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Laboratory Errors is defined as the failure to execute planned action within the laboratory cycle (from ordering examinations to reporting results). Laboratory errors have a significant impact on patient management as a majority of the diagnosis are made on the basis of laboratory tests.

Types of Laboratory Errors

  • Pre-Analytical Laboratory Errors

The pre-analytical errors occur during the patient assessment, test order entry, request completion, patient identification, specimen collection, specimen transfer, etc. in the laboratory. Some of the common pre-analytical laboratory errors include ordering tests for the wrong patient, selection of inappropriate collection containers, labeling containers improperly, etc.

What steps can be implemented to avoid pre-analytical errors?

Types of Pre-Analytical Errors: -

  • Inappropriate test request
  • Order entry errors
  • Misidentification of patients
  • Inappropriate container
  • Inadequate sample collection and transport
  • Inadequate sample volume ratio
  • Sorting and routing errors
  • Labeling errors

Healthcare centers can take the following measures to avoid the chances of pre-analytical errors:-

  • Generate clear and precise written procedures.
  • Provide healthcare professionals and medical staff appropriate training to understand the laboratory cycle.
  • Continuously monitor the quality indicators.
  • Improve communication between healthcare professionals and facilitate interdepartmental cooperation.
  • Analytical Errors

The analytical phase begins when the patient’s specimen is brought to the laboratory for testing, and ends when the results are interpreted and verified. Not processing the specimen properly before the analysis can impact the overall accuracy of the test results.

What can be done to prevent analytical errors?

Analytical quality compliance’s have been clearly established in Internal Quality Controls (IQC) and External Quality Assessment (EQA). The role of EQA is to offer reliable data that allows laboratories to assess and monitor the quality status of internal procedures, the suitability of diagnostic systems, and competency and accountability of the staff.

It is the responsibility of laboratory professionals to extensively analyze EQA samples and reports, identify trends, investigate the root causes of errors, implement and monitor corrective measures, and verify the effectiveness of the actions.

Types of Analytical Errors

  • Equipment malfunction
  • Sample mix-ups/interference
  • Undetected pitfalls in quality control
  • Non-adherence of the predetermined procedures
  • Post-Analytical Errors

In the post-analytical error phase, the tested results are extended to medical professionals wherein they interpret the results and make diagnostic decisions accordingly. Inappropriate use of laboratory test results, critical result reporting, wrong transmission of correct results, etc. are some of the errors associated with the post-analytical phase of laboratory testing process.

What can be done to prevent the post-analytical errors?

Incorrect transmission of data is one of the primary factors resulting in post-analytical errors, especially when the results and numbers are entered manually. It is imperative to provide the medical staff with appropriate training in order to follow a clear and systematic reporting procedure and avoid data inaccuracy and omission.

Healthcare centers can also leverage IT solutions to simplify their post-analytical phase. In order to improve the reporting of critical values and efficiency of test report delivery, healthcare centers can integrate a computerized communication system and avoid potential errors. Furthermore, these IT solutions make it easier to reach out to physicians as well as patients via call or text, thereby eliminating any communication barriers in transmitting the test results.

Types of Post-analytical Error

  • Failure in reporting
  • Erroneous validation of analytical data
  • Improper data entry
  • Non-arrival of hard copy result

Implementing Active Evaluation System to Avoid Errors

Laboratories errors pose a direct threat to patient safety as approximately, 85% of all diagnosis are made on the basis of laboratory test results. Healthcare centers can enhance patient safety by putting an effective system into place to identify and monitor quality failures in processes and procedures. By constantly assessing the laboratory cycle, medical staff will be able to identify the pitfalls during the early stages, and implement corrective measures to mitigate any future occurrence of such errors.

Dr. Divaanshu Gupta

Dr. Divaanshu Gupta is a cardiac anaesthesiologist in Manipal Hospital, Jaipur. He has done his M.B.B.S. as well as M.D. Anaesthesia from S.M.S. Medical College. He has a vast experience of working in various critical care units of government as well as corporate hospitals.

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