Preanalytical quality improvement: From dream to reality

Giuseppe Lippi, Jeffrey J. Chance, Stephen Church, Paola Dazzi, Rossana Fontana, Davide Giavarina, Kjell Grankvist, Wim Huisman, Timo Kouri, Vladimir Palicka, Mario Plebani, Vincenzo Puro, Gian Luca Salvagno, Sverre Sandberg, Ken Sikaris, Ian Watson, Ana K. Stankovic, Ana Maria Simundic

Research output: Contribution to journalArticlepeer-review

Abstract

Laboratory diagnostics (i.e., the total testing process) develops conventionally through a virtual loop, originally referred to as "the brain to brain cycle" by George Lundberg. Throughout this complex cycle, there is an inherent possibility that a mistake might occur. According to reliable data, preanalytical errors still account for nearly 60%-70% of all problems occurring in laboratory diagnostics, most of them attributable to mishandling procedures during collection, handling, preparing or storing the specimens. Although most of these would be "intercepted" before inappropriate reactions are taken, in nearly one fifth of the cases they can produce inappropriate investigations and unjustifiable increase in costs, while generating inappropriate clinical decisions and causing some unfortunate circumstances. Several steps have already been undertaken to increase awareness and establish a governance of this frequently overlooked aspect of the total testing process. Standardization and monitoring preanalytical variables is of foremost importance and is associated with the most efficient and well-organized laboratories, resulting in reduced operational costs and increased revenues. As such, this article is aimed at providing readers with significant updates on the total quality management of the preanalytical phase to endeavour further improvement for patient safety throughout this phase of the total testing process.

Original languageEnglish
Pages (from-to)1113-1126
Number of pages14
JournalClinical Chemistry and Laboratory Medicine
Volume49
Issue number7
DOIs
Publication statusPublished - Jul 1 2011

Keywords

  • errors
  • laboratory diagnostics
  • patient safety
  • preanalytical phase
  • quality

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

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