To develop criteria for unacceptable performance the subset of data used was the results from Australian and New Zealand participants for the years 2008 – 2010. The results showed a small number of participants that consistently did well at the top, a large population of participants in the middle and a population of participants that consistently were ranked below 10% who required further investigation. Results for both General and Breast diagnostic modules were similar.
When the average discordant sum was compared with the average survey score, the results showed that as the average survey score went down, the average discordant sum went up. In the Breast diagnostic module, the average discordant sum was higher for a larger proportion of participants than in the general diagnostic module. Two reasons for this may be that some participants enrol in the Breast module for educational reasons / interest but do not report breast cases everyday or that day to day participants would refer complex cases seen in the QAP survey.
From extensive modelling of the data retrospectively, empirically derived benchmarks were proposed. Using reviewed data from each laboratory that fell within the proposed benchmark, the Anatomical Pathology Performance Review Committee considered whether the proposed benchmark could be used as a trigger of concern.
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The Role of External Quality Assurance in Identifying Poor Laboratory Performance(PDF 518 KB)