Janice - Thanks for your reply. Can I make the following comments.
1. You are quite right - what the users do may not be the same but checking what they do once a month using EQA is not going to ensure what they do the rest of the time is good.
2. You say EQA showed a "sudden" bias. Presumably the EQA the month before had been OK so what if the Bias occurred 1 or 2 days after the last EQA. Is no internal QA processed?
3. Good quality Laboratory activity and staff and its/their involvement in POCT will ensure consumables are stored correctly and not used after their sell by date.
4. EQA is meant to compare different methods, systems, equipment and processes and ensure these are comparable and of an acceptable standard nationally. IQC is to ensure the same quality from day to day having established an acceptable quality/standard from EQA.
5. We want the right answer on the right patient at the right time EVERY time. Not just once a month when we do the EQA.
David
>>> Janice Still <[log in to unmask]> 04/08/08 16:55:11 >>>
David, I can only assume that you have your tongue firmly in your cheek. If not, then you have successfully taken my breath away! The analysers may be the same, the cartridges and reagents may be the same,but what the USERS do to them is certainly not the same.I am also concerned by your mention of "tweaking". I thought that we had all abandoned fiddle factors long ago.
Every single one of my analysers is individually EQA enrolled and I would not have it any other way. Recently the EQA showed a sudden negative bias on PCO2 on one analyser, which was eventually traced to the sample path not being kept at 37C. If I was only looking at EQA on one analyser, how would this have been picked up? If you decided to take the lab as your "typical " instrument, where it is looked after by qualified BMS staff, what hope mwould there be for the instrument in A/E and all the misuse that it gets?You simply CANNOT blithely assume that one size fits all. How do you know that consumables have been stored correctly, or have been used before the sell by date? At the end of the day the whole object of EQA is to ensure that the PATIENT gets the right result on the instrument that their blood is analysed on. Yes it is expensive. Live with it. And I hope your patients do.
JanMrs. J. Still,
POCT Manager,
Biochemistry Dept,
Watford General Hospital. 01923-217998.
The views expressed in this message are personal and do not reflect West Herts NHS Hospitals Trust policy.
----- Original Message ----
From: David Robertshaw <[log in to unmask]>
To: [log in to unmask]
Sent: Monday, 4 August, 2008 2:09:19 PM
Subject: Cross site EQA
The Leeds/Bradford Biochemistry service has four sites all with the same analytical equipment using the same reagents and IQA. IQA performence is compared regularly and used to "tweak" the analysers to get the same answers across all sites. Why then do we need to enrol all four sites in the same EQA scheme?? If one analyser is performing satisfactorily compared to the "National norm", (as evidenced by EQA), and the other analysers compare satisfactorily with that one why repeat the EQA analysis?? I believe many hospitals with several Blood Gas Analysers of the same make will only EQA one and accept performnce of the others on the basis of IQA. Could this principle not be applied far more widely particularly in the light of networking and the fact that equipment, reagent production, cartridge manufacture and standards are common across many sites.
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