Mechanisms of measuring key performance indicators in the pre-analytical phase

In the total testing process (TTP) most errors in laboratory processes occur in the extra analytical phase. This includes the pre-analytical and the post-analytical. Interests in the pre-analytical phase has been growing at an incredible rate over the last decade. Alongside this growing interest, the standards laboratories are monitored against have also changed to state that the laboratory must also take responsibility for monitoring the pre-analytical phase and ensuring healthcare errors are kept to a minimum. To address this there has been some excellent work in Europe looking at what key performance indicators (KPIs) should be measured balanced with what is practical. The article here looks at how these indicators should be selected and acted upon but focusses on how they should be measured. There are a number of different options including audit, non-conformance (NC) logging, manual recording in a database or the use of laboratory information systems [e.g., Laboratory Information Management System (LIMS)]. The best method of collecting the data is to automate wherever possible. The process must be robust not just in collection but in how data are extracted, reviewed and what actions will be taken if problems are identified. There should also be a mechanism to make data available to users.