Preanalytical errors in medical laboratories: a review of the available methodologies of data collection and analysis.
Preanalytical errors have previously been shown to contribute a significant proportion of errors in laboratory processes and contribute to a number of patient safety risks. Accreditation against ISO 15189:2012 requires that laboratory Quality Management Systems consider the impact of preanalytical processes in areas such as the identification and control of non-conformances, continual improvement, internal audit and quality indicators. Previous studies have shown that there is a wide variation in the definition, repertoire and collection methods for preanalytical quality indicators. The International Federation of Clinical Chemistry Working Group on Laboratory Errors and Patient Safety has defined a number of quality indicators for the preanalytical stage, and the adoption of harmonized definitions will support interlaboratory comparisons and continual improvement. There are a variety of data collection methods, including audit, manual recording processes, incident reporting mechanisms and laboratory information systems. Quality management processes such as benchmarking, statistical process control, Pareto analysis and failure mode and effect analysis can be used to review data and should be incorporated into clinical governance mechanisms. In this paper, The Association for Clinical Biochemistry and Laboratory Medicine PreAnalytical Specialist Interest Group review the various data collection methods available. Our recommendation is the use of the laboratory information management systems as a recording mechanism for preanalytical errors as this provides the easiest and most standardized mechanism of data capture.
1 Department of Clinical Biochemistry and Immunology, Peterborough City Hospital, Peterborough, UK.
Jamie
J
West
2 Liverpool Clinical Laboratories, Blood Sciences Department, Aintree University Hospital, Liverpool, UK.
Jennifer
J
Atherton
3 Derriford Combined Laboratory, Plymouth Hospitals NHS Trust, Plymouth, Devon, UK.
Seán J
SJ
Costelloe
4 Becton Dickinson Diagnostics, Preanalytical Systems (PAS), Oxford, UK.
Ghazaleh
G
Pourmahram
4 Becton Dickinson Diagnostics, Preanalytical Systems (PAS), Oxford, UK.
Adam
A
Stretton
5 Clinical Chemistry Department, New Cross Hospital, Wolverhampton, UK.
Michael
M
Cornes
D019985:Benchmarking; D002624:Chemistry, Clinical / Q000379:methods / Q000592:standards*; D019963:Clinical Chemistry Tests / Q000592:standards*; D002984:Clinical Laboratory Information Systems / Q000458:organization & administration*; D003625:Data Collection / Q000379:methods*; D003951:Diagnostic Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D006801:Humans; D007753:Laboratories; D011786:Quality Control
Preanalytical errors; laboratory errors; patient safety; quality indicators