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External Quality Assessment (EQA) and Proficiency Testing (PT) are valuable tools in the quality improvement process. They provide objective evidence of laboratory competence for customers, accrediting bodies, and regulatory agencies, and serve as a unique source of information that is not obtainable in other ways. Traditional EQA/PT schemes tend to address only the analytical process (examination procedures), but some innovative schemes have been recently introduced to evaluate both pre- and post-analytical activities of the medical laboratory. The most important considerations in selecting an EQA/PT program include the evidence that: (i) samples are commutable (i.e. they behave like patient samples), (ii) reference values are traceable, (iii) method comparability with available peer groups is allowable, (iv) the size of peer group is statistically appropriate, and (v) both the timeliness and the usefulness of reports is granted. Careful evaluation of a single EQA/PT result should be coupled with active tracking of all results over time, and monitoring performances represent a challenging issue for medical laboratories. It is also important to consider that every EQA/PT scheme presents some limitations and that it is not appropriate to use EQA/PT as the sole means for evaluating laboratory quality. Therefore, there is the need to underline that internal quality control (IQC), EQA/PT and other tools have to be implemented and used to monitor and improve the quality in laboratory diagnostics. [ABSTRACT FROM AUTHOR]

To guarantee excellent performance and service, the process of identifying and treating error risks must be integrated into the total testing process. Quality Assurance Programs (QAPs) represent an important tool that allows us to identify errors and pinpoint any need for further systematic investigations, and to rectify procedures to improve the inputs and processes by which the service is delivered. The models used by the laboratory to assure quality and manage the risk of errors have been modified in line with an approach in which the identification of quality goals and the redefinition of professionals duties and responsibilities are indispensable. Error risk is currently high in some areas of laboratory activity, and QAP is needed now more than ever. The present paper provides some descriptive examples of an approach that can be followed to manage an External Quality Assessment Scheme (EQAS) and quality indicators (QIs), the main tools used by laboratories to assure the quality of their service, for the prevention of error risk. In particular, we describe the correct approach to choose EQAS, to use information from the EQAS report, to design a QI model, and to analyze any QI data. The examples highlight that any well-designed quality system can be ineffective if it is not managed by highly competent professionals with a deep sense of responsibility. Clin Chem Lab Med 2007;45:756–65. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about External Quality Assessment schemes.