title: Harmonization of pre-analytical quality indicators.
abstract: Quality indicators (QIs) measure the extent to which set targets are attained and provide a quantitative basis for achieving improvement in care and, in particular, laboratory services. A body of evidence collected in recent years has demonstrated that most errors fall outside the analytical phase, while the pre- and post-analytical steps have been found to be more vulnerable to the risk of error. However, the current lack of attention to extra-laboratory factors and related QIs prevent clinical laboratories from effectively improving total quality and reducing errors. Errors in the pre-analytical phase, which account for 50% to 75% of all laboratory errors, have long been included in the 'identification and sample problems' category. However, according to the International Standard for medical laboratory accreditation and a patient-centered view, some additional QIs are needed. In particular, there is a need to measure the appropriateness of all test request and request forms, as well as the quality of sample transportation. The QIs model developed by a working group of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) is a valuable starting point for promoting the harmonization of available QIs, but further efforts should be made to achieve a consensus on the road map for harmonization.
authors.affiliation: Department of Laboratory Medicine, University Hospital, Padova, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Plebani
authors.affiliation: Department of Laboratory Medicine, University Hospital, Padova, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Sciacovelli
authors.affiliation: Department of Laboratory Medicine, University Hospital, Padova, Italy.
authors.forename: Ada
authors.initials: A
authors.lastname: Aita
authors.affiliation: Department for Quality and Accreditation, University Hospital, Padova, Italy.
authors.forename: Maria Laura
authors.initials: ML
authors.lastname: Chiozza
mesh_terms: D006801:Humans; D007753:Laboratories / Q000592:standards*; D019300:Medical Errors / Q000517:prevention & control*; D061214:Patient Safety / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000592:standards*
keywords: clinical laboratories; harmonization; patient safety; pre-analytical-phase; quality indicators