Error evaluation in the laboratory testing process and laboratory information systems.

Azila Arifin,Maryati Mohd.-Yusof

doi:10.5937/jomb0-31382

Abstract

BackgroundThe laboratory testing process consist of five analysis phases featuring the total testing process framework. Activities in laboratory process, including those of testing are error-prone and affect the use of laboratory information systems. This study seeks to identify error factors related to system use and the first and last phases of the laboratory testing process using a proposed framework known as total testing process-laboratory information systems.MethodsWe conducted a qualitative case study evaluation in two private hospitals and a medical laboratory. We collected data using interviews, observations, and document analysis methods involving physicians, nurses, an information technology officer, and the laboratory staff. We employed the proposed framework and Lean problem solving tools namely Value Stream Mapping and A3 for data analysis.ResultsErrors in laboratory information systems and the laboratory testing process were attributed to failure to fulfill user requirements, poor cooperation between the information technology unit and laboratory, inconsistency of software design in system integration, errors during inter-system data transmission, and lack of motivation in system use. The error factors are related to system development elements, namely, latent failures that considerably affected the information quality and system use. Errors in system development were also attributed to poor service quality.ConclusionsComplex laboratory testing process and laboratory information systems require rigorous evaluation in minimizing errors and ensuring patient safety. The proposed framework and Lean approach are applicable for evaluating the laboratory testing process and laboratory information systems in a rigorous, comprehensive, and structured manner.

Highlights

A mistake or inefficiency in one of the stages of the laboratory testing chain can affect the overall process implementation and management, and subsequently physician diagnosis [1, 2]
Evaluation of the overall system used in the hospitals and laboratories involved the laboratory information systems (LIS), lab testing process and other health information systems (HISs)
The LIS evolved from a stand-alone system that only supports internal laboratory operations to a system with extended functions that are connected to HISs

Summary

Introduction

A mistake or inefficiency in one of the stages of the laboratory testing chain can affect the overall process implementation and management, and subsequently physician diagnosis [1, 2]. Many errors identified in laboratory test results were caused by a complex, error prone, unreliable, and poorly designed LIS [4, 5]. These outcomes are aggravated when the LIS linked patient and test data to other units and institutions and involved data exchange because of complex inter system interaction [6]. The nurse did not realize that she had mistakenly chose the wrong test type during the request process. The to-be processed flow diagram is similar with that of the as-is process (Figure 3), except for the replacement of the two problems with the following two solutions.

Methods

Results

Discussion

Conclusion