Small Steps for a Big Change: Attention towards Preanalytical Error

Aims: The study aimed to evaluate the preanalytical errors in the Indoor patient department in tertiary care Hospital. To calculate the percentage of preanalytical errors in the Indoor patient department in our Hospital and to recommend standard operative interventions to improve quality of results. To test the effectiveness of attention by continuous educational action at reducing preanalytical errors and improving patient care.

Study Design: An observational study.

Place and Duration of Study: The work was done from July 2014 to July 2015 at a tertiary care Hospital India.

Methodology: We retrospectively reviewed the samples and test request forms received at Biochemistry laboratory for one month. The outcome measures were incomplete laboratory forms, mislabeling samples, inappropriate tests, wrong container, poor quality of samples and transportation problems. Two weeks of interventions in the form of continuous educational training and education regarding standard operative procedures were given to stakeholders to raise awareness towards the preanalytical phase. Two weeks later, data was monitored again for one month.

Results: 2330 and 2130 samples and request forms were monitored before-after intervention respectively from wards for one month each. Of the total chances of preanalytical errors, 22.17% were due to inappropriate tests, 81.5% were related to incomplete patient information, 97% lacking clinical information, 18.8% errors related to specimen information, 3.5% errors were of the deranged quality of the specimen, and in4.5% transportation problems were observed. Subsequently, these were reduced to 10%, 20%, 16.4%, 7.5%, 2.3%, 3.1% respectively. A significant difference in percentage change was observed in all the above errors after the one-month interventions for the reduction in preanalytical errors.

Conclusion: The results of the present study revealed that taking small steps in the form of implementing standard operative procedures for collection, storage and transport facilities and continuous educational training of stakeholders would reduce big errors occurring due to human factors in preanalytical phase. We need good interdepartmental communication and cooperation to achieve good laboratory results and patient well being. This study improved the quality of test results and patient care.