Measuring the impact: Severity of harm from laboratory errors in 195 tests

Area of Science:

• Clinical Chemistry
• Laboratory Medicine
• Patient Safety

Background:

• Accurate laboratory test results are crucial for patient diagnosis and treatment.
• Errors in laboratory testing can lead to significant patient harm.
• A systematic assessment of harm severity for laboratory test errors is needed.

Purpose of the Study:

• To objectively assess the potential severity of harm from erroneous results across 195 laboratory tests.
• To survey specialist physicians and medical biochemistry experts for their risk perceptions.
• To establish objective severity scores for laboratory test errors.

Main Methods:

• A survey of 514 experts (75 medical biochemists, 439 clinicians) was conducted.
• Participants rated the severity of harm for erroneous results of 195 laboratory tests (scale 1-5).
• Harm scores were matched with error effects identified from existing literature.

Main Results:

• Tests for cardiac biomarkers, blood gases, coagulation, critical ions, toxic elements, and drug levels were perceived as high-risk.
• Medical biochemists assigned higher severity scores to specific tests like total bilirubin and certain drug levels.
• High-risk tests identified include activated partial thromboplastin time, prothrombin time, international normalized ratio, and D-dimer.

Conclusions:

• A high agreement (91%) exists between clinicians and medical biochemists on harm severity scores.
• Objective severity scores for laboratory test errors were established.
• This study identifies high-risk laboratory tests, enabling targeted quality improvement initiatives.