Guidance for quality control practices and precision goals for CBCs based on IQMH patterns-of-practice survey

Area of Science:

• Medical Laboratory Science
• Hematology
• Quality Management

Background:

• Effective medical laboratory quality management systems are crucial for accurate patient results.
• Internal quality control (IQC) procedures are essential for monitoring laboratory test systems.
• The Institute for Quality Management in Healthcare (IQMH) surveyed quality control (QC) practices in routine hematology.

Purpose of the Study:

• To assess current quality control (QC) practices in routine hematology laboratories in Ontario.
• To identify variations in QC procedures among laboratories performing complete blood counts (CBC) and leukocyte differentials.
• To develop consensus practice recommendations and precision goals for QC standardization.

Main Methods:

• An online survey was distributed to 184 Ontario laboratories.
• The survey focused on QC practices for CBC and leukocyte differential testing.
• Data collected included QC methods, frequency, and limit-setting strategies.

Main Results:

• All surveyed laboratories utilized commercial QC, with 80% supplementing with in-house patient QC.
• QC analysis frequency varied based on manufacturer recommendations, parameter stability, and clinical impact.
• Laboratories employed diverse methods for setting QC limits, including standard deviation and manufacturer precision goals.

Conclusions:

• Significant variation exists in the quality control (QC) practices of Ontario hematology laboratories.
• Consensus practice recommendations and precision goals were established.
• These guidelines aim to guide and standardize QC practices for improved laboratory quality assurance.