THE SOUTH AFRICAN INSTITUTE OF MEDICAL
RESEARCH CONTACT Prof Mike Stewart e - mail
qc_at_mail.saimr.wits.as.za
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W.H.O COLLABORATING CENTRE FOR ANTIMICROBIAL
RESISTANCE MONITORING (G08) CONTACT Dr Fred C.
Tenover, PhD Or Laura Jevitt Anti-infectives
Investigation Section, Epidemiology and
Laboratory Branch, Centres for Disease Control
and Prevention, 1600 Clifton Rd, NE MS G 08,
Atlanta, GA 30333
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• WHAT DO THEY INVOLVE
• COST
• UKNEQAS It costs approx  GBP700 for the scheme
  and about GBP110 for each shipment.
• DISTRIBUTION There are 10 distributions of 4
  samples each/year. Each distribution has one
  sample for antibiotic sensitivities (they are
  thinking of making this 2/distribution).

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2. WHO SCHEME Two distributions a year
consisting of two tests each. Participation is
free apart from local costs. LAB SKILLS Lab
staff at least OND, ability to perform blood
cultures, antibiotic sensitivity tests, API
tests, serotyping, microscopy etc. TIME
Specimens processed alongside other patient
samples hence no extra time is required.
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SIMULATED EQA SPECIMEN SPECIMEN Throat
swab. Request Isolation of likely
pathogen Procedure Reconstitute the sample
following attached procedure. Plate onto
Chocolate and Blood agar plates. Incubate 370C
with 5 CO2. For 24 hours. Check for growth of
alpha haemolytic raised colonies. Perform Gram
stain ( neg capsulated diplococci or strep in
short chains). RESULTS Fill the results in the
form provided and send back to for evaluation
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WAY FORWARD IT IS ADVISABLE TO START WITH THE
WHO/CDC PROGRAM AND BUILD CAPACITY FOR THE MORE
RIGOROUS AND MORE FREQUENT NEQAS SCHEME
LATER. THE UKNEQAS SCHEME IS MORE EXPENSIVE AND
MORE INVOLVING. THERE ARE MORE SCHEMES
AVAILABLE. ANY THOUGHTS FROM THE AUDIENCE???