THE ROLE OF EQA IN HARMONIZATION OF REFERENCE INTERVALS IN CROATIA LABQUALITY DAYS, 2015, HELSINKI...

THE ROLE OF EQA IN HARMONIZATION OF REFERENCE INTERVALS IN CROATIA

LABQUALITY DAYS, 2015, HELSINKI FINLAND

Department of Medical Biochemistry and Laboratory Medicine,

Reference Center of the Croatian Ministry of Health for the Production of Reference Values in the Feld of General Medical Biochemistry, Merkur University Hospital, Zagreb, Croatia  Z. Flegar-Meštrić, V. Radišić Biljak

The role of EQA in harmonization of RI in Croatia

Clinical quality of laboratory results:reference intervals

Analytical quality of laboratory results:quality specifications – laboratory methods

National project: Harmonization of laboratory results

National EQA is organised since 1973.

Voluntary Mandatory

Law on Medical Biochemistryon July 17, 2003.

The role of EQA in harmonization of RI in Croatia

International EQA schemes

EQALM-EQALIS–IMEP 17: The International Measurement Evaluation Programme, 2007 (28 participants from Croatia)

EQALM International INR Project, 2008 (26 participants from Croatia)

EQALM-NOKLUS Project on Post-Analitycal Automated Haematology Survey, 2010; 2011; 2012 (each year 10 participants from Croatia)

EQALM -WBC Morphology Project -Effect of Storage on EDTA-Anticoagulated Blood Cell Morphology, 2012 (Merkur, University Hospital)

LABQUALITY MASTER SCHEME (Merkur, University Hospital)

EQA data base:Harmonization of laboratory results

I phase

Analytical comparability of the results:obligatory use of recommended analytical methods

II phase

Clinical comparability of the results:- reference intervals for the Croatian population

GOALS

Project Harmonization of laboratory results

Croatian Chamber of Medical Biochemists

Department of Medical Biochemistry and Laboratory Medicine, University Hospital Merkur, Reference center of the Ministry of Health for the production of reference values in the field of general medical biochemistry

Croatian Society of Medical Biochemistry and Laboratory Medicine

I phase: ANALYTICAL QUALITY

Croatian Chamber of Medical biochemists (CCMB)

Obligatory use of recommended analytical methods (IFCC methods)

CCMB RECOMMENDED METHODS

Expert committees of the Croatian Chamber of Medical Biochemists choose and recommended

the analytical methods to be used, in the field of:- Laboratory haematology- Laboratory coagulation- Biochemistry: metabolites, electrolytes,

mycroelements, enzymes, lipids, proteins, urine analyses

2003: Low on Health Care

2003: Low on Medical Biochemistry

2004: CCMB - Rules on auditing MBLs and medical biochemists

2005: CCMB - Manual for auditing (Protocol, Self- Assessment Questionnaire, Criteria for Performance Evaluation

Professional and legal framework for quality improvement in Croatian

MBL

testInterlab. CV%

before the use of recommended anal. methods

Interlab. CV%after the use of

recommended anal. methods

LD 27 5

CK 7 3

CHS 31 8

Long-term evaluation of EQA results: - after the obligatory use of the

recommended analytical methods

LD

LD

before: CV= 27%

after: CV= 5%

Reference values for the Croatian population:- Laboratory haematology- Laboratory coagulation- General medical biochemistry

( metabolites, electrolytes, mycroelements, enzymes, lipids, proteins, urine analyses

II phase: CLINICAL QUALITY(clinical comparability of laboratory results)

Department of Medical Biochemistry and Laboratory Medicine, University Hospital Merkur-

Reference Centre of the Ministry of Health for the Production of Reference Values, Zagreb, Croatia

Regional representative of WHO EQA in- IEQAS Lab. Haematology since 1985- IEQAS Lab. Coagulation since 1992- national EQA: 1978 - 2014

Todays activities are directed to standardization and harmonization in laboratory medicine

Accredited according HRN EN ISO 15189:2008 in 2007

Department of Medical Biochemistry and Laboratory Medicine, University Hospital Merkur-

Reference Centre of the Ministry of Health for the Production of Reference Values, Zagreb, Croatia

PRODUCTION OF REFERENCE VALUES

Reference values for the Croatian population in the field of general

medical biochemistry

n=2246 n=998

CHILDREN: 8 do 19 years

ADULTS: 20 do 70 yearsADULTS: 20 do 70 years

Representative reference

sample group

n=3244

http://www.kb-merkur.hr

Supported by the Ministry of Science, Education and Sports of the Republic of Croatia

Document on national harmonization of laboratory results in the field of general medical biochemistry

Reference Centre of the Ministry of Health for the Production of Reference Values, , University Hospital Merkur, Zagreb, Croatia

Introduction of global reference intervals for those tests for which the reference measurement system is established

What is the role of EQA in harmonization of laboratory results?

1. to provide a high-level overview of laboratory performance across different methods, and different analytical equipment

2.TO ENHANCE PATIENTS CARE THROUGH IMPROVED ANALYTICAL AND CLINICAL QUALITY OF LABORATORY RESULTS

LABQUALITY DAYS, 2015, HELSINKI FINLAND

LABQUALITY DAYS, 2015, HELSINKI FINLAND

LABQUALITY DAYS, 2015, HELSINKI FINLAND

LABQUALITY DAYS, 2015, HELSINKI FINLAND

LABQUALITY DAYS, 2015, HELSINKI FINLAND

LABQUALITY DAYS, 2015, HELSINKI FINLAND

Thank you for your attention!

LABQUALITY DAYS, 2015, HELSINKI FINLAND