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Detecting Preanalytical Errors Using Quality Indicators in a Hematology Laboratory.

Khalid Alshaghdali1, Tessie Y Alcantara, Raja Rezgui

  • 1Department of Medical Laboratory Science, College of Applied Medical Sciences, University of Hail, Saudi Arabia (Drs Alshaghdali, Rezgui, and JC Alcantara and Ms TY Alcantara); Department of Medical Laboratory Science, School of Pharmacy, College of Health Sciences, University of Wyoming, Casper (Dr Cruz); and Department of Clinical Laboratory, Maternity and Pediatric Hospital, Hail, Saudi Arabia (Messrs Alshammary and Almotairi).

Quality Management in Health Care
|September 6, 2021
PubMed
Summary
This summary is machine-generated.

Continuous monitoring of quality indicators (QIs) in hematology revealed significant preanalytical errors, primarily clotted specimens and sample issues. However, error rates decreased over time, highlighting the value of QIs for improving laboratory performance.

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Area of Science:

  • Clinical Laboratory Science
  • Hematology
  • Quality Management

Background:

  • Continuous monitoring of laboratory performance is essential for error detection and improvement in laboratory medicine.
  • The preanalytical phase is a critical stage where errors can significantly impact patient care and diagnostic accuracy.

Purpose of the Study:

  • To review quality indicators (QIs) used in a clinical hematology laboratory.
  • To identify and quantify laboratory errors occurring in the preanalytical phase of hematology testing.

Main Methods:

  • A retrospective review of all samples received in the Hematology Laboratory over three years (January 2017 - December 2019).
  • Evaluation of preanalytical issues using a defined set of QIs.
  • Comparison of QI rates against established quality specifications and sigma-based performance levels.

Main Results:

  • Out of 95,002 blood samples, 8,852 (9.3%) exhibited preanalytical errors.
  • "Clotted specimen" (3.6%) and "samples not received" (3.5%) were the most frequent errors.
  • A decreasing trend in preanalytical errors was observed, from 11.6% to 6.5% over the study period.

Conclusions:

  • Preanalytical errors, particularly those related to specimen quality from collection issues, remain a significant challenge in hematology laboratories.
  • Quality indicators are effective tools for assessing and improving performance in the preanalytical phase.
  • Ongoing monitoring and management of QI data are crucial for sustained quality improvement in laboratory medicine.