Medical laboratory or clinical laboratory is the place where pathology tests are conduct on biological specimens to diagnose the disease and confirm about the health of patients.
Without laboratory testing doctors just guess about patient health for accurate diagnosis doctors rely on lab reports it signifies patient treatment depends on laboratory diagnosis. So, it is mandatory that laboratory reports must be accurate, reliable, and precise. Any inaccuracy or error in diagnosis can harm the patient health.
To certain the accuracy and make lab diagnosis and reports accurate and reliable it ought that carry out each task with great care and make every step of laboratory free from errors. Basically, laboratories working is divided in three phases pre analytical, analytical and post analytical phases. Today laboratories are taking forward steps and more focus on analytical phase or quality control to ensure accurate results but sometimes the pre and post analytical phase are neglected that prompt the inaccuracy. To maintain quality system, it is must to make every phase free of errors.
As the world advances day by day many technologies have been developed that make humans work easier. As same there are many technologies that significantly minimize laboratory errors. This article apprises about those technologies that contribute to reduce errors of pre and post analytical phase.
Pre analytical phase is paramount phase of laboratory where your laboratory process is started so any error in start can continuing error at the end. Pre analytical phase of lab contains many steps due to which it is prone to errors. For accurate diagnosis it’s essential to make first step accurate. Most common errors of pre-analytical phase are:
- Wrong order entry
- Wrong specimen labelling or identification
- Presence of interfering substance
- Improper handling
These errors can be minimized by introduction of some technologies like
- Computerized physician order entry system. For accurate diagnosis and result firstly it is must that select appropriate test, wrong test selection prompts whole process going to wrong, delay patient treatment, repeated testing, and financially affect patient. The paper-based test requisition causes this error due to poor or ununderstandable writing. This error can be minimized many percent by establishing “computerized physicians order entry system that enables the physician to request a test directly through computer in this way the wrong entries of tests can be reduced. This technology improves efficiency and accuracy of laboratory.
- Automated patient or specimen lD system. Specimen identification error is ubiquitous error that directly affects patient health because misidentification or mislabelling lie at the root of misdiagnosis. Handwritten labels cause this error owing to omit a line, number or name. But many technologies have been elaborated that meliorate to avoid this error. Barcode identification system is one of effective way that eliminates human errors and significantly decreases misidentification of sample. Even the lab automated machines entail barcode scanners that enormously decrease rate of error. Not only that but Radiofrequency identification, magnetic strips, optional character recognition also same technologies to reduce patient ID error.
- Serum indices. Presence of interfering substance in sample is one of most deleterious error of pre analytical phase that causes incorrect measurement of analyte. Haemolysis, lipemia and icterus are most frequent interfering substance that befall due to inappropriate collection, handling, and timing. Presence of interfering substances change concentration of analyte in sample by absorbing light with different wavelengths. Most lab detect these interferences by visual examination that prompt unreliable results. But this can be fix by serum indices the automated system that enable lab to quantify these interfering substances with confidence. Serum indices use bio chromatic wavelength for measurement then by calculation of absorbance show level of haemolysis, lipemia, and icterus in sample and increase accuracy and reliability of results.
- Pre-analytical robotic workstation. Pre analytical phase entail many steps or process due to which most prone to error but error can reduce when whole specimen processing becomes automated that possible by pre-analytical workstation the automated system that minimize most of human errors it enables sample identification, sorting, aliquoting, decapping, recapping, level detection, automated centrifuge and detect interfering elements. In this way improve accuracy and integrity of specimen processing not only that but also protect lab personnel from biohazard, infection and contamination by decrease sample handling.
Post analytical phase last and ultimate phase of laboratory that give appraisal of lab diagnosis or sum up of pre-analytical and analytical phase. This phase necessitates transmission of accurate and reliable report to authentic person on time. Any error in this phase annihilate total testing process. The most common error that occurs in post analytical phase are
- Delay transmission of reports
- Reported to wrong patient
- Inappropriate verification of results
But these errors can diminish by implementing new technologies as such
- Auto validation of results. Transmission of laboratory report to authentic person on time that must b accurate and reliable is prior goal and target of lab. But as with population health issues or problems propagate owing to increase number of testing due to which some time this goal doesn’t come true. Manual validation of results takes significant time and may omit step that causes errors. But Auto validation of test results can demote this issue or error. It is automated system that verify result without need of lab person. Auto validation system is based on predetermined rules and criteria that implemented in Laboratory information system (LIS). These rules entail analytical measurement range (AMR), pre analytical and analytical flags, limit check, critical value, delta check and consistency check. If result is fulfilling on these parameters verified automatically if any result doesn’t fall any of parameter not verified automatically. This technology ambitiously minimize error that previously befall, help to catchup out of range result, alert about critical value etc. It not only reduces errors but also enhance patient safety and lab quality.
- Electronic transmission of reports. patient treatment and diagnosis rely on lab reports, so it is fundamental to deliver report on time to authentic person. Notably those patients who need immediate treatment. This can achieve by implement electronic report transmission that enable quick access of report. Today there are many software have been developed that enable faster transmission and improve accuracy. As the analysis concluded patient get report by SMS alert or notification but it is rigorous that patient must collect hard copy from laboratory. This technology also generous when labs are in different city or long distances area but immediate need of report. In such extent this technology ensures diagnosis and treatment on time.
Implement quality system is prior goal of lab that achieves when engrossed on all steps of laboratory and make them error free. New advances and technologies help to achieve this by save time, disparage errors, decrease workload and assure quality system. But these automation demand good take care by daily maintenance. Beside this it is liability of laboratory technologist and technician to helve automation painstakingly. As such improve performance and assure accuracy.