Quinton Mikayla, Newton Duane W, Neil Becky, Mitchell Sondra, Mostafa Heba H
The Johns Hopkins Hospital, Baltimore, MD, United States of America.
Bio-Rad Laboratories, Hercules, CA, United States of America.
J Clin Virol. 2024 Apr;171:105655. doi: 10.1016/j.jcv.2024.105655. Epub 2024 Feb 12.
Quality control (QC) is one component of an overarching quality management system (QMS) that aims at assuring laboratory quality and patient safety. QC data must be acceptable prior to reporting patients' results. Traditionally, QC statistics, records, and corrective actions were tracked at the Johns Hopkins Molecular Virology Laboratory using Microsoft Excel. Unity Real-Time (UnityRT), a QMS software (Bio-Rad Laboratories), which captures and analyzes QC data by instrument and control lot per assay, was implemented and its impact on the workflow was evaluated. The clinical utility of real-time QC monitoring using UnityRT is highlighted with a case of subtle QC trending of HIV-1 quantitative control results.
A comprehensive workflow analysis was performed, with a focus on Epstein Barr Virus (EBV) and BKV quantitative viral load testing (Roche cobas 6800). The number of QC steps and time to complete each step were assessed before and after implementing UnityRT.
Our assessment of monthly QC data review revealed a total of 10 steps over 57 min when using Microsoft Excel, versus 6 steps over 11 min when using UnityRT. HIV-1 QC monitoring revealed subtle trending of the low positive control above the mean from November to December 2022, correlating with a change in the reagent kit lot. This associated with a shift in patients' results from positives below the lower limit of quantification to positives between 20 and 100 copies/mL.
UnityRT consolidated QC analyses, monitoring, and tracking corrective actions. UnityRT was associated with significant time savings, which along with the interfaced feature of the QC capture and data analysis, have improved the workflow and reduced the risk of laboratory errors. The HIV-1 case revealed the value of the real-time monitoring of QC.
质量控制(QC)是全面质量管理体系(QMS)的一个组成部分,旨在确保实验室质量和患者安全。在报告患者结果之前,QC数据必须是可接受的。传统上,约翰霍普金斯分子病毒学实验室使用Microsoft Excel跟踪QC统计数据、记录和纠正措施。实施了Unity Real-Time(UnityRT),这是一款QMS软件(伯乐公司),它按仪器和每个检测批次的对照品来捕获和分析QC数据,并评估了其对工作流程的影响。通过一个HIV-1定量对照结果出现细微QC趋势的案例,突出了使用UnityRT进行实时QC监测的临床实用性。
进行了全面工作流程分析,重点是爱泼斯坦-巴尔病毒(EBV)和BK病毒定量病毒载量检测(罗氏cobas 6800)。在实施UnityRT前后,评估了QC步骤的数量和完成每个步骤所需的时间。
我们对每月QC数据审查的评估显示,使用Microsoft Excel时,总共需要10个步骤,耗时57分钟,而使用UnityRT时,只需6个步骤,耗时11分钟。HIV-1 QC监测显示,2022年11月至12月,低阳性对照品出现细微的高于平均值的趋势,这与试剂试剂盒批次的变化相关。这伴随着患者结果从低于定量下限的阳性转变为20至100拷贝/毫升之间的阳性。
UnityRT整合了QC分析、监测和跟踪纠正措施。UnityRT显著节省了时间,其QC捕获和数据分析的接口功能改善了工作流程,降低了实验室错误风险。HIV-1案例揭示了QC实时监测的价值。