Frequency of Rejected Samples in the Hematological Departments: A Comparison Between Palestinian Medical Complex Hospital and Hebron Governmental Hospital.

Abstract

Background: Clinical laboratories play a vital role in diagnosis and management of patients. They use established protocols for sample collection and analysis, and several criteria to judge the quality of clinical samples intended for laboratory analysis. Two essential performance measures recommended for clinical laboratories are rejected samples and turnaround time (TAT), which have substantial clinical consequences for patient safety. This study evaluates these two measures in the hematological departments among the two biggest Palestinian Governmental Hospitals in the West Bank region, the Palestinian Medical Complex Hospital (PMCH), and the Hebron Governmental Hospital (HGH). This study is the first one to evaluate the rejected samples from Palestinian governmental hospitals.

Methods: A retrospective analysis of rejected hematology samples was conducted over eight months (February-September 2023). Rejection frequencies, causes, and their influence on TAT were assessed according to the Ministry of Health guidelines.

Results: PMCH exhibited a significantly higher rejection rate (2.1%) than HGH (1%), primarily due to clotted EDTA and Na-citrate tubes. The TAT for rejected samples was longer at HGH (over 10 hours) than at PMCH (5-6 hours).

Conclusion: The study revealed a high specimen rejection rate, and prolonged TAT for EDTA samples, with approximately 40% of rejected samples not repeated within 24 hours. These findings provide baseline data to guide future quality improvement initiatives, staff training, and standardization of preanalytical procedures, ultimately enhancing laboratory quality and patient safety. Larger-scale studies are recommended to further investigate the factors contributing to sample rejection and inform corrective measures.