UK National Renal Transplant EQA Scheme

1
UK National Renal Transplant EQA Scheme
Ian Roberts Department of Cellular Pathology,
Oxford Radcliffe Hospitals
The National Renal Transplant EQA Scheme is
sponsored by Fujisawa Ltd
2
EQA in Histopathology

• maintenance improvement of diagnostic standards
• education vs performance assessment
• required for CPD and CPA
• RCPath EQA steering committee -
• sets performance standards
• investigates substandard performance

3
EQA in Histopathology

• substandard performance
• anonymous letter of enquiry
• NQA Advisory panel informed and determine
  whether low EQA scores reflect standards of
  routine practice
• site visit
• review panel
• Medical Director informed

4
EQA in Histopathology
these procedures should be activated only in
exceptional circumstances, and should cause no
more concern to EQA participants than the
possibility of being reported for incompetence by
a colleague
5
EQA in Histopathology
slides circulated to participants responses
submitted to scheme organiser feedback of group
diagnoses to participants cases discussed at
participants meeting diagnoses scored persistent
substandard performers identified remedial action
6
Renal Transplant EQA Scheme
slides circulated to participants responses
submitted to scheme organiser feedback of group
diagnoses to participants cases discussed at
participants meeting
slides circulated to participants responses
submitted to scheme organiser feedback of group
diagnoses to participants cases discussed at
participants meeting
7
Renal Transplant EQA Scheme

• 44 participants from 31 centres
• Case submission
• 7 sets of slides (HE and PAS/silver)
• diagnostic lesion is present in all slides
• biopsy is adequate by Banff criteria

8
(No Transcript)
9
Renal Transplant EQA Scheme

• participants divided into 6 cells
• Circulations organised using Genpath software
• sets circulation dates
• automatic reminder letters

10
(No Transcript)
11
(No Transcript)
12
Educational value

• enables pathologists to compare their diagnoses
  and their Banff grading with the whole group
• identifies differences in use of terminology
• identifies misunderstanding of the Banff
  classification and its application
• ongoing measure of the reproducibility of Banff
  criteria
• highlights areas of diagnostic difficulty

13
Terminology
14
Application
15
Reproducibility
16
Reproducibility
17
Reproducibility
18
Difficult diagnoses
19
Difficult diagnoses
20
Renal Transplant EQA Scheme

• identifies practical difficulties in the
  application of the Banff schema in routine
  practice
• identifies areas of diagnostic difficulty that
  should be specifically addressed in the future

21
Renal Transplant EQA Scheme

• identifies practical difficulties in the
  application of the Banff schema in routine
  practice
• identifies areas of diagnostic difficulty that
  should be specifically addressed in the future
• for the patients
• improves the diagnostic accuracy of the
  pathologist looking at their biopsy

22
(No Transcript)