Quality control in a Holter laboratory

Summary form only given. The quality control program in the Holter laboratory has been on going for three years. Over this time, volume has increased from 5794 ECG (electrocardiographic) tapes/year (1987) to 6038 (1988) and 6400 (projected 1989). Technician productivity has increased from 4.8 tapes/day (1987) to 5.1 (1988) and 5.7 (1989). Because of the complex process necessary to produce a full report, an attempt has been made to examine the quality at each step, with the equipment separated from the technician component The equipment is tested for frequency response and timing, with isolated problems being identified. Since the laboratory serves 30 hospital clinics, the greatest problem is electrode placement on the patient. Eighteen hours of analyzable data were obtained from 92% of the recordings. Accuracy of analysis is measured by technicians' bi-weekly reading of a hand-counted tape from a library. Accuracy for the laboratory has increased from 87% (1987) and 90% (1988) to 93% (1989). Precision is measured by technicians' biweekly reading of a tape that they had read in the previous 2 weeks. Precision for the laboratory was 95% in 1988 and 96% in 1989.<>