Automated Specimen Inspection, Quality Analysis, and Its Impact on Patient Safety: Beyond the Bar Code

[摘要] Reduction in medical errors is a major focus of the US health system as it faces its largest restructuring in history. The emphasis on error reduction follows several revealing reports from the Institute of Medicine estimating the number of errors and resulting morbidity and mortality in US hospitals. The motivation for reducing medical errors is increased patient satisfaction as well as large reduction in healthcare costs. Therefore, automation (i.e., integrating, streamlining, and coordinating through technology) of the many processes within medical institutions should be a national priority.Within laboratories, there are many sequential processes that must occur flawlessly to prevent errors. However, error rates in clinical laboratories have been estimated to be around 1%, which doesn't come close to an ideal goal of 1 error per million events, or a well-known quality concept called Six Sigma, which is 3.4 errors per million events. Many clinical laboratory errors occur in the sample receipt and preparation process, also known as accessioning (1, 2). Specimen accessioning errors may be attributed to many factors including improper labeling at the time of collection, inadequate vial filling, or selection of an inappropriate vial (e.g., citrate vs EDTA to prevent clotting). Collectively, these are considered phlebotomy errors. Additional errors may occur when reading the specimen information and determining if the specimen is appropriate for analysis (e.g., if it was transported on ice, if required). Even when all the previous parameters are within acceptable specifications, the specimen may have inherent patient-specific issues such as excessive icterus, lipemia, or hemolysis. Well-trained accessioners can identify most of these quality issues by careful inspection and by …

[学科分类] 过敏症与临床免疫学