Reducing the occurrence of errors in a laboratory's specimen receiving and processing department

Abstract

Frequent, preventable medical errors can have an adverse effect on patient safety and quality as well as leading to wasted resources. In the laboratory, errors can occur at any stage of sample processing; pre-analytical, analytical, and post analytical stages. However evidence shows most of the laboratory errors occur during the pre-analytical stage. The receipt and processing of specimens is one of the main steps in the pre-analytical stage. Errors in this stage could be due to mislabeling, incorrect test entry and entering the wrong location, among other reasons. Most of these errors are preventable. At the Riyadh Regional Laboratory of the Ministry of Health, we found that there was an average of 2.31 errors per 1000 processed samples; these errors had occurred during the pre-analytical stage. These samples were returned back from other laboratory departments, such as Chemistry, Hematology and Microbiology, to the receiving and processing department. We decided to carry out an improvement project where we applied a systematic approach to identify and analyse the root causes of the problem using quality tools such as a process flowchart and a fish-bone diagram. The Model for Improvement was used and several PDSA (Plan, Do, Study, Act) cycles were run to test interventions which aimed to prevent laboratory processing errors and mistakes. The project results showed a 25% reduction in errors during the pre-analytical stage.