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The European Preanalytical Scientific Committee (EPSC), a group of clinicians and scientists launched a new resource at the 2007 EUROMEDLAB Congress in Amsterdam in June, a Web site called specimencare.com.
Prior to the launch of specimencare.com, laboratorians had no choice but to search multiple sites and other sources to answer vexing questions about the preanalytical phase, which begins when a physician orders a test and continues until the specimen is loaded onto an analyzer. The in-vitro measurement may not reflect the true in-vivo status due to preanalytical variables that impact the specimen quality. Therefore, preanalytical variables can directly impact a doctor�s diagnosis and a patient�s care.
specimencare.com is designed to be an extensive resource for laboratorians and medical professionals, and to specifically address the varied preanalytical needs of laboratories in Western and Eastern Europe, the Middle East and Africa. Further, specimencare.com provides a principal resource for information about how to reduce preanalytical variability, as well as access to guidelines, event news, links, and training tools.
The site�s goals are to: (1) provide a quick, easy path to a comprehensive selection of relevant literature; (2) raise awareness in the laboratory and medical community of preanalytical variables and their effects; (3) improve the safety and efficiency of laboratory services by controlling preanalytical variables; and (4) promote industry best practices.
specimencare.com periodically features an �In Focus� column that addresses topical issues. The first �In Focus� feature discussed haemolysis, a leading factor in sample rejection, and includes details of practices and procedures designed to help minimize haemolysis.
Prof. Norbert Blanckaert, M.D., Ph.D., M.B.A., Professor Ordinarius, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
Dr. Anne J. Vassault, Ph.D., Associate Professor, Universit� de Paris XI, College d'Enseignement Pharmaceutique Hospitalier, Paris, France
Prof. Pierangelo Bonini, M.D., Ph.D., Professor, Clinical Biochemistry, School of Medicine, University of San Raffaele, Milano, Italy
Prof. Giuseppe Lippi, M.D., Associate Professor, Clinical Biochemistry, University of Verona, Italy
Prof. Vladimir Palicka, M.D., Ph.D., Professor, Biochemistry and Professor of Internal Medicine, Charles� University of Prague, Czech Republic
Dr. Sol Green, Ph.D., FACB, Director of Medical & Clinical Affairs, Europe, Middle East and Africa, BD Diagnostics � Preanalytical Systems, New Jersey, U.S.A.
Dr. Steve Kitchen, Ph.D., Head Clinical Scientist at the Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, England
EPSC members Profs. Bonini, Blanckaert, and Lippi presented a workshop at the EUROMEDLAB Congress, entitled �Improving Patient Outcomes Through Excellence in Preanalytical Phase.�
What goes wrong in the preanalytical phase? Prof. Bonini pointed out that, because the preanalytical phase is largely performed outside the clinical laboratory, it is not within the control of laboratory management. Yet considerable evidence in the literature demonstrates the impact of the preanalytical phase on patient safety and the quality of the clinical laboratory process. According to seven separate studies conducted at different healthcare facilities, errors occurring in the preanalytical phase ranged from 32% to 75% of total clinical laboratory errors, compared to the analytical phase, at 13% to 32%1. (See �Improving patient outcomes through excellence in the preanalytical phase�, slide 7). Utilizing analytical quality control methods has led to a reduction of errors in the analytical phase. Improving preanalytical processes will likely have a major impact on reducing the overall test error rate, as well.
What is the impact of preanalytical errors? Prof. Blanckaert described another study that showed 71% of a healthcare organization�s incidents were classified as preanalytical problems, and 5% of those incidents were phlebotomy-related and led to an adverse event2. (See �Improving Patient Outcomes Through Excellence in Preanalytical Phase,� slide 40).
So, what can be done? Prof. Lippi emphasized the development of a multifaceted strategy to enhance quality throughout the total testing process. This starts with a systematic analysis of specimen workflows, continues with education and thorough monitoring via error tracking systems, and ends with the elimination or redesign of flawed procedures3. (See �Improving Patient Outcomes Through Excellence in Preanalytical Phase,� slide 54).
Dr. Sol Green, Ph.D., FACB, EPSC member and Director of Clinical Affairs, Europe, Middle East and Africa, BD Diagnostics � Preanalytical Systems, says, �specimencare.com aims to be the single source for laboratory professionals who need answers to questions � no matter how unique � regarding preanalytical variables that can affect the quality of laboratory testing. It supplies information to help them determine what actions to take to insure that they can provide physicians with the best results, and ultimately, the best patient care.�
The EPSC gratefully acknowledges the sponsorship of specimencare.com by BD Diagnostics � Preanalytical Systems. Comments and suggestions are welcomed at www.specimencare.com.
References:
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Errors in Laboratory Medicine. Bonini PA et al. Clin Chem 2002; 48: 691-698.
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Classifying Laboratory Incident Reports to identify problems that jeopardize patient safety. Michael L. Astion, Kaveh G Shojania, Tim R Hamill, Sara Kim & Valerie L NG. Am J Clin Pathol 2003; 120: 18-26.
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Quality improvement in laboratory medicine. Focus on extra-analytical issues. Lippi G. Clin Lab Med. |