Improving Hematology Lab Results: Detecting Preanalytical Errors through Quality Metrics

Abstract

Objective: To evaluate pre-analytical quality indicators in hematology laboratory to improve and strengthen healthcare outcome.

Methodology: This retrospective study was conducted in the hematology section of Pathology lab, at National Institute of Cardiovascular Diseases (NICVD) from 01-06-2024 to 30-11-2024. A total of 188,682 consecutive samples received for investigations in the hematology department were included in the study. The pre-analytical issues were reviewed and evaluated using a set of quality indicators (QIs), including Quantity not sufficient (QNS), Hemolysed, Clotted, Wrong labeling, Wrong Vacutainer, Sample redo, and insufficient blood volume

Results: The hematology department analyzed a total of 188,682 blood samples over the study period from 01 June to 30 Nov 2024. Overall, 689 (0.35%) samples was found to have quality indicators issues. The most frequent error was “Clotted specimen” 392(56.8%), “Quantity not sufficient (QNS)” 277(40.2%), Wrong labeling in 12 (1.74%), Hemolysed sample 07(1.0%), and sample redo was 01(0.14%) out of all 689 rejected samples.

Conclusion: The study shows that hematology department maintained a low percentage of errors across key quality indicators due to the strict implementation of SOPs and the recording of sample rejection data. Future studies could focus on assessing the impact of specific interventions or exploring new indicators to further refine continuous quality monitoring in hematology labs as an important tool for self-assessment