Adel Osama SayedQuality ManagerAl Borg Medical Laboratories

What is IQASInter-laboratory Quality Assessment Surveys; a program enables a laboratory to compare its performance against other laboratories and assure the accuracy and reliability of test results it provides.

Purpose of IQASPowerful tool to identify the problems with

methods/equipments, ensure the effectiveness of the training of new staff and be used in evaluating staff performance.

To satisfy national accreditation; Central Board for Accreditation of Healthcare Institutions (CBAHI)

To be preparatory phase for laboratories that will go for international Accreditation

IQAS ProcessesSamples Preparation;Distributes samples on the regular schedule;The participants analyze the tests and report results to the IQAS provider;

The results are subjected to statistical analysis based on ISO 13528 standards using robust mean and standard deviation;

The participants are received their evaluation report

2010 : Split samples between two Al Borg Branches

HCV JeddahDammam MachineGrade

IMH-01Negative

Negative Axsym

Acceptable

IMH-02 Positive Positive Axsym Acceptable

HIV JeddahDammam MachineGrade

IMH-01 Positive Positive Axsym Acceptable

IMH-02Negative

Negative Axsym

Acceptable

2011 Start with one pool for specific tests , run between Al Borg Branches Evaluation based on standard deviation index (SDI)

SDI = (R-M)/SDR = Participant result M = Target mean valueSD = Standard deviation for peer group

Chemistry Round Participants

Glucose Urea U.A Creat

Cholest TG

Jeddah 79 43 4.1 2.29 170 161Makka-2 88 49 4.4 1.92 182 180Al Samer 79 44 4.3 2.3 176 159Al Salama 75 41 4.3 2.2 161 150Al Thagher 82 44.8 4.2 2.4 183 158Al Madinah

8044 4.3 2.4 179 162

HAIL 80 43 4.1 2.3 176 166GIZAN 79 45 4.1 2.3 179 158Makka-1 85 35 4 3.5 190 175ABHA 81 41 4.2 2.2 178 145

SDI ScoreGlucos

e Urea U.A CreatCholes

t TGPeer Mean 81.75 43.74 4.28 2.38 179.81 164.13Peer SD 3.44 3.27 0.15 0.33 8.11 9.72

DI Jeddah -0.80 -0.23 -1.20 -0.26 -1.21 -0.32DI Makka-2 1.82 1.61 0.78 -1.39 0.27 1.63DI Al Samer -0.80 0.08 0.12 -0.23 -0.47 -0.53DI Al Salama -1.97 -0.84 0.12 -0.54 -2.32 -1.45DI Al Thagher 0.07 0.32 -0.54 0.07 0.39 -0.63DI Al Madinah -0.51 0.08 0.12 0.07 -0.10 -0.22DI HAIL -0.51 -0.23 -1.20 -0.23 -0.47 0.19DI GIZAN -0.80 0.39 -1.20 -0.23 -0.10 -0.63DI Makka-1 0.95 -2.67 -1.86 3.43 1.26 1.12DI ABHA -0.22 -0.84 -0.54 -0.54 -0.22 -1.97

TSH Sample

2012:

Participation some of Al Borg Clients

Running the program with 2 samples

2013Participation of more Clients

Using new evaluation software based on ISO 13528

Introduction of graphics for performance scores

Statistical Calculations (ISO13528)  Alb AST Ca Chol Creat Glu HDL K ALT T.P Urea Uric

Acid

Unit g/dl U/l mg/dl mg/dl mg/dl mg/dl mg/dl mmol/l U/l g/dl mg/dl mg/dl

Assessment |Z|<=2 |Z|<=2 |Z|<=2 |Z|<=2 |Z|<=2 |Z|<=2 |Z|<=2 |Z|<=2 |Z|<=2 |Z|<=2 |Z|<=2 |Z|<=2

No. of laboratories that submitted results

15 21 15 19 21 21 17 8 20 10 20 19

No. of laboratories with quantitative values

15 21 15 19 21 21 17 8 20 10 20 19

Assigned value 4.3 18.3 8.1 187.0 1.36 100.2 43.4 4.7 1.9 6.9 33.0 5.0

Target s.d. 0.2 1.8 0.4 9.3 0.10 5.0 6.5 0.5 0.2 0.3 2.5 0.4

Lower limit of tolerance 3.8 14.6 7.3 168.3 1.15 90.2 30.4 3.7 1.5 6.2 28.1 4.1

Upper limit of tolerance 4.7 21.9 8.9 205.7 1.56 110.3 56.4 5.6 2.3 7.6 38.0 5.8

Standard error 0.1 0.6 0.2 1.4 0.03 1.3 0.8 0.1 0.4 0.1 0.6 0.0

Plan of 2014Increase number of participants Standardized the program (sample preparation, statistical calculations,…..) with full support of GSO

Increase number of samples in each round Introducing surveys covering tests not in a formal proficiency testing programs

Plan of 2014√ Increase number of participants … 60 participants

√ Standardized the program with full support of GSOWith the help of GSO, we cooperate with one of expert in the field of statistical treatment of PT to upgrade our system to conform to ISO/IEC 17043.√ Increase number of samples in each roundIncrease number of chemistry samples to be 3 instead of 2 samples per round and planning to be 4 per round

Signing of Memorandum of Understanding

Looking forIntroducing Educational Activities

Introducing Surveys for tests not covered by formal PT program

THANK YOU