Errors in laboratory medicine: practical lessons to improve patient safety

Area of Science:

• Laboratory Medicine
• Healthcare Quality Improvement
• Patient Safety

Background:

• Patient safety is significantly impacted by healthcare errors.
• Clinical pathology laboratories in the US routinely collect error rate data.
• A standardized list of critical performance measures for laboratories was previously lacking.

Purpose of the Study:

• To define critical performance measures in laboratory medicine.
• To report error rates associated with these measures.
• To provide actionable strategies for error reduction to enhance patient safety.

Main Methods:

• A comprehensive literature review was conducted, focusing on College of American Pathologists (CAP) Q-Probes and Q-Tracks studies.
• Data from over 130 interlaboratory studies were analyzed.
• Experiences from ongoing (Q-Tracks) and time-limited (Q-Probes) studies were synthesized.

Main Results:

• Preanalytic and postanalytic performance measures exhibited higher error rates than analytic measures.
• Eight critical performance measures were identified: customer satisfaction, test turnaround times, patient identification, specimen acceptability, proficiency testing, critical value reporting, blood product wastage, and blood culture contamination.
• Benchmarks for error rates were established, with recommendations for patient safety improvement.

Conclusions:

• The eight identified performance measures are practical, valuable, and essential for patient care.
• Implementation of these measures aids in meeting regulatory requirements.
• Laboratories are encouraged to adopt these measures and standardize their data analysis and error reduction strategies based on published findings.