title: Implementing self sustained quality control procedures in a clinical laboratory.
abstract: BACKGROUND
  Quality control is an essential component in every clinical laboratory which maintains the excellence of laboratory standards, supplementing to proper disease diagnosis, patient care and resulting in overall strengthening of health care system. Numerous quality control schemes are available, with combinations of procedures, most of which are tedious, time consuming and can be "too technical" whereas commercially available quality control materials can be expensive especially for laboratories in developing nations like Nepal. Here, we present a procedure performed at our centre with self prepared control serum and use of simple statistical tools for quality assurance.
  
  
  METHODS
  The pooled serum was prepared as per guidelines for preparation of stabilized liquid quality control serum from human sera. Internal Quality Assessment was performed on this sample, on a daily basis which included measurement of 12 routine biochemical parameters. The results were plotted on Levey-Jennings charts and analysed with quality control rules, for a period of one month.
  
  
  RESULTS
  The mean levels of biochemical analytes in self prepared control serum were within normal physiological range. This serum was evaluated every day along with patients' samples. The results obtained were plotted on control charts and analysed using common quality control rules to identify possible systematic and random errors. Immediate mitigation measures were taken and the dispatch of erroneous reports was avoided.
  
  
  CONCLUSIONS
  In this study we try to highlight on a simple internal quality control procedure which can be performed by laboratories, with minimum technology, expenditure, and expertise and improve reliability and validity of the test reports.
authors.affiliation: College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan, Nepal.
authors.forename: Roshan
authors.initials: R
authors.lastname: Khatri
authors.forename: Sanjay
authors.initials: S
authors.lastname: K C
authors.forename: Prabodh
authors.initials: P
authors.lastname: Shrestha
authors.forename: J N
authors.initials: JN
authors.lastname: Sinha
mesh_terms: D064790:Clinical Laboratory Services; D019411:Clinical Laboratory Techniques; D006801:Humans; D009390:Nepal; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D011786:Quality Control; D012015:Reference Standards; D015203:Reproducibility of Results
keywords: Levey-Jennings charts, pooled sera, quality control, Westgard Rule.