External quality assurance: extending the boundaries

Since 1969, UK NEQAS has been providing a comprehensive, high standard external quality assessment services in laboratory medicine. Through both education and the promotion of best practice, UK NEQAS helps ensure continued improvement in patient care and quality standards. This year’s UK NEQAS General Haematology meeting focused on the applications of new technology, the laboratory’s responsibility for quality beyond the analytical phase, and featured an in-depth examination of critical results reporting.

The first session on ‘New technology, new ways of working’ commenced with a glimpse of the latest developments in point-of-care-testing (POCT) for full blood counting (FBC) presented by former biomedical scientist Carol D’Souza. Beginning with a brief overview of POCT in this area, Carol outlined how, although this area included any FBC analysis performed on patients outside the laboratory such as in out-patient or intensive care settings, she considered that the laboratory nevertheless should always retain overall responsibility for the service. Carol gave an overview of current FBC technologies in use, which consist mainly of portable, convenient to use, handheld devices such as HemoCue systems that yield rapid results, but noted the drawbacks with these systems were that only one or two parameters are capable of being analysed. Other systems such as benchtop analysers located in satellite laboratories are able to complement the main laboratory systems and also provide additional parameters but are not so portable.

Moving on to the latest FBC POCT devices currently under development, Carol revealed that new technologies featuring microfluidic systems, image-based analysis and viscoelastic focusing were set to revolutionise POCT FBC analysis in the next few years. “The latest correlation studies are promising,” she explained, adding that these devices would feature single-use disposable cartridge systems capable of delivering rapid, multi-parameter analysis but are also designed to be virtually maintenance free. Laboratories, however, would have to assess their own in-house requirements in this area and validate the devices accordingly. “Smart POCT technology may be the future of full blood counting outside the laboratory,” Carol concluded, but warned that its use must be carefully monitored and the end product be financially viable.