Retrospective Review of Specimen Rejections in 2024: Insights from a Regional Hospital Laboratory

Specimen rejection is a critical quality indicator in clinical laboratories, often resulting from pre-analytical errors that compromise diagnostic accuracy and patient care. This retrospective study analyzed rejection patterns at a regional hospital laboratory throughout 2024 to identify leading causes and guide quality improvement strategies.

Rejection data from January to December 2024 were retrieved from the laboratory information system and categorized by documented rejection reasons. Descriptive statistics were used to determine the frequency and proportion of each category. A chi-squared test was performed to evaluate monthly variation in the top three rejection causes.

A total of 2,976 specimens were rejected during the 12-month period. The leading causes were severe hemolysis (37.67%), clotted specimen (20.40%), and insufficient specimen (8.70%). Together, the top 10 reasons accounted for approximately 88.3% of all rejections. The chi-squared test showed a statistically significant difference in the monthly distribution of the top three rejection causes (χ² = 44.95, df = 24, p = 0.0059), suggesting that the variation over time was unlikely to be due to chance.

Pre-analytical errors remained the predominant contributors to specimen rejection in 2024. The observed fluctuations across months underscore the need for targeted interventions, such as staff retraining, reinforced specimen handling protocols, and enhanced communication between clinical and laboratory teams, to improve laboratory efficiency and patient safety.