Good point, well made. I copied it from David's email and shouldn't have done. I do know the difference!!
Please call off the dogs...
Apologies!
Mike
-----Original Message-----
From: Royle Chris [mailto:[log in to unmask]]
Sent: 04 August 2008 17:35
To: Hallworth Mike (RLZ); [log in to unmask]
Subject: RE: Cross site EQA
Sorry, have I missed something?. IQA. What's that? I thought that EQA (external quality assessment) and IQC (internal quality control, with the accent on the word control) were the only terms in use? (nod towards J. Middle) Apologies if I'm not keeping up. Seems to be happening more and more these days.... :-(
Chris
Chris Royle
Service Manager,
Clinical Biochemistry and Haematology Departments,
Royal Brompton and Harefield NHS Trust,
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phone: + 44 (0)20 7351 8413
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-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Hallworth Mike (RLZ)
Sent: 04 August 2008 17:11
To: [log in to unmask]
Subject: Re: Cross site EQA
Hi Janice
I think you've missed David's point. The difference is that lab analysers have frequent and rigorous IQA checks which POCT analysers generally don't. These are used to ensure that the right results are going out - and to do it BEFORE they go out, which is rather better than waiting for the EQA to come back, when it is a bit late...
In this situation, EQA is telling you primarily about differences in method/analyser bias rather than poor consumables, instrument malfunctions etc. And there is a good argument for registering only one analyser for that purpose, and using the IQA to monitor differences between analysers (I'm not getting into the 'fiddle factor' debate!!).
I think David raises a legitimate point which merits serious discussion, not dismissed as you have done.
Mike
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Janice Still
Sent: 04 August 2008 16:55
To: [log in to unmask]
Subject: Re: Cross site EQA
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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