Yellesh Pothula

Abstract

Introduction: Laboratory bias can occur during the pre-examination, examination and post-examination stages. The appropriate laboratory practice has the great impact on health care system, more than 70% patient management mainly depend on laboratory test result. Current scenario shows huge importance of the laboratory errors and its negative impact on patient treatment outcomes. Quality improvement program main aim is to evaluate the total system performance and provide appropriate protocol to improve that performance. Therefore in this study we recorded the errors occurred in pre-examination. Aim: The aim of this study was to access the importance of quality improvement program in clinical diagnostic laboratory to reduce or eliminate the diagnostic error. Materials and Methods: The present study was conducted in King Fahad Hofuf Hospital Al-Assah (KSA) clinical biochemistry laboratory during a period of 2 years from March 2016 to June 2018. A total of 458,786 tests were performed on 147,746 outpatients and inpatients.  Results: A total of 4, 58,786 tests were performed in 1, 47,746 patients during the overall study period. The overall bias was recorded 4.35%. Out of total bias pre-examination bias was 3.15%, examination error was 0.2% and post-examination bias was 1% respectively. During 2 years study period no significant increase (P= 0.9) of total examination bias were found. Conclusion: As laboratory scientist professionals, we need to acquire proper strategies to maintain the quality in diagnostic laboratory and concern with the physicians provide effective health care service to the patients. We recommend regular assessments in all the laboratories to assure the quality in the health sector. Keywords: Pre-examination, Examination, Post-examination, Errors, Quality control.

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Abstract

Introduction: A state and local Public clinical diagnostic laboratory quality improvement usually monitored by laboratory improvement strategies. The Institute of Medicine (IOM) in 1999 delivered a report on medical errors, which later focus on patient safety. Aim: The study was undertaken to find out the effect of quality improvement programme for the prevention of laboratory diagnostic errors. Materials and Methods: Diagnostic bias is called as any error from placing order of tests to analysis of results. The diagnostic process in the laboratory mainly divided in to three stages such as, pre-analytical, analytical and post analytical phase. Results: Out of 14,047 specimens, 14.01% requisition form found without any signature of clinicians and 6.88% with no brief clinical history and provisional diagnosis. Conclusion: The concluded quality improvement implementation program for deficient of out of TAT in clinical chemistry laboratory is mandatory to achieve the patient safety goal. The last step of the PDCA cycle “ACT” to maintain constant continuous improvement as ever ending program is the responsibility of the unit team work. Keywords: Laboratory diagnostic bias, Pre analytical phase, Analytical phase, Post analytical phase, Quality assurance and quality control.

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