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THE ROLE OF EQA IN HARMONIZATION OF REFERENCE INTERVALS IN CROATIA LABQUALITY DAYS, 2015, HELSINKI FINLAND Department of Medical Biochemistry and Laboratory.

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Presentation on theme: "THE ROLE OF EQA IN HARMONIZATION OF REFERENCE INTERVALS IN CROATIA LABQUALITY DAYS, 2015, HELSINKI FINLAND Department of Medical Biochemistry and Laboratory."— Presentation transcript:

1 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

2 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

3 National EQA is organised since 1973. VoluntaryMandatory Law on Medical Biochemistry on July 17, 2003. The role of EQA in harmonization of RI in Croatia

4 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)

5 EQA data base: Harmonization of laboratory results I phase 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

6 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

7 I phase: ANALYTICAL QUALITY Croatian Chamber of Medical biochemists (CCMB) Obligatory use of recommended analytical methods (IFCC methods)

8 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

9  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

10 test Interlab. CV% before the use of recommended anal. methods Interlab. CV% after the use of recommended anal. methods LD27275 CK73 CHS318 Long-term evaluation of EQA results: - after the obligatory use of the recommended analytical methods

11 LD before: CV= 27% after: CV= 5%

12 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)

13 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

14  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

15 PRODUCTION OF REFERENCE VALUES

16 Reference values for the Croatian population in the field of general medical biochemistry n=2246n=998 CHILDREN: 8 do 19 years ADULTS: 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

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

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

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

21 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

22 LABQUALITY DAYS, 2015, HELSINKI FINLAND

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34 Thank you for your attention! LABQUALITY DAYS, 2015, HELSINKI FINLAND

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