Use of external quality assessment in extra-analytical phases in clinical laboratories in Spain: a survey by the Spanish Society of Laboratory Medicine (SEQC

Objectives: Quality indicators (QIs) are a valuable tool for monitoring and improving extra-analytical phase performance in the clinical laboratory (CL). For that reason, the Spanish Society of Laboratory Medicine (SEQC Methods: In 2023, a survey was conducted to assess the level of participation in the EQA Program, identify its potential improvements, and enhance the understanding of the collection and estimation processes of the extra-analytical QI. Results: In total, 51 % of respondents (124 responses in total) were enrolled in the program. The primary reason for participating was the need of monitoring of the extra-analytical phases (38 %). In contrast, the main reason for not taking part in the EQA Program was the difficulty in collecting data (32 %). As to potential points for improvement, 56 % considered that QI should be analyzed disaggregated by type of extraction (ambulatory vs. urgent). As many as 86 % of respondents would be interested in participating in a post-analytical phase EQA Program. Most of the suggestions about indicators to be included were related to events regarding temperature and transport times from peripheral extraction sites. Conclusions: Although interest in QIs for pre- and post-analytical phases is growing, the percentage of laboratories that collect data regularly is still limited. The findings of this survey have led the future directions for the EQA Pre-analytical Program, updating and adapting it to the current needs of CLs.