An evaluation of the errors occurring in pathology and microbiology laboratories of a tertiary care teaching hospital and their root cause analyses

Abstract

Background: Clinical laboratory testing is an important part of health-care services. Medical laboratories play a pivotal role in the health-care system and the decision-making of clinical doctors about their patients. In the era of consumer protection, everyone is aware of and tries to ensure quality health-care services to all. However, medical errors may sometimes cause undesirable consequences to patients. Therefore, it is important to know the types of errors occurring in laboratories in order to formulate strategies to prevent these. Although literature reporting errors in biochemistry laboratory is available, the literature pertaining to pathology and microbiology laboratories is very limited. Aims: This was a cross-sectional study done in pathology and microbiology laboratories of a tertiary care teaching hospital. Our study aimed to find different errors in these departments and also perform root cause analyses of these errors. Materials and Methods: The study was conducted for a period of 3 months. All the requisition forms, specimens, entered reports, and certified reports were scrutinized, and any error observed as per predefined categories was recorded. Errors that were noticed by laboratory personnel, laboratory doctors, clinicians, and nurses in the wards were included in this study. Each error was documented, and root cause analysis of the same was also done. Data were compiled on Microsoft excel worksheets (Microsoft Office Excel 2007, Redwoods, WA, USA) analyzed with GraphPad Prism 5 (GraphPad Software Inc., CA, USA). Chi-square test was applied to compare categorical data. Results: Among a total of 21,746 tests, a number of errors recorded were 304 (1.4%). The most common errors observed were preanalytical (64.5%), followed by postanalytical (18.1%) and analytical (17.4%). Conclusion: An error detection program must be in place, and it has to be acknowledged in order to ensure patients’ safety. Adequate measures must be adopted to reduce errors in laboratory.