'Need to control lab testing errors'

A report by the US Institute of Medicine in 1999 stated that as many as 98,000 people die every year because of preventable medical errors.

With the passing of time, clinical laboratory tests are growing in number and so are the complexities associated with clinical laboratory tests, including possibility of ordering unnecessary and inappropriate tests.

To handle this scenario, a working paper by Indian Institute of Management, Ahmedabad (IIMA) stresses on the need to monitor and control lab errors, improve lab performance and avoid preventable medical errors.

The paper, titled ‘Managing Clinical Laboratories: Monitor and Control Lab errors to improve lab performance,’ written by Poonam Trivedi, Nilesh Shah and Prof KV Ramani, states that with an increase in number of lab tests and complexities raises the concern on possibility of ordering unnecessary and inappropriate tests.

The paper by the IIMA team emphasises on research objective of highlighting the managerial challenges to control lab errors in order to improve lab performance.

Such unethical practices besides increasing the cost of heath care service may delay diagnosis and initiation of appropriate therapy states the paper, while stressing on the need for monitors as test results in diagnostic decision making has become an integral part of clinical medicine. More than 60%-70% of the most important decisions on admission, discharge and medication are based on lab test results.  

“With this high degree of influence, the reliability of laboratory testing and reporting is of utmost importance. Even though automation, standardisation and technological advances have significantly improved the analytical reliability of laboratory tests, lab errors still do occur in the pre-analytical, analytical and post-analytical processes of the total testing process,” states the paper. 

It further states, in order to control lab errors, it is obvious these mistakes should be monitored regularly and this calls for maintaining a detailed documentation of all errors and the causes for them.

The paper states that the responsibility of maintaining details is a lab manager’s responsibility.

“An analysis of documented lab errors and taking corrective action to avoid such errors would go a long way in minimising sample rejections and thereby provide reliable test results in the shortest possible time,” it reads.

The paper states that lab errors also occur at various stages- before sample collection, during sample collection, transportation of the sample to the lab, centrifugation, analysis, and after test results are obtained etc.

“Lab errors, as and when detected, call for sample rejection. Any rejected sample calls for repeat sample collection and analysis leading to delayed reports, and additional costs to the lab, besides impacting service quality and customer satisfaction. It is also possible that some lab errors could even go undetected and thereby could adversely affect the patients’ health due to incorrect treatment protocol,” the paper states.