An investigation in pre-analytical error in a medium sized pathology laboratory: frequency, origin, type, and a proposed intervention

Yeates, Riana Lee (2016) An investigation in pre-analytical error in a medium sized pathology laboratory: frequency, origin, type, and a proposed intervention. Masters (Research) thesis, James Cook University.

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Pre-analytical error in pathology is responsible for as much as 85% of total errors in the testing process. While many studies have examined the frequency of pre-analytical error alone, fewer studies investigate the frequency at which of different types of error occur, or categorise them for comparison across healthcare facilities. Remediation and reduction of error requires a clear understanding of the actual cause and source of error. Therefore an understanding of the type of errors may help inform strategies to reduce these errors and subsequently any impact on patients and the healthcare system. The aims of this study were to identify and characterise the pre-analytical error associated with specimens received into the Pathology Laboratory of the Townsville Hospital; utilising the extensive database of requests and results contained in the laboratory information system (LIS) and once understood, to propose an intervention designed to reduce errors originating from a clinical area with a high error rate.

The results from this study showed that pre-analytical errors are numerous and diverse, however a critical factor in determining the pre-analytical error rate was the ward from which the sample was collected. There currently is no standardised definition for each type of error within laboratory medicine, nor is there a standard unit of measure. Although recommendations for clinical indicators have been proposed, this study considers them to be too laborious and impractical for continuous monitoring and reporting to regulatory bodies. This study found that identifying the overall category of error is an efficient and focussed method for targeting an interventional strategy for the reduction of pre-analytical errors in a clinical area or ward, and that such an intervention can result in substantial savings in healthcare expenditure.

Until there is consensus on the identification and recording of pre-analytical errors, any comparison between studies should be done with caution and interpreted after proper examination of the study method. In addition, achieving a consensus on the definitions of pre-analytical error in order to monitor the frequency of error is a worthwhile goal, however the method chosen will need to be realistic, cost effective and easily implemented by all laboratories in order to be successful.

Item ID: 49872
Item Type: Thesis (Masters (Research))
Keywords: diagnostic methods, error, human error, medical errors, mistakes, pathology laboratories, pathology labs, pathology, pre-analytic error, scientific errors, Townsville hospital
Date Deposited: 15 Aug 2017 03:43
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110316 Pathology (excl Oral Pathology) @ 100%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920203 Diagnostic Methods @ 100%
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