Question

In clinical laboratory testing, how can we minimize pre-analytical, analytical and post-analytical errors?

Answer 1

The laboratory testing process is divided to three main phases.They are Pre-analytical,Analytical and Post-analytical.
Preanalytical phase of laboratory testing includes ordering,collection,handling transportation and reception of the samples.
Analytical phase includes the testing of the specimen collected
Post-analytical phase includes interpretation of the results,generating a report,storage,follow up and retesting if needed

An error in laboratory is any defect occuring in any of these phases resulting the quality of results.It affects the patient by causing a misdiagnosis and wrong treatment.The errors may also lead to a fatal reaction.So minimizing errors during a lab test is very important.
In order to avoid pre-analytical errors these steps can be taken
-Be aware of the current developments in testing
-Technological advances such as barcoding,radiofrequency identification or wristbands can help the patient identification.
-Standardizing the collection products helps reduce errors.For example components of blood collection tubes like tube walls,anticoagulants,clot activators can affect the accuracy.So it should always be standardized.
-when collecting specimen the individual should confirm the prerequisites like last food intake,time of a drug intake etc.Labelling should contain two patient identifiers.
-inadequate specimen volume or contamination of the specimen should be avoided
-Written protocols that explains all the standard procedures helps to reduce error.
-Any new test equipment should be tested first.
-Special attention should be given while transporting the specimen.Improper temperature,storage also can lead to errors and to be avoided.

In order to avoid analytical errors these steps can be followed

-The analytical quality can be improved by internal quality controls.
-New automated technologies can reduce the analytical errors to a great extend.
-Some type of antibodies may cause changes in measurements causing interference.So those informations should be checked before analyzing.
-Equipments should be checked for any malfunction.
-Procedures for analyzing th especimen should be strictly followerd to reduce errors.
-External Quality Assessment helps monitor the quality status of internal procedures.

Post-analytical errors can be minimized by

-Proper validation of the reports should be done
-Processing the results to a report form should be assessed.
-Avoiding mininterpretation of the results.
-Critical results must be reported promptly.
-Transcription errors should be avoided.
-Turn around time is important.The results should be delivered on time.