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External quality assurance in Malaysia.

H Nawawi1, H H Lim, I Zakiah

  • 1Department of Pathology, Hospital UKM, Kuala Lumpur, Malaysia.

The Southeast Asian Journal of Tropical Medicine and Public Health
|August 5, 2000
PubMed
Summary
This summary is machine-generated.

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The National External Quality Assessment Scheme (NEQAS) for clinical chemistry improves laboratory analytical performance through regular monitoring and feedback. While challenges exist, the program fosters gradual improvement and method standardization in participating laboratories.

Area of Science:

  • Clinical Chemistry
  • Laboratory Quality Management
  • Medical Diagnostics

Background:

  • The Ministry of Health Quality Assurance (QA) Programme includes the National External Quality Assessment Scheme (NEQAS) for clinical chemistry.
  • NEQAS monitors analytical performance in routine biochemical testing across pathology laboratories.
  • Performance scores identify deficiencies and provide feedback on remedial actions.

Purpose of the Study:

  • To assess the effectiveness of the NEQAS in improving analytical performance in clinical chemistry.
  • To identify factors contributing to unsatisfactory performance, such as instrumentation, reagents, methods, and laboratory management.
  • To guide future planning for enhancing the NEQAS and quality control activities.

Main Methods:

  • Monitoring of analytical performance through variance index scores (VIS) in regular quality assessment challenges.

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  • Analysis of repeated unsatisfactory scores to identify root causes, including laboratory management and equipment.
  • Evaluation of the NEQAS program through workshops, forums, and quality improvement assessments.

    • Main Results:

    • NEQAS participation has led to slow but gradual improvement in overall laboratory performance.
    • A trend towards method upgrading and standardization for better result concordance has been observed.
    • Unsatisfactory individual analyte scores often linked to technical issues, while repeated failures point to poor laboratory management.

    Conclusions:

    • NEQAS is crucial for improving analytical performance in clinical chemistry laboratories, as demonstrated by historical evidence.
    • The program's current scope is limited, with potential for expansion to more laboratories contingent on resources.
    • Future efforts should focus on method selection, continuing education, training, and research to further enhance quality improvement.