title: Preanalytical quality improvement. In pursuit of harmony, on behalf of European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working group for Preanalytical Phase (WG-PRE).
abstract: Laboratory diagnostics develop through different phases that span from test ordering (pre-preanalytical phase), collection of diagnostic specimens (preanalytical phase), sample analysis (analytical phase), results reporting (postanalytical phase) and interpretation (post-postanalytical phase). Although laboratory medicine seems less vulnerable than other clinical and diagnostic areas, the chance of errors is not negligible and may adversely impact on quality of testing and patient safety. This article, which continues a biennial tradition of collective papers on preanalytical quality improvement, is aimed to provide further contributions for pursuing quality and harmony in the preanalytical phase, and is a synopsis of lectures of the third European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)-Becton Dickinson (BD) European Conference on Preanalytical Phase meeting entitled 'Preanalytical quality improvement. In pursuit of harmony' (Porto, 20-21 March 2015). The leading topics that will be discussed include unnecessary laboratory testing, management of test request, implementation of the European Union (EU) Directive on needlestick injury prevention, harmonization of fasting requirements for blood sampling, influence of physical activity and medical contrast media on in vitro diagnostic testing, recent evidence about the possible lack of necessity of the order of draw, the best practice for monitoring conditions of time and temperature during sample transportation, along with description of problems emerging from inappropriate sample centrifugation. In the final part, the article includes recent updates about preanalytical quality indicators, the feasibility of an External Quality Assessment Scheme (EQAS) for the preanalytical phase, the results of the 2nd EFLM WG-PRE survey, as well as specific notions about the evidence-based quality management of the preanalytical phase.
authors.forename: Giuseppe
authors.identifier: http://orcid.org/0000-0001-9523-9054
authors.initials: G
authors.lastname: Lippi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Banfi
authors.forename: Stephen
authors.initials: S
authors.lastname: Church
authors.forename: Michael
authors.initials: M
authors.lastname: Cornes
authors.forename: Gabriella
authors.initials: G
authors.lastname: De Carli
authors.forename: Kjell
authors.initials: K
authors.lastname: Grankvist
authors.forename: Gunn B
authors.initials: GB
authors.lastname: Kristensen
authors.forename: Mercedes
authors.initials: M
authors.lastname: Ibarz
authors.forename: Mauro
authors.initials: M
authors.lastname: Panteghini
authors.forename: Mario
authors.initials: M
authors.lastname: Plebani
authors.forename: Mads
authors.initials: M
authors.lastname: Nybo
authors.forename: Stuart
authors.initials: S
authors.lastname: Smellie
authors.forename: Martina
authors.initials: M
authors.lastname: Zaninotto
authors.forename: Ana-Maria
authors.initials: AM
authors.lastname: Simundic
mesh_terms: D001800:Blood Specimen Collection / Q000592:standards; D002624:Chemistry, Clinical / Q000592:standards*; D019411:Clinical Laboratory Techniques / Q000592:standards*; D003951:Diagnostic Errors; D005062:European Union; D006801:Humans; D058996:Quality Improvement; D013048:Specimen Handling / Q000592:standards