Student Dissertation

Agency : Internal Quality Control; External Quality Assurance Scheme; NABL Laboratory; Quality of Laboratory Services

Objective : ï‚· To Study the Quality Assurance by IQC &EQAS in NABL Lab, ï‚· To Study the Quality Indicator in NABL Lab, ï‚· To Study the difference between time taken for lab reports generation and dispatch with the standard time set by hospital, ï‚· To Find out the cause of delay in process of sample collection to lab report dispatch, ï‚· To Check and observe the maximum utilization of resources.

Background : Quality Assurance is the total process whereby the quality of laboratory reports can be guaranteed by IQC, EQAS, Quality indicator, Remapping of processes. Incorrect Laboratory results may be due to errors occurring during specimen collection (pre-analytical stage), testing (analytical stage) and/or while reporting and interpreting (post-analytical stage) test results. Along with monitoring of quality indicator, accuracy and reliability, timely reporting of laboratory test results is now considered an important aspect of the services provided by the clinical laboratory. Accuracy of reports can be checked by the internal and external quality control. Quality indicators are the key performance areas of a lab. Quality indicator value is used to check the Quality assurance in NABL lab. TAT is also important aspect to check the efficiency of a lab. Whether or not, faster turnaround time can make any medical difference, patients and their physicians want reports as rapidly as possible. A recent review of laboratory turnaround time indicated that analysis of this time interval has helped in determining the cause of delay, which is then followed by the improvement in turnaround time.

Methodology : This is a Descriptive study and Observational study, Study Area 101 bedded Monilek Hospital & Research centre Jaipur, Sample size: Total 200 patient,100 for OPD & 100 For IPD, Data Collection- Primary data- information about process of sample collection, dispatching and processing is taken by direct observation & through interactive session with pathologist, technicians and phlebotomist. (For IQC daily IQC Report is analyzed, For EQAS monthly report is analyzed).

Findings : IQC& EQAS Report - If parameter are not in range, Then Root Because Analysis is Done Main Reasons are Equipment maintenance status, Equipment Calibration status. Quality Indicator in lab are Numbers of reporting error/1000 investigation is 8, Percentage of re-dos is 7%, Percentage of reports co-relating with clinical diagnosis is 88.6%, Percentage of adherence to safety precautions by employees working in diagnostics is 100%.Reasons for difference in TAT are-Manual slide preparation for every patient and small rotator machine ,less no. of coolant box, No fixed ward boy to dispatch sample from Dept to Lab. OPD TAT- Haematology - 1:35 hr,Biochemistry-1:30 hr, Clinical Pathology-2hr,IPD TAT Haematology-2 hr, Biochemistry-2hr 7 min, Clinical Pathology-3hr, after remapping of processes , OPD TAT- Haematology -1 hr, Biochemistry-1 hr, Clinical Pathology-1:30hr,IPD TAT Haematology -1:30 hr, Biochemistry-1:30,Clinical Pathology-2hr.

Recommendations : Calibration of machine should be at proper time, Manual entries of patient & slide preparation only when critical values. Mixer or rotator machine should be of greater capacity, every department should have coolant box according to no of patient in department.