Quality and Safety in Laboratory Medicine

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Errors in laboratory medicine have a completely different meaning today.
1). Laboratory diagnostics is conventionally defined as a science devoted to generate clinically useful information by analysing the concentration, composition and/or structure of aminoacids, proteins, lipids, carbohydrates, nucleic acids, cells, microorganisms and other exogenous compounds (i.e., drugs or toxics) in body fluids.
2). The quality of test results generation, developing through a kaleidoscope of preanalytical, analytical and postanalytical activities, is a hallmark characterizing in vitro diagnostic testing, both from an analytical and safety standpoint.
3). The former aspect mainly concerns the assurance that test results actually reflect the clinical condition in vivo, whilst the latter aspect especially regards patient safety, since diagnostic errors not only derange the clinical decision making and managed care, but will also jeopardize patient safety.

It is unquestionable that many progresses have been made over the past decades, some of which were directly promoted by laboratory professionals whilst others were powerfully stimulated by healthcare organizations such as the World Health Organization (WHO) or the US Institute of Medicine (IOM).

Many diagnostic errors are associated with laboratory testing, and many of these are preventable. However, a reduction in testing-related diagnostic errors (TDE) is hindered by the absence of a well-defined relationship between diagnostic harm and the testing process (whether from laboratory or non-laboratory sources) as well as by a lack of relevant measures for evaluation. Diagnoses typically result from the patient history and physical. However, diagnostic testing is often used to confirm initial impressions or rule out alternatives, and at least 10% of all diagnoses are not considered final until clinical laboratory testing is complete. This number most likely underestimates the actual impact of testing on diagnosis. In the emergency room, clinical laboratory testing is ordered in more than 41% of all visits. Family physicians order tests in 29% of all patient visits, and general internists, in 38% of visits. These percentages would be even higher if the calculations were based only on the 33.9% of primary care visits that involve a new complaint.

Five causes taxonomy of testing-related diagnostic error:

  • An inappropriate test is ordered
  • An appropriate test is not ordered
  • An appropriate test result is misapplied
  • An appropriate test is ordered, but a delay occurs somewhere in the total testing process
  • The result of an appropriately ordered test is inaccurate         

Thus a Rationale.—Critical values reporting is considered an important laboratory process because it can impact clinical decision making, patient safety, and operational efficiency.

Media Contact:
Allison Grey
Journal Manager
Journal of Clinical Chemistry and Laboratory Medicine
Whatsapp no.-  +1(504)608-2390
Email: jcclm@molecularbiol.com
Online submission: https://www.scholarscentral.org/submissions/clinical-chemistry-laboratory-medicine.html