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Updated: Jul 2, 2026

Remote Laboratory Management: Respiratory Virus Diagnostics
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Published on: April 6, 2019

Strategies for effective occurrence Management in Resource-Limited Clinical Laboratories: Challenges and practical

Blessing Kenechi Myke-Mbata1, Bruno Basil2, Izuchukwu Nnachi Mba3

  • 1Department of Chemical Pathology, Rev Fr. Moses Orshio Adasu University, Makurdi, Nigeria.

Clinica Chimica Acta; International Journal of Clinical Chemistry
|June 30, 2026
PubMed
Summary

This study presents a scalable framework to improve laboratory error management in resource-limited settings (RLS). Implementing a just culture and system-centric learning significantly reduces diagnostic errors and enhances healthcare sustainability.

Keywords:
ISO 15189:2022Occurrence managementPatient safetyQuality management systemsResource-limited settingsTotal testing process

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Area of Science:

  • Clinical Laboratory Science
  • Healthcare Management
  • Public Health

Background:

  • Clinical laboratory results are crucial for medical management, but resource-limited settings (RLS) face significant barriers to diagnostic safety.
  • Infrastructural issues like unreliable power, workforce shortages, and poor data systems hinder effective occurrence management in RLS.

Purpose of the Study:

  • To review system-level and organizational barriers to error management in low-resource laboratories.
  • To synthesize a scalable, phased operational framework for continuous quality improvement and patient safety in RLS.

Main Methods:

  • A comprehensive literature search (2010-2026) was conducted across multiple databases.
  • The Total Testing Process (TTP) framework and Plan-Do-Check-Act (PDCA) cycle guided the synthesis of 67 eligible records.
  • A PRISMA-informed screening process was employed for study selection.

Main Results:

  • Laboratory errors are predominantly in the pre-analytical phase (up to 68.2%), often due to human-system interface issues, manual transcription, and cold-chain failures.
  • A six-stage occurrence management roadmap, aligned with ISO 15189:2022, was developed for RLS.
  • Low-cost interventions include 'just culture' policies, in-house quality control, open-source laboratory information systems, and interdisciplinary committees.

Conclusions:

  • Enhancing error tracking in RLS is achievable through operational changes, not requiring extensive capital investment.
  • A shift from individual blame to system-centric learning, supported by stepwise accreditation mentorship models, reduces diagnostic defects.
  • These improvements contribute to the overall sustainability of health systems.