The external quality assessment schemes in Thailand.

In Thailand, the external quality assessment schemes have been organized by 2 main institutions:--The Department of Medical Science, Ministry of Public Health and The Faculty of Medical Technology, Mahidol University. Both schemes were initiated simultaneously by WHO experts in 1973. The Department of Medical Science, Ministry of Public Health established a Unit of Laboratory Quality Standards to be responsible for external quality control for clinical laboratory services. In 1996 the unit was upgraded to become The Bureau of Laboratory Quality Standards and is responsible for The National Proficiency Testing Scheme (NPTS). This includes hematology, clinical chemistry, clinical immunology, clinical microscopy, clinical microbiology and blood banking. Every laboratory is invited to be a member, free of charge. Now there are almost 800 out of 1300 laboratories all over Thailand participating in this NPTS. The proficiency testing samples are sent to the participants 3-4 times/year. The results of laboratory tests performed by participants are evaluated by using target values for every scheme, except clinical chemistry, which use participants' consensus. The control materials used in the clinical chemistry, hematology and immunology schemes are imported from aboard. The remaining control materials are prepared in house. The Faculty of Medical Technology, Mahidol University has organized 4 programs in The External Quality Assurance Scheme (EQAS):--clinical chemistry, clinical hormone, clinical microscopy and clinical immunology and serology. The first scheme was established in 1986 and the remaining schemes were established in 1999. All the control materials used are prepared in house. The members of this EQAS have to pay a membership fee. The control samples are sent to the participants 4-12 times/year. The results of laboratory tests are evaluated by using participants' consensus. There are 150-460 laboratories enrolled in this EQAS. At this time, Thailand is very conscious of quality in every field, including hospitals, and internal and external quality controls are one of the recommendations of the quality standard. So both The NPTS and The EQAS mentioned above are very important for each laboratory at the moment. The author sent questionnaires to 200 laboratories asking whether they were enrolled in an external quality assessment scheme. Fifty-seven laboratories responded and over 70% of them had joined either The NPTS or The EQAS and some of them had joined both. In addition, there are 2 new programs of external quality control:--the external quality control in red cell serology and the external quality assessment of hematology laboratory which have been established recently. However, there are still some types of laboratory that have no external quality assessment programs e.g. coagulation, serology for autoimmune disease and hemoglobin typing. External quality assessment programs for these laboratories are urgently needed.