Assessment of Extra-analytical Phase: Improving Laboratory Service and Patient Safety

Background: Laboratory quality management plans with pre-analytic, analytic and post-analytic components are key elements in ensuring patient safety. The greatest impact for overall improvement would be to focus on pre-and post-analytic services where most errors occur.

Objectives: To develop and maintain high quality practice standards for laboratory testing, to ensure patient safety by minimizing medical errors associated with laboratory service.

Methods: A review of quality management of the extra-analytic phase of the test system for improving patient safety

Results: The proportion of errors associated with the two extra-analytical phases is 4-5 times that seen in the analytical phase with the pre-analytical phase consistently representing over half of the all errors in published studies.

Conclusion: The current focus on analytical quality of the total process alone has to be expanded to include the extra-analytical phases. Laboratories need to take greater responsibility for activities, outside their immediate control for an effective laboratory service.