Errors in laboratory medicine have a considerable impact on patients outcome. Scientific literature demonstrates that a wide percentage of laboratory errors occur in the pre- and post-analytical phases of the process.
Aim of this work is the evaluation of errors that arise from pre- and post-analytical phases, in particular: a) the frequency of transcription errors; b) the agreement among laboratories in comments added to the laboratory report.
Nine clinical laboratories of the Veneto Region have been involved asking them to:
a) analyse, on about 1000 clinical requests, the correct transcription of patient's data and tests required, the data of the requesting physician, the indication of diagnostic suspicion, the information on effective availability of the laboratory report;
b) test eleven different distributed samples and add an interpretative comment to obtained results.
The results stress:
a) a greater frequency of error regarding the transcription of required tests (31.5%) than patient's data (0.46%). The diagnostic suspicion (from 21.0% to 87.0%) and the data to find out the patient (48%) are often missing. There is a minor percentage of errors as regards the data of the requesting physician (from 0.4% to 2.8%) and the information on effective availability of the laboratory report (from 0% to 2.4%).
b) a general consensus among participants regarding the obtained results, while there are differences in the reference ranges that do not seem to affect the interpretation of clinical results.
Our findings show the need for clinical laboratories to accurately control the transcription of data, namely tests required, definition of reference ranges, formulation of interpretative comments. Well designed EQA programs can support laboratories to establish appropriate reference ranges and to verify the clinical significance of their results in comparison to other laboratories allowing each laboratory to monitor its own performance and to assure a good practice.
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