Significant Reduction in Preanalytical Errors for Nonphlebotomy Blood Draws After Implementation of a Novel Integrated Specimen Collection Module.
OBJECTIVE
Most preanalytical errors at our institution occur during nonphlebotomy blood draws. We implemented an electronic health record (EHR), interfaced the EHR to the laboratory information system, and designed a new specimen collection module. We studied the effects of the new system on nonphlebotomy preanalytical errors.


METHODS
We used an electronic database of preanalytical errors and calculated the number and type of the most common errors in the emergency department (ED) and inpatient nursing for 3-month periods before (August-October 2014) and after (August-October 2015) implementation. The level of staff compliance with the new system was also assessed.


RESULTS
The average monthly preanalytical errors decreased significantly from 7.95 to 1.45 per 1,000 specimens in the ED (P < 0001) and 11.75 to 3.25 per 1,000 specimens in inpatient nursing (P < 0001). The rate of decrease was similar for mislabeled, unlabeled, wrong specimen received and no specimen received errors. Most residual errors (80% in the ED and 67% in inpatient nursing) occurred when providers did not use the new system as designed.


CONCLUSIONS
Implementation of a customized specimen collection module led to a significant reduction in preanalytical errors. Improved compliance with the system may lead to further reductions in error rates.
From the University of Massachusetts Medical School, Worcester, MA.
Rachel D
RD
Le
Department of Pathology Harvard Medical School, Boston, MA.
Stacy E F
SE
Melanson
Department of Pathology Harvard Medical School, Boston, MA.
Athena K
AK
Petrides
Department of Pathology.
Ellen M
EM
Goonan
Department of Pathology Department of Emergency Medicine.
Ida
I
Bixho
Harvard Medical School, Boston, MA Department of Nursing.
Adam B
AB
Landman
Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Anne Marie
AM
Brogan
Harvard Medical School, Boston, MA Department of Medicine, Brigham and Women's Hospital, Boston, MA.
David W
DW
Bates
Department of Pathology Harvard Medical School, Boston, MA mtanasijevic@partners.org.
Milenko J
MJ
Tanasijevic
D001800:Blood Specimen Collection / Q000379:methods*; D002984:Clinical Laboratory Information Systems; D003951:Diagnostic Errors; D057286:Electronic Health Records; D006801:Humans; D007755:Laboratories, Hospital
Information technology; Nursing collections; Patient safety; Preanalytical errors