Hong Kong Institute of Medical Laboratory Sciences Quality Assurance Programme Ltd.
Quality Assurance Programme
Non-gynaecological Slide Preparation Module
Objective of the Programme
To assess the overall technical performance of participants’ laboratories in the preparation of Non-gynaecological cytology smears.
Criteria for Participation
Any medical laboratory which provides cytology examination services is eligible to participate.
Nature of Tests
In each survey exercise participants are requested to submit Haematoxylin & Eosin (HE) and /or Papanicolaou staining (PAP) smears from any or all the following three types of Non-gynaecology cytology materials listed below.
Source of Cytology Material
Non-gynaecology cytology smears are prepared by participating laboratories using leftover clinical cytology materials received in their laboratories.
Type of Non-gynaecology Cytology Materials
1. Sputum (S)
2. Urine (U)
3. Body fluid (F) either pleural fluid or peritoneal fluid
Type of Preparation Techniques
1. Direct Smears (D)
2. Cytospin smears (C )
3. Liquid based smears (L)
Staining of Cytology
1. H&E (HE) and /or
2. Papanicolaou staining (PAP)
Labelling of Stained Cytology Slides
· Cytology smears shall be labelled with the 4-digit laboratory confidential code and no information to reveal the identity of the participant laboratory shall be included.
· Unlabelled and improperly labelled slides will not be evaluated by the panel and no mark will be given to those slides.
· Smears submitted shall be labelled with the type of material, preparation method and staining method according to pre-defined code.
Two times a year
Deadline for Return of Cytology Smears and Survey Form
Refer to the Time Schedule for the Year.
Return of Hard Copy of Survey Result Form and Cytology Smears:
A special courier service will be arranged to collect the survey form and cytology slides on the date marked on the instruction sheet. To maintain the integrity of the smears during transportation foam-padded envelope will be provided.
Participants will be requested to submit slides again within two weeks' time if broken slides are received.
Objective Criteria for Performance Evaluation of Cytology Examination
· No return or late return will be counted as not done and will be marked "ND" in the report.
· Returned slides will be examined and the quality of staining and preparation will be evaluated by the Cytopathology Panel with reference to the staining intensity, revelation of nuclear/cytoplasmic details, contrast, consistency, cell distributions, tidiness and labeling.
· Scoring of performance :
Staining Score (maximum 10)
Slide Preparation Score (maximum 10)
l Nuclear staining: 0 to 2
l Cytoplasmic staining: 0 to 2
l Staining contrast: 0 to 2
l Staining consistency: 0 to 2
l Artifacts/stain deposits: 0 to 2
l Labelling: 0 to 1
l Coverslipping: 0 to 2
l Mountant residue: 0 to 1
l Air bubble: 0 to 1
l Cell distribution: 0 to 2
l Cell preservation: 0 to 3
l The final score of the participant was computed by first taking away the highest and lowest score given by the assessors and then taking the mean of the remaining scores.
· Final report will be issued and dispatched according to the schedule of HKIMLSQAP (refer to Time Schedule for the Year)
· The final score of the participant is calculated from the staining score and the slide preparation score in the ratio of 7:3 of each submitted slide. This final score is used for grading the participant’s overall performance by the table below.
Final Overall Score of Participant
Overall Performance of Participant
> 8 marks
> 6 and <= 8 marks
> 5 and <= 6 marks
· The median score of all the participants' final score in staining and slide preparation will be shown in the report for participant's information.
· Participants' performance in each submitted slides will be displayed in bar chart for comparison with the scores of the other participants. Comparison is based on types of specimen type and staining method.
· Assessor comments on staining and preparation will be given to participating laboratories if considered necessary.
· For those with score below 5, submitted slides will be returned to the concerned participant.
· Submitted slides will be returned to the participant together with the survey report.
Certificate of Participation
A certificate of participation will also be issued indicating the number of survey results returned timely for each module,
· Should there be any disagreement with the performance evaluation; participant can appeal to the Chairman of HKIMLSQAP for amendment and review.
· The appeal shall be lodged by making a written submission providing the grounds of the appeal within four weeks from the date of receiving the survey report and return the slides for reassessment.
· Panel Head will arrange review by Panel Members if deemed necessary.
· Amended report will be issued if the appeal is substantiated.
· Submitted slides will be returned for review upon request.
Should there be any enquiry on the survey; participants are requested to contact HKIMLSQAP for assistance.
Each participant is assigned with a laboratory code for submitting survey result. The key to decipher the identities of participants is limited to few authorized members of HKIMLSQAP Council, (Council Chairman, Hon. Secretary and Office Staff) who are forbidden to release the identities of the participants.
Accreditation body would access to participant’s performance during assessment, however, HKIMLSQAP keeps all details of participant's identities confidential and will not disclose their identities to a third party unless required by legislation.