Quality Management of the Pre-Analytical Phase of Total Laboratory Testing Process: Monitoring and Control

Abstract

Background: Laboratory testing is a complex process comprising three phases that include the preanalytical, analytical and the post analytical phase of total laboratory testing process. Pre-analytical phase represents the most error prone phase of the laboratory testing process. Consequently, many problems arise mostly at pre-analytical phase of non-laboratory settings which are outside the control of the laboratory before the analysis of the submitted specimens. Objectives: To evaluate the monitoring and control of errors in the non-laboratory related pre-analytical phase of the total testing process. Methods: A literature review of the continuous quality improvement and Quality Assurance (CQI/QA) components of the preanalytical phase of total laboratory testing process. Results: The prevalence of preanalytical errors is approximately 70% of all errors that occurred in laboratory diagnostics. Many of the variables are outside the traditional laboratory areas. Errors in the pre-analytical phase can result in misdiagnosis and mismanagement and consequently compromise patient’s safety. Errors presentation at this stage requires good communication and co-operation among all health professionals involved in the total testing process from the time a laboratory request is made until the sample is ready for testing. Conclusion: In non-laboratory settings, continuous monitoring and control of the initial phase of the total testing process is critical in order to reduce pre-analytical errors so that the laboratory can achieve accurate and reliable results. Non-laboratory errors in pre-analytical phase can be monitored and controls by timely and effective coordination of health care professionals for improved patient's safety and reliable testing outputs.