Pre-analytical errors and their prevention in an emergency department setting

The pathology laboratory plays a key role in a patient's healthcare journey and the results from pathology testing can influence medication, hospital admission status and differential diagnoses. Errors in the pre-analytical phase may negatively impact the total testing process (TTP) and therefore patient outcomes. The pre-analytical phase involves multiple healthcare professionals from different disciplines and departments. An observational study of pre-analytical errors was conducted over two months at an Australian hospital emergency department (ED) and associated laboratory. This study was used to assess the type and number of pre-analytical errors occurring at this site. A Likert-Like survey targeting the ED staff was used to form a basis for the intervention phase of the experiment which aimed to reduce the overall number of pre-analytical errors occurring at this site. An intervention study focusing on educating the ED staff on pre-analytical errors from four bases (request-based, specimen-based, transport-based, and laboratory-based) was conducted over two months. The intervention was not successful in significantly reducing the number of pre-analytical errors at this site; however multiple suggestions have been made to help reduce the number of pre-analytical errors in the future. These include introducing a pneumatic tube system, running a monthly/bi-monthly training program, and implementing a training program targeting laboratory staff. An extended study with more frequent interventions is needed to assess the benefits of running an intervention training program focusing on pre-analytical errors.