Autoverification in Clinical Chemistry Laboratory

Abstract

Clinicians need accurate and fast laboratory test results. Post-analytic process affects the turnaround time of laboratory testing due to the need to verify the accuracy and to confirm all test results. It also makes errors seen. The objective of this study was to apply an autoverification system for clinical chemistry laboratory. Clinical laboratory of Faculty of Medicine, Ramathibodi Hospital, had developed the autoverification system for 35 chemistry and immunology tests. The design procedures according to the CLSI guidelines: Autoverification of Clinical Laboratory Test Results, were used to validate and implement autoverification protocols. Computer‐based rules to verify and release clinical laboratory test results were developed at Middleware (Abbott Laboratories). Autoverification rules cover 3 major areas: the limit check, the delta check and the consistence check. If test results are not within the criteria, the system will keep the results for the laboratorian inspection. The study found that 84.5% of test results were auto-released. There was a significant reduction of turnaround time on the post-analytic process, from 9 minutes to 4 minutes.  Furthermore, the system also enhanced the detection of the errors from specimen collection. A total of 770 specimens were rejected, resulting from samples with hemolysis, icterus or lipemia (n = 592), contaminations of anticoagulant or intravenous solution (n = 132) and wrong patient sampling (n = 46). In conclusion, the autoverification system can actually be applied in a clinical chemistry laboratory. The benefit of its implementation is to improve the post analytical turnaround time performance. It can greatly reduce manual review time and effort of laboratory staff by focusing manual review on only a small portion of potentially problematic specimens and test results.  Moreover, properly designed autoverification can lead to increased detection of errors caused by incorrect specimen sampling.