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Quality assurance of the pre- and post analytical phase

Sverre Sandberg1,2,*

1NOKLUS, 2Lab clin Biochem, Haaukeland Univ Hospital, Bergen, Norway


What expectations do clinicians have to point of care instruments? It is probably very simple. In the public sector it is about timeliness. In the private sector it is about timeliness and money. In both situations, the clinicians definitely will expect the laboratory result to be “true” – what they read in the display, they trust. They will seldom think that errors can occurs in the pre- and/ or postanalytical phase.

The Norwegian organisation for quality improvement of primary care laboratories (Noklus) is addressing also the extraanalytical phases. The pre-analytical phase is addressed by circulating questionnaires to GP offices and nursing homes regarding patient identification, sample drawing and sending etc. Feedback is given with information about best practice. The practices are also visited by laboratory consultants that guide them in correct laboratory procedures. The postanalytical phase is addressed through automatic registering from the patients e-journals what constituents are requested and what results are obtained in each patient consulting the physician. This information is sent to Noklus. In this way physicians will get information about how they use the laboratory compared to others. In addition, case histories are circulated to GPs and nursing home physicians addressing clinical problems where the laboratory result will play an essential part. Again feedback reports are given comparing each physicians results with those of others. Courses addressing pre-analytical, analytical and postanalytical factors are organised for more than 5000 physicians and their co-workers each year. Practical examples of these activities will be given in the lecture.

 

Keywords: Laboratory organization