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Klinisk Biokemi i Norden · 2 2013
NOKLUS: Norsk kvalitets-
forbedring av laboratorie-
virksomhet utenfor sykehus
The Norwegian Quality Improvement of
Primary Care Laboratories
Background
The quality improvement scheme was established in
1992 and is financed by the Quality Improvement
Fund III that was established by an agreement between
the Norwegian Medical Association, Government and
the Norwegian Association of Local and Regional Aut-
horities. The aim of the quality assurance system is that
tests should be requested, analyzed and interpreted in
agreement with defined professional standards and
in accordance with the patients needs for diagnosis,
treatment and management.
Participation in this EQAS is voluntary and there is
no fee for general practitioners and private specialists.
Laboratories within medical biochemistry, Health Care
Centers, Nursing Homes, Military Camps and other
laboratories can participate for full cost.
The scheme has an educational purpose.
The quality improvement scheme is run by a leader
and a representative steering committee. A reference
group and several other expert groups are available to
advise the leader. The Norwegian Medical Associa-
tion provides secretarial support for the organization.
NOKLUS is certified according to NS-EN ISO
9001:2002.
Development of EQA activities
From 1993 to 2012 the number of participants has
increased from 1300 to more than 2900, and num-
ber of components in the surveys from four to 53.
The surveys are for qualitative, semi quantitative or
quantitative tests and are sent out once or twice a year,
except for surveys made for hospital laboratories that
are sent out four times a year. When possible, we use
native control materials and target values from refe-
rence methods. Participants from smaller laboratories
(outside hospitals) receive a validation of the results
as “Good”, “Acceptable” or “Poor”, both for precision
and trueness.
Other services
Advisers for laboratories outside hospitals
Advisory medical laboratory technicians employed
by Noklus are located in regional clinical chemistry
departments (hospital laboratories) in Norway. The
advisory medical laboratory technicians are responsible
for promoting quality assurance at the laboratories of
the primary health care centers in their region. Whose
duties include regular phone calls to health care cen-
ters, practice visits and the organizing of practical and
theoretical educational courses for all staff at health
care centers. During 2011 advisory medical laboratory
technicians arranged 373 courses (5660 participants)
and 57% of all participating health care centers were
visited. They also compile and distribute a manual to
all participating centers. The manual contains informa-
tion about near-patient testing and is updated regularly.
SKUP
Scandinavian evaluation of laboratory equipment for
primary health care
,
SKUP
, is a co-operative commit-
ment of NOKLUS, “DAK-E” in Denmark and EQUA-
LIS in Sweden. SKUP was established in 1997 at the
initiative of laboratory medicine professionals in the
three countries. SKUP is led by a Scandinavian steering
committee and the secretariat is located at NOKLUS in
Bergen, Norway.
The purpose of SKUP is to improve the quality of
near patient testing in Scandinavia by providing objec-
tive and supplier-independent information on analytical
quality and user-friendliness of laboratory equipment.
This information is generated by organizing SKUP
evaluations. A complete evaluation requires one part
performed by experienced laboratory personnel as well
as and one part performed by the intended users. Each
evaluation is presented in a
SKUP report
to which a
unique
report code
is assigned
The Norwegian Diabetes Register for Adults
Since 2006 NOKLUS has been working on the deve-
lopment of a National Diabetes Register for Adults.
The register was commissioned by the Norwegian
Department of Health and Social Affairs and is finan-
ced by Health Region West. The main objective of the
register is to improve the quality of diabetes care and
reduce diabetes complications by encouraging annual
registration of data on glycaemic control, associated car-
diovascular risk factors, processes of diabetes care and
diabetic complications. Data is collected electronically
