Art and Science of Laboratory Medicine

Art and Science of Laboratory Medicine

Thursday, January 29, 2015

Diagnostic errors and laboratory medicine – causes and strategies

While the frequency of laboratory errors varies greatly, depending on the study design and steps of the total testing process (TTP) investigated, a series of papers published in the last two decades drew the attention of laboratory professionals to the pre- and post-analytical phases, which currently appear to be more vulnerable to errors than the analytical phase. In particular, a high frequency of errors and risk of errors that could harm patients has been described in both the pre-pre- and post-post-analytical steps of the cycle that usually are not under the laboratory control. In 2008, the release of a Technical Specification (ISO/TS 22367) by the International Organization for Standardization played a key role in collecting the evidence and changing the perspective on laboratory errors, emphasizing the need for a patient-centred approach to errors in laboratory testing.

A further step in the journey towards improved understanding of the issue is the recent demonstration that errors in laboratory medicine are part of a much wider issue, commonly known as “diagnostic error”, thus definitively linking laboratory-associated errors to patient safety problems. The current awareness of the nature of laboratory testing-associated errors, in particular the link between appropriate test ordering and result interpretation/utilization, and their potential in reducing diagnostic errors, should herald a change in the old paradigm which was focused only on errors detected within the laboratory walls. Evidence-based quality indicators represent a
formidable tool for improving quality and decreasing the risk of errors in the total testing process.

Read more:
eJIFCC January 2015.pdf

Source: eJIFCC, Mario Phlebani

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