Twelve years of the Brazilian External Quality Assessment Program in Immunohematology: benefits of the program.

The Brazilian External Quality Assessment Program in Immunohematology (BEQAPI) was introduced with the objective of evaluating the quality of diagnosis in immunohematology. From 1992 to 2003, proficiency tests for ABO grouping, Rh (D, C, c, E, e), K phenotyping, direct antiglobulin testing (DAT), antibody screening (AS), and antibody identification (AI) were performed. A total of 41 evaluations were carried out in 223 institutions. Over the period of 12 years, the program included 8,014 ABO typing, 8,000 RhD typing, 5,193 Rh typing (C, c, E, e), 5,101 K phenotyping, 7,939 AS, 4,533 AI, and 7,912 DATs. Erroneous responses were classified as clerical, technical, or undetermined. A substantial proportion of erroneous responses due to clerical errors occurred in ABO typing (76/76 errors), RhD typing (34/58 errors), and Rh phenotyping (50/73 errors). Technical errors occurred predominantly for weak D (91/95 errors), AS (252/301 errors), and AI (321/335 errors). Based on these results, since 1996, participants have received "Questions and Case Studies" in Immunohematology as an incentive for training and education. The results of the present study show an improvement in the performance of participants in the course of the program. We found that a well-organized external proficiency program can contribute to the improvement of quality of testing in Immunohematology.