Quality audit of haematology laboratory: Challenges and opportunities

Abstract

Introduction: Laboratory results play an essential role in both medical decision-making and inpatient management. In many clinical scenarios, laboratory test results are essential to make the right diagnosis or choosing the suitable treatment regimen. The aims and objectives were to study 13 National Accreditation Board for Testing and Calibration Laboratories (NABL)-specific common quality indicators (QIs) in the haematology laboratory of a tertiary care teaching hospital. Materials and Methods: NABL accredited a laboratory-based, cross-sectional study done in the haematology laboratory of NABH-recognised tertiary care teaching hospital over 5 years from January 2017 to April 2022 with a sample size of 1586,096. Quality parameters studied include sample rejection rates, sample redo rates, routine turnaround time (TAT), critical reports and their TAT, corrected reports, staining quality etc. The QI rates were calculated on a monthly basis, and trends were analysed. P < 0.05 was considered statistically significant. Results: The most common error was clotted sample 634 (0.04%), followed by rejection due to the misidentification of sample 128 (0.008%). Several monthly critical alerts showed an upward trend (P = 0.045) which could be attributed to increased awareness amongst laboratory staff. Redo rates showed no significant change in trend over the study period. Conclusion: Updating the knowledge on laboratory services, adequate training of the staff and sensitisation about the importance of the QIs in all three phases will help minimise errors.

Keywords

• analytical
• post-analytical
• pre-analytical
• quality control
• quality indicators