Laboratory results are involved in the vast majority of patient diagnoses and treatment plans. The tests that generate those results are proliferating in number and becoming increasingly complex and targeted. This is a concern for all healthcare providers, particularly those who order the tests and use the results to determine care for their patients
A recent ECRI Institute
patient-safety report on laboratory errors found most happen in the pre-analytic and post-analytic stages—including labeling mistakes, wrong tests ordered and misinterpretation of the results—underscoring how important it is that all healthcare providers work as a team to improve patient care. Working together, lab professionals, healthcare providers, medical schools, health information technology specialists, certifying bodies and hospital administrators need to commit to ensuring lab tests are appropriately ordered and used and analyses are accurate.
Together, we can break down the silos as recommended by the report. We all need to do our part—clinicians and lab professionals must talk to and work with each other to reduce testing-related errors. Laboratory professionals need to emerge from the lab and lend our expertise in utilization, test interpretation and process management. Physicians
should use computerized physician-order entry and clinical decision-support tools whenever possible to ensure they are accurately ordering and interpreting tests. Medical education at all levels (from initial clinical training to continuing medical education) should include training in the appropriate ordering of tests and interpretation of results. And all parties must collaborate to discuss needs, issues, problems and possible solutions.
Laboratories must also have sufficient personnel. We can't afford to push the envelope of doing more with less. And we must hire and retain the best. At the American Society for Clinical Pathology, we believe strongly that laboratory personnel be required to demonstrate their competence through certification and licensure mechanisms, two areas we believe can be strengthened at the state and federal levels.
There are many types of testing errors, and they happen inside and outside the lab. There's no single solution. But if we work together and combine our knowledge and experience, we can continue to reduce all types of errors and provide safer, better quality medicine for our patients. Dr. Steven H. Kroft is president of the American Society for Clinical Pathology and vice chair for clinical pathology and director of hematopathology at the Medical College of Wisconsin at Milwaukee.