Preanalytical quality improvement: in quality we trust.
Total quality in laboratory medicine should be defined as the guarantee that each activity throughout the total testing process is correctly performed, providing valuable medical decision-making and effective patient care. In the past decades, a 10-fold reduction in the analytical error rate has been achieved thanks to improvements in both reliability and standardization of analytical techniques, reagents, and instrumentation. Notable advances in information technology, quality control and quality assurance methods have also assured a valuable contribution for reducing diagnostic errors. Nevertheless, several lines of evidence still suggest that most errors in laboratory diagnostics fall outside the analytical phase, and the pre- and postanalytical steps have been found to be much more vulnerable. This collective paper, which is the logical continuum of the former already published in this journal 2 years ago, provides additional contribution to risk management in the preanalytical phase and is a synopsis of the lectures of the 2nd European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)-Becton Dickinson (BD) European Conference on Preanalytical Phase meeting entitled "Preanalytical quality improvement: in quality we trust" (Zagreb, Croatia, 1-2 March 2013). The leading topics that will be discussed include quality indicators for preanalytical phase, phlebotomy practices for collection of blood gas analysis and pediatric samples, lipemia and blood collection tube interferences, preanalytical requirements of urinalysis, molecular biology hemostasis and platelet testing, as well as indications on best practices for safe blood collection. Auditing of the preanalytical phase by ISO assessors and external quality assessment for preanalytical phase are also discussed.
U.O. Diagnostica Ematochimica, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy. glippi@ao.pr.it
Giuseppe
G
Lippi
Kathleen
K
Becan-McBride
Darina
D
Behúlová
Raffick A
RA
Bowen
Stephen
S
Church
Joris
J
Delanghe
Kjell
K
Grankvist
Steve
S
Kitchen
Mads
M
Nybo
Matthias
M
Nauck
Nora
N
Nikolac
Vladimir
V
Palicka
Mario
M
Plebani
Sverre
S
Sandberg
Ana-Maria
AM
Simundic
D002624:Chemistry, Clinical / Q000592:standards*; D002648:Child; D019411:Clinical Laboratory Techniques / Q000592:standards*; D015510:Clinical Medicine / Q000592:standards*; D006801:Humans; D008967:Molecular Biology; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D016482:Urinalysis