A successful clinical laboratory should place an emphasis on lab accuracy and precision, in order to deliver accurate, timely results for clinicians and their patients. But there’s the potential for errors in every laboratory environment, so how do you keep these mistakes to a minimum?
Multiple studies indicate that the majority of medical lab errors originate in the pre-analysis and post-analysis stages outside of the laboratory; that is, errors such as incorrect sampling or failing to notify patients correctly of results. Errors inside the clinical lab have decreased significantly over recent years, but they can still be present – putting staff and patient safety at risk, increasing costs, and eroding confidence in results. As such, there’s enormous incentive to minimise these laboratory errors, in fact, our Bio Molecular Systems biotechnical equipment is currently assisting many laboratories to reduce errors across all stages of analysis.
In order to understand how to reduce laboratory errors, let’s take a closer look at the most prevalent.
The Types Of Laboratory Errors
In the health and medical industry, the accuracy, precision, and speed of laboratory testing is a vital component of clinical care. Despite advancements in the automation and implementation of Laboratory Information Management Systems (LIMS), which are put in place to alert technicians to potential errors, mistakes can still occur at any stage of the testing process. These laboratory errors are categorised into three critical stages or types of laboratory errors: preanalytical errors, analytical errors, and postanalytical errors.
Preanalytical Errors
Preanalytical errors consist of mistakes that occur from the time a physician orders a test, to the beginning of the analysis phase. Errors that occur during the preanalysis phase can significantly impact the accuracy of test results. Preanalytical errors can happen both within the laboratory and outside the direct control of the laboratory.
Within the laboratory:
* errors in the sorting and routing of specimens
* mistakes in transferring samples between containers (pour-off errors)
* and labelling inaccuracies.
Outside the laboratory:
* incorrect test requests
* patient misidentification
* order entry errors
* poorly labelled containers
* using inappropriate containers
* issues with sample collection and transportation
* inadequate sample volume ratio or insufficient sample volume
* or collecting a specimen from an infusion route.
Analytical Errors
Analytical errors in the laboratory, though less frequent than preanalytical errors, can have severe consequences, such as potentially endangering the lives of patients. Analytical errors in the laboratory occur during the actual testing phase, and are primarily due to:
* instrument malfunctions or equipment failures
* failure to adhere to standard operating procedures
* mix-ups in sample identification
* interference in test results
* or lapses in quality control.
Postanalytical Errors
Postanalytical errors in laboratory diagnostics occur after the testing process, and typically involves the handling and evaluation of laboratory test results. Postanalytical errors can significantly impact clinical decision-making and patient care. Common problems include:
* delays in reporting or failure to report test results
* excessive turnaround times
* incorrect data entry, manipulation, calculations, and transmission or reporting of data
* errors in validating analytical data
* and the misdirection of results to healthcare providers, meaning results are sent to the wrong patient.
How To Reduce Laboratory Errors With 5 Key Strategies
Lab errors can arise systematically or on a random basis. It’s important to consider diverse aspects including your lab technology, procedures, and people when addressing errors in a clinical lab environment. In response to the types of laboratory errors, you might want to begin by focusing on these following five key strategies to help improve the accuracy and precision in a laboratory settings.
Focus on staff training
Inadequate knowledge and training of lab staff is a proven contributor to lab errors. Staff may not be aware of gaps in their knowledge as they prepare or handle samples, or they may struggle to operate new lab technology without adequate training and support. Of course, it can be a challenge to train lab technicians with so many labs feeling the pressure of cost reductions and personnel shortages, however, training of laboratory staff has a direct bearing on the reduction of errors in this type of environment, therefore it should be considered a priority.
Human error is one of the biggest factors that affects accuracy and precision in a laboratory. The better training and support that teams receive, the more equipped they will be to correctly follow formalised procedures and best practices.
With equipment such as the Myra liquid handler being so easy and intuitive to use, training staff will be a much simpler process, also helping to ensure that lab errors will be kept to a minimum.
Participate in proficiency testing programs
One effective way of testing and confirming whether your lab is performing tests and measurements competently, is to use external assessment schemes. Proficiency testing involves the circulation of samples by a proficiency testing program or authority. Each participating laboratory reports their sample results back to the program or authority, to then assess their performance against desirable quality specifications. Depending on your lab’s location, proficiency testing may be available for human pathology quality management as well as other life sciences.
Proficiency testing can provide invaluable insights into your lab performance, and build reassurance around your quality control systems for optimal lab accuracy and precision.
Use clinical lab automation to its full potential
Lab automation technology, automatic pipetting for example, is being increasingly adopted thanks to its many advantages. The most error-prone and complicated lab processes can now be streamlined with new technologies. Lab technicians will have fewer manual and repetitive tasks to carry out, arguably freeing up their focus and minimising user errors that might otherwise arise if they were working “on autopilot” to complete mundane activities. Because samples don’t need to be physically handled as often, this can reduce the risk of mix-ups and mistakes while improving biosafety protocols.
The right automated lab equipment will not only carry out tasks, but will help to identify errors if they arise. We are currently working on further developing our Myra liquid handler, so not only will it automate calibration through its integrated camera, but very soon it will also be able to actively monitor for user errors in deck layout, such as missing tubes.
Minimise transcription error in a laboratory
Manual transcription errors are potentially very dangerous in a clinical lab setting and can be more common than expected – in just one dataset of glucose levels, a troubling 3.7% of manual entries differed from their interfaced values. To minimise the chance of a transcription error in a laboratory setting which would lead to clinicians and patients receiving the wrong transcribed results, it’s ideal to automate as many transcription processes as possible.
This is precisely why we designed the Myra liquid handler and the Mic qPCR cycler to work through the same intuitive software. Both fully integrated systems transmit data seamlessly, dramatically reducing transfer time while maintaining integrity in data management. An additional option to resolve pre-analytical errors is to implement a barcode-based sample management system across patient wristbands, forms, and specimens.
Identifying your lab’s error sources
Naturally, identifying the exact source of variability or errors in any specific lab, will require a thorough review of its processes, technology, and staff support. In any case, it pays to be proactive, whether that be through conducting staff surveys or implementing new automated clinical lab automation technology. What’s more, implementing the latter could even assist you to actively identify errors and report them, avoiding common analytical errors in the laboratory.
There are many benefits that come with reducing lab errors in a medical context. Greater accuracy will boost lab safety, confidence in your results, and ultimately help clinicians to deliver a superior level of communication and care to patients.
Try Bio Molecular Systems For Quality Data Faster
Now you understand the differing laboratory errors and how to avoid them, you will be able to optimise your lab accuracy and precision for the benefit of every individual who relies on your service responsibilities.
At Bio Molecular Systems, we’ve developed our biotechnology products to address the most common lab issues. Whether your aim is to minimise laboratory errors or improve efficiency and flexibility in the lab, we have the solutions. Our products are currently in use all over the world, from COVID-19 diagnostic centres to rugged mobile lab environments.
If you’re interested in trying a free in-lab demo of our qPCR lab equipment, including the Mic magnetic induction cycler with CE-IVD and TGA approval, we encourage you to get in touch. We have distributors in your area who can help to arrange a complimentary two-week trial for the ultimate in lab accuracy and precision.