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Review
. 2020 Jun 15;30(2):020502.
doi: 10.11613/BM.2020.020502.

Errors within the total laboratory testing process, from test selection to medical decision-making - A review of causes, consequences, surveillance and solutions

Cornelia Mrazek  1 , Giuseppe Lippi  2 , Martin H Keppel  1 , Thomas K Felder  1 , Hannes Oberkofler  1 , Elisabeth Haschke-Becher  1 , Janne Cadamuro  1
Affiliations
Review

Errors within the total laboratory testing process, from test selection to medical decision-making - A review of causes, consequences, surveillance and solutions

Cornelia Mrazek et al. Biochem Med (Zagreb). .

Abstract

Laboratory analyses are crucial for diagnosis, follow-up and treatment decisions. Since mistakes in every step of the total testing process may potentially affect patient safety, a broad knowledge and systematic assessment of laboratory errors is essential for future improvement. In this review, we aim to discuss the types and frequencies of potential errors in the total testing process, quality management options, as well as tentative solutions for improvement. Unlike most currently available reviews on this topic, we also include errors in test-selection, reporting and interpretation/action of test results. We believe that laboratory specialists will need to refocus on many process steps belonging to the extra-analytical phases, intensifying collaborations with clinicians and supporting test selection and interpretation. This would hopefully lead to substantial improvements in these activities, but may also bring more value to the role of laboratory specialists within the health care setting.

Keywords: extra-analytical phase; laboratory medicine; patient safety; quality indicators; total testing process.

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Conflict of interest statement

Potential conflict of interest: None declared.

Figures

Figure 1
Figure 1
Published data on error rates (reference numbers are indicated in brackets) related to analyses/tests.
Figure 2
Figure 2
Published data on error rates (reference numbers are indicated in brackets) related to survey responders. HIL - haemolysis, icterus, lipemia.
Figure 3
Figure 3
Published data on error rates (reference numbers are indicated in brackets) related to missed diagnoses of malpractice claims.
Figure 4
Figure 4
Published data on error rates (reference numbers are indicated in brackets) related to errors.
Figure 5
Figure 5
Published data on error rates (reference numbers are indicated in brackets) related to samples. IV - intravenous.
Figure 6
Figure 6
Error rates related to phlebotomies in an observational study (42).
See this image and copyright information in PMC

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