title: Classification of reasons for rejection of biological specimens based on pre-preanalytical processes to identify quality indicators at a university hospital clinical laboratory in Turkey.
abstract: OBJECTIVE
  Specific types of error should be identified and corrected in each laboratory to ensure quality results. The objectives of this study were:
  
  
  METHODS
  Data on rejected biological specimens in the laboratory information system from January 2013 to January 2014 were analyzed. SSRs according to the type of pre-preanalytical error and collection area were determined.
  
  
  RESULTS
  In total, 971,780 biological specimens were received during the period and 26,070 (2.7%) specimens were rejected based on our laboratory rejection criteria. The most frequent reason for the rejection was the clotted specimen (55.8% of total rejections), followed by inadequate volume (29.3% of total rejections). Most of the clotted specimens were received from adult hospital inpatient services (54.3%), followed by pediatric hospital inpatient services (26.8%). High rates of inadequate volume were also observed in samples originating from adult and pediatric hospital inpatient services, especially in the premature, neonatal, intensive care, and oncology units.
  
  
  CONCLUSIONS
  The SSR of clotted specimens was selected as the QI for the preanalytical phase in our laboratory. The selected QI will help to define the effects of our specific interventions and corrective actions, and thus allow monitoring of quality improvement in our hospitals.
authors.affiliation: Hacettepe University Faculty of Medicine, Department of Medical Biochemistry, Turkey; Hacettepe University Hospitals, Clinical Pathology Laboratory, Ankara, Turkey. Electronic address: lincilay@gmail.com.
authors.forename: Incilay
authors.initials: I
authors.lastname: Sinici Lay
authors.affiliation: Hacettepe University Faculty of Medicine, Department of Medical Biochemistry, Turkey; Hacettepe University Hospitals, Clinical Pathology Laboratory, Ankara, Turkey.
authors.forename: Aslı
authors.initials: A
authors.lastname: Pınar
authors.affiliation: Hacettepe University Faculty of Medicine, Department of Medical Biochemistry, Turkey; Hacettepe University Hospitals, Clinical Pathology Laboratory, Ankara, Turkey.
authors.forename: Filiz
authors.initials: F
authors.lastname: Akbıyık
mesh_terms: D006785:Hospitals, University / Q000458:organization & administration*; D006801:Humans; D007755:Laboratories, Hospital; D019984:Quality Indicators, Health Care; D013048:Specimen Handling; D014421:Turkey
keywords: Clinical laboratory; Patient safety; Pre-preanalytical errors; Quality indicator; Specimen rejection