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• Performance
• Statistical analysis
• Assessment of unsatisfactory performance
• Unsatisfactory performance – action criteria
• Persistent Unsatisfactory Performance (PUP)
• National Quality Assurance Advisory Panel (NQAAP)
• External performance monitoring

Assessment of unsatisfactory performance

In the vast majority of cases a DI limit of + 2.0 is set as the limit of acceptable performance within groups for each parameter. For haemoglobin, normal INR and APTT ratio, D-dimer, low white cell (<1.0x10 9 /l) and platelet counts (<10x10 9 /l) where results are very tight, we have a limit of + 3.0, which seems more appropriate. For all other parameters the DI limits are 2.0. On no occasion would the limit exceed 3.0.

Hazardous performance would be designated as any DI exceeding + 4.0 (5.0 for normal PT, normal PTT/ratio & Haemoglobin) where this would affect clinical interpretation or therapeutic intervention. Where no underlying reason for hazardous performance can be identified (obvious reasons could be incorrect reconstitution or incorrect sample used for specific test in multiple sample dispatches) the participant is contacted ahead of a repeat sample or samples being dispatched. This enables investigation into hazardousperformance to start as soon as possible.

In all other cases, participants are issued a repeat sample or samples either during the results return period when their return is out with consensus or at the time of reporting when a result has been truncated.