Quality Assessment in the Laboratory: Errors in the Total Testing Process in the Clinical Chemistry Laboratory at University of Gondar Hospital, Northwest Ethiopia

Abstract

Laboratory services have been described as the major processes contributing to safe patient care in the modern healthcare sector. However, occurrences of errors in the overall testing processes impair the clinical decision-making process. Such errors are supposed to be high in resourcepoor countries, like Ethiopia. Therefore, this study was aimed to assess errors in the total testing process in the Clinical Chemistry Laboratory of University of Gondar Hospital. For this purpose, a cross-sectional study was conducted at the University of Gondar Hospital from February to March 2016. All the required data were collected using established quality indicators. Data were analyzed using SPSS version 20. Frequencies and cross tabulations were used to summarize descriptive statistics. A total of 3259 samples and corresponding laboratory request forms were received for analysis. Analysis of the overall distribution of errors reveals that 89.6% were pre-analytical errors, 2.6% were analytical, and 7.7% were postanalytical errors. Of the pre-analytical errors, incomplete request form filling was the most frequent error observed followed by sample rejection rate (3.8%). Analytical errors related to internal and external quality control exceeding the target range, (14.4%) and (51.4%) respectively were reported. Excessive Turnaround Time (TAT) and unreported critical value cases were major defects in the post-analytical phase of quality assurance. The study shows that relatively high frequency of errors, which alarms the importance of quality indicators to assess errors in the total testing process should improve the quality of healthcare services based on these findings using laboratory standards