title: Practical solution for control of the pre-analytical phase in decentralized clinical laboratories for meeting the requirements of the medical laboratory accreditation standard DIN EN ISO 15189.
abstract: This report was written in response to the article by Wood published recently in this journal. It describes a practical solution to the problems of controlling the pre-analytical phase in the clinical diagnostic laboratory. As an indicator of quality in the pre-analytical phase of sample processing, a target analyte was chosen which is sensitive to delay in centrifugation and/or analysis. The results of analyses of the samples sent by satellite medical practitioners were compared with those from an on-site hospital laboratory with a controllable optimized pre-analytical phase. The aim of the comparison was: (a) to identify those medical practices whose mean/median sample values significantly deviate from those of the control situation in the hospital laboratory due to the possible problems in the pre-analytical phase; (b) to aid these laboratories in the process of rectifying these problems. A Microsoft Excel-based Pre-Analytical Survey tool (PAS tool) has been developed which addresses the above mentioned problems. It has been tested on serum potassium which is known to be sensitive to delay and/or irregularities in sample treatment. The PAS tool has been shown to be one possibility for improving the quality of the analyses by identifying the sources of problems within the pre-analytical phase, thus allowing them to be rectified. Additionally, the PAS tool has an educational value and can also be adopted for use in other decentralized laboratories.
authors: Uberörtliche Gemeinschaftspraxis für Laboratoriumsmedizin Leverkusen-Köln-Wenrath, Standort Köln, Labor Laser und Kollegen, Cologne, Germany. vacata@labor-leverkusen.de
authors: Vladimir
authors: V
authors: Vacata
authors: Gerlinde
authors: G
authors: Jahns-Streubel
authors: Mirjana
authors: M
authors: Baldus
authors: William Graham
authors: WG
authors: Wood
mesh_terms: D000068:Accreditation / Q000379:methods* / Q000592:standards; D002624:Chemistry, Clinical / Q000592:standards*; D019411:Clinical Laboratory Techniques / Q000592:standards*; D007753:Laboratories / Q000592:standards*; D011188:Potassium / Q000097:blood / Q000592:standards; D011786:Quality Control; D013048:Specimen Handling / Q000592:standards*
chemical_list: D011188:Potassium