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Interventions to Increasing Test Cancellation Rates in Blood Bank Based on a Multi-Year Review
Insights
Blood bank test cancellations, primarily due to specimen quality and ordering errors, significantly impact patient care. Addressing these issues is crucial for improving laboratory efficiency and reducing delays.
Area of Science:
- Medical Laboratory Science
- Transfusion Medicine
- Quality Management in Healthcare
Background:
- Test cancellations in blood bank laboratories lead to wasted resources and delayed patient care.
- Identifying root causes of cancellations is essential for targeted improvement strategies.
Purpose of the Study:
- To identify the primary reasons for blood bank test cancellations.
- To establish targets for improving test cancellation rates.
Main Methods:
- Retrospective review of canceled blood bank tests from January 2017 to December 2020 in Hail, Saudi Arabia.
- Analysis of data from the quality assurance database to determine cancellation reasons.
Main Results:
- A total of 2,017 (2.7%) test cancellations occurred over four years, with an increasing trend.
- Specimen quality issues (61.9%) and test order problems (33.9%) were the leading causes.
- Clotted specimens (48.5%), incorrect test orders (15.6%), and duplicate orders (13.9%) were the most frequent specific reasons.
Conclusions:
- Test cancellations present a significant challenge in clinical laboratories, necessitating focused interventions.
- Inter-professional collaboration on specimen collection/handling and laboratory error reduction can minimize cancellations.
- Data-driven analysis of cancellation reasons is key to developing effective strategies for reduction.
Background:
Apart from the wasted resource, canceled tests cause delay of test results thus affecting patient care. The study aimed to identify the reasons for the test cancellation of samples received in a blood bank laboratory and determine the improvement target.
Methods:
The study retrospectively reviewed the canceled tests in a blood bank laboratory of a hospital in Hail, Saudi Arabia, from January 2017 to December 2020. Records of the canceled test taken from the quality assurance database were utilized to identify the various reasons.
Results:
A total of 2,017 (2.7%) test cancellations were recorded in the 4-year study period with increasing rates noted. The two primary reasons were specimen quality issues (61.9%) and problems related to test orders (33.9%). The main reason for test cancellation was clotted specimen (48.5%) followed by incorrect test order (15.6%) and duplicate test order (13.9%). Statistically, a significant difference exists between the annual rates and reasons of cancellation, X2 (6, n = 2,017) = 83.24, p < 0.001.
Conclusions:
Test cancellations due to various reasons remain a significant challenge for clinical laboratories. Detailed analyses on these major reasons can aid in displaying an effective approach to decrease the cancellation rates. Harmonization among inter-professional health workers concerning specimen collection and handling, and involving clinical laboratory personnel could minimize laboratory errors and avoid test cancellations.
