Preventing Errors in the Hematology Laboratory to Improve Patient Safety

Course Author:
Linda Sandhaus, MD
Director, Core Laboratory for Hematology, University Hospitals of Cleveland, Cleveland, OH
Associate Professor of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH

MOC^[?]: MK
Intended Audience: Pathologists, Residents, Pathologist Assistants, Medical Technologists, Medical Laboratory Technicians, Students

The routine CBC and leukocyte differential (Diff) count remain important sources of laboratory errors. This eCourse identifies and offers solutions to the most common errors in the hematology lab. These errors occur even with the availability of automated technology, good quality control practices and mandatory proficiency programs and have the potential to jeopardize patient safety. By focusing on real-life challenges faced by medical technologists in a high-volume hospital-based laboratory, this eCourse describes how to discover and reduce latent and systematic errors. Through root-case analyses of errors that have occurred in our laboratory, we have identified several factors that may contribute to errors in reporting CBC/Diff results.

Specific diagnostic challenges covered in the eCourse include:

• Large volume and variety of data to review
• Complex algorithms for verification of abnormal results
• Slide preparation and microscopic interpretation
• Insufficient training of technical staff
• Laboratory information system design and data entry problems

Many errors result from a complex interaction between people, automated analyzers, and computerized information systems. Investigation and classification of these errors can reveal systematic problems and lead to effective interventions. Actual quality improvement projects in laboratory hematology are described and evaluated.

The ASCP designates these educational activities for a maximum of 2 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activities.

These activities meet MOC Part II Lifelong Learning requirements. These activities meet MOC Part II Self-Assessment Module requirements.

ASCP designates these activities for a maximum of 2 CMLE credits. These activities meet CMP and state licensure requirements for laboratory personnel.