Pre-analytical phase errors constitute the vast majority of errors in clinical laboratory testing

Area of Science:

• Clinical Laboratory Science
• Patient Safety
• Healthcare Quality Improvement

Background:

• Clinical laboratory errors can compromise patient safety.
• Pre-analytical errors are consistently identified as the most frequent type of laboratory error.
• Understanding error patterns in contemporary practice is crucial for quality improvement.

Purpose of the Study:

• To determine the types and frequency of errors in clinical laboratory testing.
• To analyze the distribution of errors across pre-analytical, analytical, and post-analytical phases.
• To identify the most common error types in a core laboratory setting.

Main Methods:

• Retrospective analysis of errors in a core laboratory from January 2022 to May 2023.
• Data collection through technologist interventions, incident reports, and laboratory information system (LIS) reports.
• Errors were categorized into pre-analytical, analytical, and post-analytical phases; total test volumes were assessed.

Main Results:

• Over 37 million billable results and 11 million specimens were analyzed, with 87,317 errors recorded.
• Pre-analytical errors constituted 98.4% of all errors, with hemolysis being the most common (69.6%).
• Excluding hemolysis, pre-analytical errors still represented 94.6% of the remaining errors.

Conclusions:

• The study confirms that pre-analytical errors are the predominant type of error in clinical laboratory testing.
• Findings are consistent with previous research, underscoring the persistent challenge of pre-analytical variability.
• Enhanced tools and strategies are necessary for effective detection and mitigation of pre-analytical errors.