Authors: Elaine Leung, Anna Johnston, Brian Olsen, Hong Chang, Tracy Martin, Miranda Wozniak, David Good

ABSTRACT

Introduction

Examination of a blood film is the second most common hematology test, after the complete blood count. Interpretation of a peripheral blood film by trained laboratory professionals provides valuable diagnostic information. The Institute for Quality Management in Healthcare (IQMH) Hematology Scientific Committee developed a questionnaire to gather information regarding current practices for manual blood film review and reporting from laboratories participating in IQMH Morphology proficiency testing (PT) surveys.

Methods

An online survey was distributed to 174 laboratories, 97% submitted results.

Results

Of the respondents, the majority (82%) indicated affiliation with small or medium‐sized hospitals (<500 beds). Eighty per cent of respondents had core laboratory technologists performing manual blood film reviews, while only 2% utilized dedicated hematology technologists with morphology expertise. All respondents had a policy for manual blood film review by a technologist, 70% did not have blood films reviewed by a senior/charge technologist prior to review by a physician. The majority (88%) of participants included morphological findings in their critical result list; of these, 98% include malaria and 88% include the first‐time finding of blasts as critical results. Fifty-nine per cent of participants indicated that they have a procedure in place to ensure that interpretation and confirmation of first‐time potentially significant morphological findings are available from a physician at all times.

Conclusion

This survey identified significant variation in blood film review and reporting practices across participating laboratories. The IQMH Hematology Scientific Committee will develop best practice recommendations to guide and standardize practice.

This paper was first published online, ahead of print, on September 17, 2020. Read the complete article in the International Journal of Laboratory Hematology (IJLH) print version; Volume 43, Issue 2.