Preanalytic Errors in the Clinical Laboratory: A 5-Year Follow-up
Rita H. Khoury, MD; Asha Gandhi, BS; B. P. Salmon, MS; Danielle Pasquale, BS; Peter Gudaitis, BA; Dauna Gudaitis, BA
(2015) Abstracts and Case Studies From the College of American Pathologists 2015 Annual Meeting (CAP ’15). Archives of Pathology & Laboratory Medicine: October 2015, Vol. 139, No. 10, pp. e2-e186.
Context: Medical errors account for 98 000 deaths in US hospitals each year; the actual number is higher because hospitalized patients are a small percentage of the population. Reducing medical error is one of the main patient-safety goals in laboratories. Order entry accuracy is part of the quality management indicators to improve the performance and overall quality of the laboratory.
Design: Data were collected based on order-entry accuracy from 2010 to 2014. Errors were divided into 3 levels: level 1, failure to update information; level 2, failure to enter/add information; and level 3, entering wrong patient name, incorrect tests entered, or missing tests. Statistical analysis was done using Analyse-it.
Results: The percentage total error ranged from 4.3% in 2010 to 1.1% in 2014. Most errors were level 2; physician name discrepancy was the most common. New employees increased the error percentage until they received training. Increasing online ordering and implementing in-service sessions to educate staff about the common errors helped lower the error rate.
Conclusions: We were able to decrease errors by encouraging clients to use online order entry and by increasing our ongoing monitoring of the accuracy of the order-entry error and then using the results as a quality indicator. In addition, having supervisors and employees involved in the error reduction by having regular meetings to discuss common mistakes and strategies to reduce them was one of the most successful tools to reduce errors.