NPQR Facilitates Data Collection to Reduce Pre-Analytical Errors, Improve Patient Outcomes

Most errors that occur in the medical laboratory originate from pre-analytical processes. This is often frustrating for pathologists and laboratory professionals since the laboratory is dependent on submitting departments to avoid these types of errors. A pre-analytical error can arise during patient identification and/or preparation, test order entry, request completion, specimen collection or transport, or specimen receipt in the laboratory, making these risk-laden issues challenging for many laboratories.

Through the National Pathology Quality Registry (NPQR), ASCP provides pathologists and laboratory professionals the ability to leverage LIS data to measure and reduce pre-analytical errors in diagnostic testing. A team of ASCP experts who deal with these issues on a daily basis have developed a set of consensus-based recommendations to address pre-analytical errors. The NPQR provides participants with a way to capture and communicate information on pre-analytical errors, translate this information into an action plan and effectively operationalize these recommendations.

Sachin Gupta, PhD, MT(ASCPⁱ)MBⁱ, Laboratory Quality and Informatics Lead at BayCare Health System, in Clearwater, Florida, said the NPQR data will help his facilities identify information at the patient, unit and collector level. The information can then be used to educate multi-disciplinary teams on best practices for specimen collection, ultimately resulting in fewer re-draws and improved patient outcomes.

BayCare Health System uses various ways to educate team members on best specimen collection practices, including targeted one-on-one training with a supervisor, venipuncture skill development classes, online training for specimen collection, lab in-services and following a competency check-list.

“The NPQR information will help us to understand what policy or protocol needs to be improved,” Dr. Gupta said, adding, “For example, if we know that we have more pre-analytical errors (emanating) from nursing draws, it will give us an opportunity to create nursing guidelines on specimen collection.”

NPQR data has shown that hemolyzed specimens, clotted specimens and specimens deemed “quantity not sufficient” result in the greatest number of rejected specimens and, therefore, offer the most significant opportunities for improvements during in the pre-analytical phase.

“The reduction in rejection rates will improve not only patient experience due to fewer number of re-draws, but also patient outcomes,” Dr. Gupta said.

BayCare recently launched a multi-disciplinary project with the laboratory and clinical nursing teams to improve specimen collection and reduce the number of rejected specimens. The group developed nursing venipuncture guidelines and designed online training for team members based on best practices for specimen collection.

NPQR offers organizations an effective platform to obtain data that is otherwise difficult to attain using existing systems. “NPQR not only allows you to compare your organization’s data to that of your peers,” Dr. Gupta said, “but you can also benchmark data (with other institutions) for various measures. The data will support various quality improvement efforts to collaborate with other departments to improve on patient-centered measures and improve patient outcomes.”

To learn more about the benefits of participating in the NPQR, click here. For more information and descriptions of the NPQR's measures click here.