title: Spanish Preanalytical Quality Monitoring Program (SEQC), an overview of 12 years' experience.
abstract: BACKGROUND
  Preanalytical variables, such as sample collection, handling and transport, may affect patient results. Preanalytical phase quality monitoring should be established in order to minimize laboratory errors and improve patient safety.
  
  
  METHODS
  A retrospective study (2001-2013) of the results obtained through the Spanish Society of Clinical Biochemistry and Molecular Pathology (SEQC) External quality assessment (preanalytical phase) was performed to summarize data regarding the main factors affecting preanalytical phase quality. Our aim was to compare data from 2006 to 2013 with a previously published manuscript assessing the 2001-2005 period.
  
  
  RESULTS
  A significant decrease in rejection rates was observed both for blood and urine samples. For serum samples, the most frequent rejection causes in the first period were non-received samples (37.5%), hemolysis (29.3%) and clotted samples (14.4%). Conversely, in the second period, hemolysis was the main rejection cause (36.2%), followed by non-received samples (34.5%) and clotted samples (11.1%). For urine samples, the main rejection cause overall was a non-received sample (up to 86.1% of cases in the second period, and 81.6% in the first). For blood samples with anticoagulant, the number of rejections also decreased. While plasma-citrate-ESR still showed the highest percentages of rejections (0.980% vs. 1.473%, p<0.001), the lowest corresponded to whole-blood EDTA (0.296% vs. 0.381%, p<0.001).
  
  
  CONCLUSIONS
  For the majority of sample types, a decrease in preanalytical errors was confirmed. Improvements in organization, implementation of standardized procedures in the preanalytical phase, and participation in a Spanish external quality assessment scheme may have notably contributed to error reduction in this phase.
authors.forename: María Antonia
authors.initials: MA
authors.lastname: Llopis
authors.forename: Josep Miquel
authors.initials: JM
authors.lastname: Bauça
authors.forename: Nuria
authors.initials: N
authors.lastname: Barba
authors.forename: Virtudes
authors.initials: V
authors.lastname: Álvarez
authors.forename: Montserrat
authors.initials: M
authors.lastname: Ventura
authors.forename: Mercè
authors.initials: M
authors.lastname: Ibarz
authors.forename: Rubén
authors.initials: R
authors.lastname: Gómez-Rioja
authors.forename: Itziar
authors.initials: I
authors.lastname: Marzana
authors.forename: Juan Jose
authors.initials: JJ
authors.lastname: Puente
authors.forename: Marta
authors.initials: M
authors.lastname: Segovia
authors.forename: Debora
authors.initials: D
authors.lastname: Martinez
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Alsina
mesh_terms: D001800:Blood Specimen Collection / Q000592:standards; D019411:Clinical Laboratory Techniques / Q000592:standards*; D006461:Hemolysis; D006801:Humans; D007753:Laboratories / Q000592:standards; D059021:Laboratory Proficiency Testing / Q000379:methods; D011786:Quality Control; D012189:Retrospective Studies; D013030:Spain; D013048:Specimen Handling / Q000592:standards*; D016482:Urinalysis / Q000592:standards