Abstract: ObjectiveTo evaluate the implementation effectiveness of patient pre-classified-based real-time quality control (PCRTQC) combined with conventional intemal quality control (IQC) in emergency biochemistry testing. MethodsBased on emergency patient testing data (modeling sample size n= 68 953) from the Laboratory Medicine Center,Suzhou Municipal Hospital, between November 2024 and February 2025, a PCRTQC model was constructed and validated. Since March 2025, this model was applied to real-time monitoring of emergency biochemistry analytes,including potassium(K*），alkaline phosphatase （ALP)，aspartate amin-otransferase （AST)，total protein (TP)，and uric acid (UA). A combined quality control workflow integrating IQC and PCRTQC was established. ResultsInstrument- and analyte-specific PCRTQC models were established and integrated with IQC to form a combined laboratory quality control system. Preliminary verification demonstrated that when a continuous shift occurred in IQC results for ALP testing, PCRTQC showed no abnormality，and the shift was subsequently confirmed to be caused by a QC material issue. Additionally,PCRTQC effectively provided early warning of systematic bias in K* testing due to improper loading of the reference solution. ConclusionThe combined PCRTQC and IQC workflow allows for real-time and continuous monitoring for the system performance of emergency biochemistry testing,dynamically identifies the errors during analytical process,and provides timely alerts. This approach efectively enhances the quality of emergency biochemistry testing，ensures the timelinessand accuracy of test results,and holds certain clinical applicability.