Error Rate of Pre-Analytical Process at Laboratory in Thailand Medical School
Keywords:
Specimen rejection, Pre-analytical errors, Clotted bloodAbstract
Although the topic of pre-analytical errors has been investigated and reported for more than fifty years, pre-analytical error data from Thailand is scarce. Accordingly, this study aimed to monitor the causes and frequency of pre-analytical errors at the Department of Clinical Pathology of Siriraj Hospital – Thailand’s largest national tertiary referral center. This study retrospectively evaluated the causes and frequency of clinical pathology specimens that were rejected at the center during the October 2017 to September 2018. The errors were analyzed separately for out-patient, in-patient and outside hospital. Descriptive statistics and the six-sigma scale were used to summarize our findings. Of the 2,475,917 specimens that were received during the study period, there were a total of 4,147 pre-analytical errors (0.17%). Eighty-two percent of those are from our center’s in-patient department. Of the 6 broad types of pre-analytical errors that were evaluated, the vast majority occurred during the sample collection process (84.9%). Clotted blood was the single most common error (63.7%). The results of this study revealed an overall specimen rejection rate of 0.17%. The six-sigma scale for out-patient, in-patient and outside hospital were 4.90, 4.10 and 4.50, respectively. The six-sigma scale of in-patient was lower than acceptable limit (4.15). Appropriate detection and prevention strategies should be developed and implemented to effectively reduce this error rate.
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