Evaluation of pre-analytical phase performance of emergency laboratory by harmonized quality indicators and six sigma

Arumalla VK, Chelliah S, Madhubala V

Pdf Page Numbers :- 64-70

Veerendra Kumar Arumalla^1,*, Selvakumar Chelliah² and Madhubala V¹

¹Department of Biochemistry, ESIC Medical College & PGIMSR, KK Nagar, Chennai-600078, Tamil Nadu, India.

²Department of Biochemistry, Employees State Insurance &Post graduate Institute of Medical Education and Research, Manicktala, Kolkata-700054, West Bengal, India.

*Corresponding author: Veerendra Kumar Arumalla, Associate Professor, Department of Biochemistry, ESIC Medical College & PGIMSR, KK Nagar, Chennai-600078, Tamil Nadu, India. Mobile: +91 8072959429; Email: drveerendraarumalla@gmail.com

Received 12 December 2020; Revised 20 February 2021; Accepted 26 February 2021; Published 10 March 2021

Citation: Arumalla VK, Chelliah S, Madhubala V. Evaluation of pre-analytical phase performance of emergency laboratory by harmonized quality indicators and six sigma. J Med Sci Res. 2021; 9(2):64-70. DOI: http://dx.doi.org/10.17727/JMSR.2021/9-10

Copyright: © 2021 Arumalla VK et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Background: Pre-analytical errors account for up to 70% of all the errors made in laboratory diagnostics which are mostly not directly under laboratory control. Laboratories across the world have been using different Quality indicators (QIs) for identifying and quantification of pre-analytical errors. Objective of the present study is to identify the different pre-analytical errors with their frequency and to assess the pre-analytical phase performance of emergency laboratory by using harmonized Quality Indicators and six sigma metrics.

Methods and material: A prospective observational study was conducted from January 2019 to December 2019 to monitor the inappropriateness of samples and test request forms. We have quantified the performance of pre-analytical phase of our emergency laboratory based on the harmonized QIs proposed by The International Federation of Clinical Chemistry Working Group on Laboratory Errors and Patient Safety (IFCC- WGLEPS) and six sigma metrics.

Results: Emergency laboratory received a total of 55431 samples during Jan- 2019 to Dec- 2019. Number of pre-analytical errors were 1089 which accounted for 1.96% of total samples received. Haemolysed samples, clotted samples and samples with insufficient volume were contributed to 37%, 26% and 15% of the total pre-analytical errors respectively.

Conclusions: Pre-analytical phase performance of our emergency laboratory complies with the quality specifications laid by the International Federation of Clinical Chemistry Working Group on Laboratory Errors and Patient Safety (IFCC-WGLEPS). Implementation of harmonised QIs assures the comparability of laboratory findings with different laboratories across the world.

Keywords: pre-analytical errors; harmonized quality indicators; IFCCWG-LEPS