title: Ten years of preanalytical monitoring and control: Synthetic Balanced Score Card Indicator.
abstract: BACKGROUND
  Preanalytical control and monitoring continue to be an important issue for clinical laboratory professionals. The aim of the study was to evaluate a monitoring system of preanalytical errors regarding not suitable samples for analysis, based on different indicators; to compare such indicators in different phlebotomy centres; and finally to evaluate a single synthetic preanalytical indicator that may be included in the balanced scorecard management system (BSC).
  
  
  METHODS
  We collected individual and global preanalytical errors in haematology, coagulation, chemistry, and urine samples analysis. We also analyzed a synthetic indicator that represents the sum of all types of preanalytical errors, expressed in a sigma level. We studied the evolution of those indicators over time and compared indicator results by way of the comparison of proportions and Chi-square.
  
  
  RESULTS
  There was a decrease in the number of errors along the years (P<0.001). This pattern was confirmed in primary care patients, inpatients and outpatients. In blood samples, fewer errors occurred in outpatients, followed by inpatients.
  
  
  CONCLUSIONS
  We present a practical and effective methodology to monitor unsuitable sample preanalytical errors. The synthetic indicator results summarize overall preanalytical sample errors, and can be used as part of BSC management system.
authors: Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain ; Department of Biochemistry and Molecular Pathology, Universidad Miguel Hernandez, Elche, Spain.
authors: Maria
authors: M
authors: Salinas
authors: Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain ; Department of Biochemistry and Molecular Pathology, Universidad Miguel Hernandez, Elche, Spain.
authors: Maite
authors: M
authors: López-Garrigós
authors: Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain ; Department of Clinic Medicine, Universidad Miguel Hernandez, Elche, Spain.
authors: Emilio
authors: E
authors: Flores
authors: Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain.
authors: Ana
authors: A
authors: Santo-Quiles
authors: Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain.
authors: Mercedes
authors: M
authors: Gutierrez
authors: Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain.
authors: Javier
authors: J
authors: Lugo
authors: Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain.
authors: Rosa
authors: R
authors: Lillo
authors: Department of Radiology, University of Virginia, Charlottesville, VA, USA.
authors: Carlos
authors: C
authors: Leiva-Salinas
mesh_terms: D019411:Clinical Laboratory Techniques / Q000379:methods / Q000592:standards*; D003430:Cross-Sectional Studies; D003951:Diagnostic Errors / Q000517:prevention & control*; D005260:Female; D005568:Forms and Records Control / Q000592:standards; D006801:Humans; D008297:Male; D008499:Medical Records / Q000592:standards*; D012189:Retrospective Studies
keywords: Preanalytical phase; balanced scorecard; errors in laboratory medicine; patient safety