Review of Key Performance Indicator in a Hematology Laboratory: A Preventable Source of Error
Keywords:
Laboratory errors, Pre-analytical, Analytical, Post-analytical, Laboratory testing, Laboratory servicesAbstract
Objective: To assess the key performance indicators and the laboratory errors in the hematology laboratory.
Methodology: A cross-sectional study was conducted at the DDRRL Hematology laboratory from October 2021 to September 2022. Data from the blood bank and hematological laboratory were collected. The primary investigator managed every step of the data-gathering operation. All the tools required for the process were gathered and arranged on a tray or trolley to be safe, accessible, and readily visible. Sterile glass or plastic tubes with rubber covers were used for blood collection. The information acquired during the study was inserted into a computer using an Excel sheet. SPSS version 20 was used for the analysis.
All samples from the hematology section of DDRRL were included in this study, while all error-free samples were excluded.
Result: From July to December, 414,400 hematology request forms were collected from OPD, private wards, IPD and Emergency. Overall, 2376 (0.573%) hematology laboratory errors were detected, of which 419 were Pre-analytical errors, 122 were analytical, and 1834 were post-analytical errors.
Conclusion: We can lower the errors' likelihood if we appropriately handle the pre-analytical variables. Additionally, care must be taken when training workers to minimize the possibility of mistakes.
References
Dahm MR, Georgiou A, Herkes R, Brown A, Li J, Lindeman R et al. Patient groups, clinicians and healthcare professionals agree – all test results need to be seen, understood and followed up. Diagnosis(Berl). 2018; 5(4): 215-22. doi: 10.1515/dx-2018-0083.
Sciacovelli L, Lippi G, Sumarac Z, West J, Pinto Castro IG, Vieria KF et al. Quality Indicators in Laboratory Medicine: the status of the progress of IFCC Working Group "Laboratory Errors and Patient Safety project. Clin Chem Lab Med. 2017; 55(3): 348–357. doi: 10.1515/cclm-2016-0929.
Lubin IM, Astles JR, Shahangian S, Madison B, Parry R, Schmidt RL et al. Bringing the clinical laboratory into the strategy to advance diagnostic excellence. Diagnosis(Berl). 2021; 8(3): 281-94. doi: 10.1515/dx-2020-0119.
Plebani M, Laposata M, Lippi G. A manifesto for the future of laboratory medicine professionals. Clin Chim Acta. 2019; 489: 49-52. doi: 10.1016/j.cca.2018.11.021. Epub 2018 Nov 13.
Chhillar N, Khurana S, Agarwal R, Singh NK. Effect of pre-analytical errors on quality of laboratory medicine at a neuropsychiatry institute in North India. Indian J Clin Biochem. 2011; 26(1): 46-9. doi: 10.1007/s12291-010-0082-2.
Najat D. Prevalence of pre-analytical errors in clinical chemistry diagnostic labs in Sulaimani city of Iraqi Kurdistan. PloS one. 2017; 12(1): e0170211.
doi: 10.1371/journal.pone.0170211.
Maillet É, Paré G, Currie LM, Raymond L, de Guinea AO, Trudel MC et al. Laboratory testing in primary care: a systematic review of health IT impacts. Int J Med Iform. 2018; 116: 52-69. doi: 10.1016/j.ijmedinf.2018.05.009. Epub 2018 May 21.
Kadi? D, Avdagi?-Ismi? A, Hasi? S. The prevalence of pre-analytical errors in the laboratory of the Cantonal Hospital Zenica in Bosnia and Herzegovina. Med Glas. (Zenica). 2019; 16(1): 1-6. doi: 10.17392/979-19.
Gyawali P, Shrestha RK, Bhattarai P, Raut BK, Aryal M, Malla SS. Evaluation of Pro-analytical errors: Inadequacies In the completion of laboratory requisition forms. J Nepal Assoc Med lab Sci. 2012; 11(1): 43-48.
Bakan E, Umudum FZ. Automation of extra-analytical phase for clinical laboratory. Turkish J Biochem. 2021; 46(2): 115-28. doi: 10.1515/tjb-2020-0138.
Nagaraj RB, Ansari MK, Shivanna BD. Evaluation of Quality Control in Clinical Hematology laboratory by using Six-Sigma. Ann Roman Soc Cell Biol. 2021; 25(4): 20354-9.
Kumar V, Gill KD. Basic concepts in clinical biochemistry: A practical guide. Springer Singapore; 2018 Mar 30.
Trivedi P, Shah N, Ramani KV. Managing clinical laboratories: monitor and control lab errors to improve lab performance. Indian Institute of Management. 2011.
Lippi G, Da Rin G. Advantages and limitations of total laboratory automation: a personal overview. Clin Chem Lab Med. 2019; 57(6): 802-11. doi: 10.1515/cclm-2018-1323.
