Clinical Laboratory Quality Practices When Hemolysis Occurs.

Area of Science:

• Clinical Laboratory Science
• Quality Improvement in Healthcare
• Diagnostic Testing

Background:

• Hemolyzed specimens lead to delayed results, increased testing, and higher healthcare costs.
• Specimen hemolysis poses significant challenges in clinical laboratory operations.
• Indirect patient harm and financial burdens are associated with hemolysis.

Purpose of the Study:

• To evaluate current quality improvement practices for managing specimen hemolysis.
• To identify strategies employed by laboratories to address hemolysis.
• To assess the effectiveness of interventions aimed at reducing hemolysis rates.

Main Methods:

• A survey questionnaire was distributed to participants of the College of American Pathologists (CAP) Chemistry Survey Program.
• The survey focused on hemolysis detection, reporting, and reduction practices.
• Data were collected from 846 responding laboratories regarding their policies and actions.

Main Results:

• While many labs have written policies for analytes like potassium, standardized hemolysis reporting across analyzers is limited.
• Most participants have not validated manufacturer hemolysis data, though validation efforts are successful.
• Corrective actions to reduce hemolysis are common, but 70% report slow progress, with many using the same specimen flag for hemolysis, lipemia, and icterus.

Conclusions:

• Specimen hemolysis adversely affects healthcare quality and increases costs.
• Current practices for measuring, reporting, and reducing hemolysis require significant improvement.
• Enhanced strategies are necessary to effectively manage and mitigate the impact of hemolysis in clinical laboratories.