‘Fifteen percent of microbiology reports are wrong!’: further experience with an internal quality assessment and audit scheme

摘要: Abstract Infection control teams critically depend on the quality of diagnostic microbiology laboratories with which they are associated. Internal assessment (IQA) by specimen resubmission measures consistency laboratory performance and can be adapted for medical audit, but few appear to include these techniques as part their procedures. We established an IQA scheme in our bacteriology May 1989, mean discrepancy rate first two years was nearly 15%. During next covered this report, extended audit microbiologists' comments reports, a standardized scoring introduced. Results from collated analysed thrice yearly, altered extra staff training planned reduce discrepancies. Four thousand four hundred fourteen specimens (1·4% workload) were resubmitted, 325 (7·4%) gave discrepant results. years, overall fell consistently 9·4 3·2%. Fifty-three discrepancies (1·2%) microscopy, 243 (5·5%) between culture Substantial decreases technical followed initiatives sputum bacteriology, anaerobic recognition improved illumination cabinet. Problems consistent staphylococci urine isolates mixed culture, faecal microscopy have proved difficult eradicate. There 20·3% comments, only 0·4% would been likely result different patient outcomes. The cost running £4474 per annum, equating surcharge £0·058 each routine specimens. Discrepancies therefore reduced about two-thirds at £1·88 prevented; we believe offers good value money.