Makubi AN, Meda C, Magesa A, Minja P, Mlalasi J, Salum Z et al. Audit of clinical-laboratory practices in haematology and blood transfusion at Muhimbili National Hospital in Tanzania. Tanzan J Health Res. 2012; 14(4): 257-62.
Chawla R, Goswami B, Tayal D, Mallika V. Identification of the types of pre-analytical errors in the clinical chemistry laboratory: 1-year study at GB Pant Hospital. Lab Med. 2010; 41(2): 89-92.
Zaidi SSH, Sana M, Ghafoor MT. Assessment of Total Laboratory Errors in Clinical Chemistry Laboratory: Experience at a Tertiary Care Hospital. Liaquat National J Prim Care. 2022; 4(1): 6-10. doi: 10.37184/injpc.2707-3521.4.7.
Sciacovelli L, Lippi G, Sumarac Z, del Pino Castro IG, Ivanov A, De Guire V et al. Pre-analytical quality indicators in laboratory medicine: Performance of laboratories participating in the IFCC working group "Laboratory Errors and Patient Safety" project. Clin Chim Acta. 2019; 497: 35-40. doi: 10.1016/j.cca.2019.07.007. Epub 2019 Jul 8.
Kaushik N, Green S. Pre-analytical errors: their impact and how to minimize them. MLO Med Lab Obs. 2014; 46(5): 22, 24, 26.
Haroon ZH, Javaid H, Rashid H, Tahir M, Butt MQ, Afridi N. Pre-analytical errors in a peripheral hospital laboratory. Pak Armed Forces Med J. 2014; 64(2): 315-18.
Tadesse H, Desta K, Kinde S, Hassen F, Gize A. Errors in the Hematology Laboratory at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. BMC Res Notes. 2018;11(1): 420. doi: 10.1186/s13104-018-3551-y.
Lima-Oliveira G, Volanski W, Lippi G, Picheth G, Guidi GC. Pre-analytical phase management: a review of the procedures from patient preparation to laboratory analysis. Scand J Clin Lab Invest. 2017; 77(3): 153-63. doi: 10.1080/00365513.2017.1295317. Epub 2017 Mar 7.
De la Salle B. Pre?and postanalytical errors in haematology. Int J Lab Hematol. 2019; 41(Suppl 1): 170-6. doi: 10.1111/ijlh.13007.
Gaur K, Puri V, Shukla S, Sharma S, Suman S, Singh R. Finish before the start: Analyzing pre-analytical sample errors in a tertiary care hematology laboratory. Indian J Pathol Microbiol. 2020; 63(3): 435-40. doi: 10.4103/IJPM.IJPM_191_19.
Teshome M, Worede A, Asmelash D. Total clinical chemistry laboratory errors and evaluation of the analytical quality control using sigma metric for routine clinical chemistry tests. J Multidiscipl Healthc. 2021; 14: 125-136. doi: 10.2147/JMDH.S286679.
Sakyi AS, Laing EF, Ephraim RK, Asibey OF, Sadique OK. Evaluation of analytical errors in a clinical chemistry laboratory: a 3 year experience. Ann Med Health Sci Res. 2015; 5(1): 8-12. doi: 10.4103/2141-9248.149763.
Abdollahi A, Saffar H, Saffar H. Types and frequency of errors during different phases of testing at a clinical medical laboratory of a teaching hospital in Tehran, Iran. N Am J Med Sci. 2014; 6(5): 224-8. doi: 10.4103/1947-2714.132941.
Sikaris K. Performance criteria of the post-analytical phase. Clin Chem Lab Med. 2015; 53(6): 949-58. doi: 10.1515/cclm-2015-0016.
Hawkins R. Managing the pre-and post-analytical phases of the total testing process. Ann Lab Med. 2012; 32(1): 5-16. doi: 10.3343/alm.2012.32.1.5.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Journal of Liaquat University of Medical & Health Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Submission of a manuscript to the journal implies that all authors have read and agreed to the content of the undertaking form or the Terms and Conditions.
When an article is accepted for publication, the author(s) retain the copyright and are required to grant the publisher the right of first publication and other non-exclusive publishing rights to JLUMHS.
Articles published in the Journal of Liaquat University of Medical & health sciences are open access articles under a Creative Commons Attribution-Noncommercial - Share Alike 4.0 License. This license permits use, distribution and reproduction in any medium; provided the original work is properly cited and initial publication in this journal. This is in accordance with the BOAI definition of open access. In addition to that users are allowed to remix, tweak and build upon the work non-commercially as long as appropriate credit is given and the new creations are licensed under the identical terms. Or, in certain cases it can be stated that all articles and content there in are published under creative commons license unless stated otherwise.