Evaluation of analytical errors in a clinical chemistry laboratory: a 3 year experience

Abstract

Background: Proficient laboratory service is the cornerstone of modern healthcare systems and has an impact on over 70% of medical decisions on admission, discharge, and medications. In recent years, there is an increasing awareness of the importance of errors in laboratory practice and their possible negative impact on patient outcomes.
Aim: We retrospectively analyzed data spanning a period of 3 years on analytical errors observed in our laboratory. The data covered errors over the whole testing cycle including pre‑, intra‑, and post‑analytical phases and discussed strategies pertinent to our settings to minimize their occurrence.
Materials and Methods: We described the occurrence of pre‑analytical, analytical and post‑analytical errors observed at the Komfo Anokye Teaching Hospital clinical biochemistry laboratory during a 3‑year period from January, 2010 to December, 2012. Data were analyzed with Graph Pad Prism 5(GraphPad Software Inc. CA USA).
Results: A total of 589,510 tests was performed on 188,503 outpatients and hospitalized patients. The overall error rate for the 3 years was 4.7% (27,520/58,950). Pre‑analytical, analytical and post‑analytical errors contributed 3.7% (2210/58,950), 0.1% (108/58,950), and 0.9% (512/58,950), respectively. The number of tests reduced significantly over the 3-year period, but this did not correspond with a reduction in the overall error rate (P = 0.90) along with the years.
Conclusion: Analytical errors are embedded within our total process setup especially pre‑analytical and post‑analytical phases. Strategic measures including quality assessment programs for staff involved in pre‑analytical processes should be intensified.

Keywords: Errors, Post‑analytical, Pre‑analytical Quality control