External quality assurance in thrombosis and hemostasis: an international perspective.

External Quality Assurance in Thrombosis and Hemostasis (EQATH) was organized in 2005 as an international collaboration of external quality assurance (EQA) programs and organizations with a common interest in improving the quality of hemostasis testing. The goals include exchanging of information regarding program operations; exchanging split specimens among programs to determine if there are differences in practice; participating in value setting of standards; and providing outreach programs to locations in the world without EQA support of hemostasis testing in laboratories. The organization currently includes 11 EQA programs from 10 countries. A survey of program structure and function revealed variation in the size and structure among the programs. In general, the staffing levels paralleled the size and complexity of the program. The number of laboratory participants in the EQA programs ranged from 58 to 1700. The presentation of testing covered in the program (modules) ranged from a program with a single module of a single test, to programs with single modules of many different types of tests, to a program with 13 modules, each of which contains a limited scope of related tests. Participating laboratories were graded (pass/fail or out with consensus) by six of the EQA programs, whereas five programs report the results to the laboratory for self-evaluation. Of the 11 programs responding, seven have deemed status from an accrediting or licensing agency, and successful participation satisfied requirements for accreditation for the participating laboratory. This type of benchmarking activity and cooperative activity among EQA programs will lead to improvement of the programs.