Are we getting better at the preanalytical phase or just better at measuring it?

Giuseppe Lippi, Camilla Mattiuzzi, Chiara Bovo


There is now consolidated evidence that the vast majority of laboratory errors occur in the extra-analytical phases of the total testing process, and especially in the preanalytical phase. Although development and dissemination of best practice recommendations for this crucial area of diagnostic testing have greatly contributed to reinforce error identification and reporting strategies, it is also undeniable that the combination of greater consciousness about preanalytical issues and technological advancements have helped decreasing the inherent vulnerability of many preanalytical activities, thus finally making the preanalytical phase less vulnerable to errors, slips and lapses. Many potential strategies can be adopted for reducing preanalytical errors, including education and training of healthcare staff on phlebotomy practice and preanalytical errors, greater observance of available phlebotomy guidelines, dissemination of specimen collection modules or phlebotomist check-lists, certification of phlebotomists, transmission of periodic preanalytical quality reports to phlebotomists, establishment of direct feed-back between laboratory professionals and phlebotomists, use of quality and validated blood collection systems for drawing blood, along with introduction of harmonized means for recording preanalytical errors.