The pre-analytical phase is, without a doubt, the “Achilles heel” of laboratory processes. Despite technological advances in the automation of analyses, it is at this stage – which involves everything from the request for the test to the collection, packaging and transportation of samples – that most laboratory errors occur. These errors directly impact patient safety and the effectiveness of clinical decisions, generating rework, wasting resources and, ultimately, putting health at risk.
Why is the pre-analytical phase so critical?
Studies indicate that between 60% and 70% of laboratory errors occur in the pre-analytical phase. This stage involves delicate processes that depend on multiple professionals – from doctors and technicians to administrative staff – and involves variables that are difficult to standardize. The most common errors include:
- Incorrect patient identification: A simple registration error can lead to misdiagnosis and inadequate treatment.
- Inadequate registration of the request: Misinterpretation or incorrect completion of the form may result in the request for the wrong exam.
- Insufficient sample collection or volume: Samples with inadequate volume compromise the analysis and may require a new collection.
- Inadequate transportation and packaging: Carelessness in the conservation and transportation of samples may result in hemolysis, contamination or deterioration of components, affecting the reliability of the results.
Each of these failures not only compromises the examination, but can also lead to a domino effect, damaging the entire diagnostic chain.
Relevant information and real impact
In a study conducted in public health laboratories, data showed that, in a single year, more than 9,700 samples were discarded due to non-conformities, out of an approximate total of 132,500 tests performed. The most frequent justifications for these discards were:
- Request cancelled due to expiration of screening period (28%)
- Sample unsuitable for requested analysis (28%)
These figures reflect not only operational failures, but also the urgent need to rethink the management of the pre-analytical phase. Even with sophisticated computerized systems – such as GAL, which manages the samples – the effectiveness of the process depends crucially on the training and attention of the professionals involved.
What's at stake?
When a pre-analytical error occurs, the impact extends beyond the laboratory. Each discarded sample means the loss of valuable data. Furthermore, repeat testing generates additional costs and can delay the confirmation of critical diagnoses, compromising medical decision-making and, consequently, patient safety.
The reliability of laboratory tests is directly linked to the quality of the sample. In a scenario where each result can determine a crucial medical intervention, there is no room for error. Thus, pre-analytical error is not just an operational failure – it is a real risk that compromises the entire healthcare system.
A call to action: empowerment and standardization
We cannot accept that the weakest link in laboratories is precisely the pre-analytical phase. It is imperative that there is serious and continuous investment in:
- Training and qualification of all professionals involved: Doctors, technicians, nurses and administrators need to have in-depth knowledge of the protocols and implications of each stage of the process.
- Review and simplification of operational manuals: Clear, objective and easily accessible protocols are essential to reduce errors in requests and registration.
- Implementation of traceability and control systems: Tools such as the use of barcodes and robust computerized systems are essential to guarantee data integrity.
- Audits and quality indicators: Constant monitoring of indicators – such as rejection rates and non-conformities – must be used to implement corrective actions quickly and effectively.
Conclusion
Errors in the pre-analytical phase represent a risk that cannot be underestimated. They compromise the quality of tests, generate unnecessary costs and, above all, can put patients' lives at risk. In an environment where each test is unique and irreplaceable, the failure of a single link can compromise the reliability of the diagnosis.
Innovation, combined with a policy of continuous training and qualification, is the necessary response to overcome this challenge. It is time to rethink and transform the way the pre-analytical phase is managed – because excellence in diagnosis begins long before the sample is processed.
For this and other reasons, Greiner Service Tech offers products and services that work in pre-analytical, promoting better operational efficiency for the laboratory and focusing on patient safety.
Leonardo Lippel
Account Executive | Greiner Bio-One Service Tech
linkedin.com/in/leonardolippel/
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