A systems approach to assure optimal proficiency testing in the hematology laboratory.

Although CLIA 88 has probably caused the laboratorian to place inordinate emphasis on proficiency testing, we believe that it will ultimately improve clinical laboratory practice. Due to the increased numbers of challenges within a mailing, the laboratorian has a greater ability to gauge magnitudes and types of any existing error. These magnitudes can be compared with previously established limits to determine the need for corrective action. Laboratories are encouraged to devise a system to guarantee accurate preanalytic, analytic, and postanalytic PT processing and reporting. Due to the relatively low imprecisions of today's hematology analyzers compared with the HCFA limits, most hematology laboratories should focus their attention on measures of and factors affecting long-term control and calibration. More attention should be paid to moving averages of indices and the analytic performance in regional or manufacturer control pools.