Errors in a Stat Laboratory: Types and Frequencies 10 Years Later

TLDR

Patient safety concerns have highlighted the need for clinical laboratories to track error rates across the entire testing cycle, including pre‑, intra‑, and post‑analytical phases. This study applied a 1996 monitoring design in 2006 to assess laboratory error rates in four departments—internal medicine, nephrology, surgery, and intensive care. Over three months, clinicians recorded suspected errors during 51,746 analyses, with a laboratory physician reviewing each day to confirm 160 errors. The error frequency fell to 3,092 ppm, significantly lower than 4,700 ppm in 1996, and of the confirmed errors, 61.9 % were pre‑analytical, 15 % analytical, and 23.1 % post‑analytical.

Abstract

In view of increasing attention focused on patient safety and the need to reduce laboratory errors, it is important that clinical laboratories collect statistics on error occurrence rates over the whole testing cycle, including pre-, intra-, and postanalytical phases.The present study was conducted in 2006 according to the design we previously used in 1996 to monitor the error rates for laboratory testing in 4 different departments (internal medicine, nephrology, surgery, and intensive care). For 3 months, physicians and nurses were asked to pay careful attention to all test results. Any suspected laboratory error was recorded with associated pertinent clinical information. Every day, a laboratory physician visited the 4 departments and a critical appraisal was made of any suspect results.Among a total of 51 746 analyses, clinicians notified us of 393 questionable findings, 160 of which were confirmed as laboratory errors. The overall frequency of errors, 3092 ppm, was significantly lower (P <0.05) than in 1996 (4700 ppm). Of the 160 confirmed errors, 61.9% were preanalytical errors, 15% were analytical, and 23.1% were postanalytical.During the last decade the error rates in our stat laboratory have been reduced significantly. As demonstrated by the distribution pattern, the pre- and postanalytical steps still have the highest error prevalences, but changes have occurred in the types and frequencies of errors in these phases of testing.