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SECTION III: COLA CRITERIA FOR QUALITY LABORATORY PERFORMANCEHE 3 EIf you perform automated hematology, (CBC’s and/or reticulocyte counts) are a minimum of two levels of commercialcontrol run each day of patient testing?Laboratories are encouraged to consider their individual operating environments, instrument stability, and personnelcompetency when determining the total number of times to perform controls each day of patient testing.Laboratories are encouraged to run all levels of control provided for their system each day of testing. This provides ahigher level of assurance that results covering the entire reportable range are reliable.Laboratories with multiple shifts may wish to have staff on each shift perform controls. In such cases the laboratorymay elect to use a patient control on additional shifts. A patient control is a patient specimen which would have beenheld over from the morning. It should not be more than twenty four hours old and kept under refrigeration until neededand brought completely to room temperature and well mixed prior to use. The patient specimen should be picked soas to be different from the control to be used. For example, if a normal patient is used, a high or low control shouldbe run or if a normal control is to be used, a patient specimen with abnormal values should be used. The laboratoryalso needs to establish acceptable ranges for patient replicates. For example, a WBC of +/– 0.5 or an Hct +/– 3.0 ofthe original value obtained for that specimen may be deemed acceptable. Another option for establishing acceptableranges is to use the ranges that the control manufacturer has established for the equivalent control to the patientspecimen used. For example, use the spread (range) for the high control when using a patient specimen that originallyread in the high range as the second control.HE 4 RIf you perform automated differential counts, have criteria been established for when a manual cell count mustbe performed to verify the automated count?You may also answer this question “yes” if you have established criteria for when to send a differential to a referencelaboratory. The differential does not need to be performed in-house to meet this criterion.HE 5 RIf you prepare blood smears, are they properly stained; free of precipitate; and have a uniform cell distribution?You need to record that your smears are checked regularly for appropriateness of staining. This can be included in therecords of your hematology instrument’s daily, weekly, or monthly checks.HE 6 RDoes the blood smear report include an evaluation of red cell morphology?Red blood cell morphology provides clues to the diagnosis of many diseases, including anemias and sickle cell disease.HE 7 RDoes the blood smear evaluation include a platelet estimate from the peripheral smear?HE 8 EIf you perform manual cell counts on a hemacytometer: Is a control counted in duplicate and the resultsdocumented at least every eight hours of testing?Be sure to record the date, time, and result of the control.3-62. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .© 2007 COLA FOR MORE INFORMATION CONTACT COLA PHONE 800.981.9883 | FAX 410.381.8611 | ON-LINE www.cola.org