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Related Experiment Videos

Errors in clinical laboratories or errors in laboratory medicine?

Mario Plebani1

  • 1Department of Laboratory Medicine, University Hospital of Padova and Center of Biomedical Research, Castelfranco Veneto, Italy. mario.plebani@unipd.it

Clinical Chemistry and Laboratory Medicine
|May 30, 2006
PubMed
Summary

Laboratory errors frequently occur before and after testing, not during. Minimizing pre- and post-analytical mistakes is crucial for total quality laboratory services and patient safety.

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Area of Science:

  • Laboratory Medicine
  • Clinical Pathology
  • Quality Management in Healthcare

Background:

  • Clinical laboratories traditionally focus on analytical quality control.
  • Evidence shows most errors occur in pre-analytical and post-analytical phases.
  • Analytical errors have decreased, but interference remains a concern, especially in immunoassays.

Purpose of the Study:

  • To describe common and high-risk errors in pre-, intra-, and post-analytical laboratory testing.
  • To provide practical advice for measuring and reducing laboratory error risks.
  • To advocate for a broader definition and classification of laboratory errors.

Main Methods:

  • Review of recent surveys on laboratory medicine errors.
  • Analysis of error rates in pre-analytical, analytical, and post-analytical phases.

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  • Incorporation of recommendations from International Organization for Standardization (ISO) on laboratory error.

    • Main Results:

    • Pre-analytical factors account for 46-68.2% of errors; post-analytical factors contribute 18.5-47%.
    • Analytical errors have decreased but can significantly impact patients (e.g., immunoassays).
    • Many "laboratory errors" stem from external factors like communication or process design.

    Conclusions:

    • Total quality in laboratory services requires minimizing errors in pre- and post-examination steps.
    • A patient-centered approach necessitates addressing errors beyond the analytical phase.
    • Broader definitions and classifications of laboratory errors are needed for comprehensive quality improvement.