Errors in medical laboratory but still forgotten

Error is an important problem in laboratory medicine and can be seen in any clinical settings. The error can occur at any step of laboratory investigation ranging from pre-pre analytical, preanalytical, analytical, post analytical and post-post analytical steps. The problem is well described in textbook but the clinical practitioner usually forgets this problem. There are many attempts to control and get rid of the error but it has never been successful. Generally, the error might be due to human or non-human factor. The use of new tool and system in laboratory might be helpful for reduce the problem. Nevertheless, it should be noted that the problem due to human error is usually sporadic, unpredictable and hard to control. Some might propose that the quality system might be a tool to control the error in laboratory medicine. The accreditation is usually done and becomes the fashion in several developing countries. In fact, the quality system such as ISO system is only a simple code for controlling of the under developed practitioners. It does not the way to generate the “quality culture”. Of interest, in ISO certified medical laboratory in tertiary university hospital in developing country, the error still occurs at a very high rate (1). The application of system and documentation code as well as guideline are usually used and mentioned for effectiveness (2). Nevertheless, the quality cannot be generated by huge workload on paper work to supply the documents for quality accreditation system but the quality should come from the deep part of the mind of the practitioner. To reduce the problem, the education system is needed (3). Repeated and continuous education focusing on the “error” should be given to medical personnel at each level.

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned and reviewed by the Section Editor Guo-Ming Zhang (Department of Laboratory Medicine, Shuyang People’s Hospital, Shuyang, China).

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jlpm.2017.08.01). The author has no conflicts of interest to declare.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

References

1. Wiwanitkit V. Types and frequency of preanalytical mistakes in the first Thai ISO 9002:1994 certified clinical laboratory, a 6 - month monitoring. BMC Clin Pathol 2001;1:5. [Crossref] [PubMed]
2. Barbé B, Yansouni CP, Affolabi D, et al. Implementation of quality management for clinical bacteriology in low-resource settings. Clin Microbiol Infect 2017;23:426-33. [Crossref] [PubMed]
3. Lillo R, Salinas M, Lopez-Garrigos M, et al. Reducing preanalytical laboratory sample errors through educational and technological interventions. Clin Lab 2012;58:911-7. [PubMed]