More than 70% of diagnostic errors happen within the testing process,1 from ordering tests and collecting samples to processing tests and sharing results. ECRI, an independent nonprofit patient safety organization, analyzed patient safety adverse events and near-misses in the U.S. They found that one-third related to diagnosis errors overall. Technical or processing errors accounted for 23% of the events, and 20% were attributed to mixed-up samples, mislabeled specimens, and tests performed on the wrong patient.1
LGC Clinical Diagnostics’ recent white paper, Diagnostic Errors: The Laboratory’s Essential
Role in Addressing Today’s Challenges, examines current research on diagnostic errors, the challenges labs face, and ways to address the problems affecting diagnostic errors. In an earlier article, we reviewed the two most significant issues (staffing shortfalls and rising testing demand) for labs and the role of quality and safety. This follow-up discusses potential solutions, including lab automation.
Create greater awareness of laboratory careers
- Attract young people to the field before they choose a college. This can involve increasing their exposure to STEM subjects in junior high school, participating in high school job fairs, and pursuing internships like the one offered at Boston Children’s Hospital.
- Increase early education programs such as the Spencerport (New York) High School’s medical laboratory assisting and phlebotomy course and the Johns Hopkins Initiative for Careers in Science and Medicine, which provides biomedical research opportunities for high school students.
- Engage those in medical or science jobs looking to make a change through professional societies and associations and innovative education opportunities similar to the Loyola University Chicago Medical Laboratory Science summer immersion program.
Make job satisfaction a priority
- Be competitive in the job market by offering compensation commensurate with education and experience, regularly evaluate and adjust, and review and improve shift differentials.
- Create a positive team environment that prioritizes employee engagement, relies on effective feedback, and sets clear and specific goals.
- Adopt practices that reduce stress and burnout, such as flexible scheduling and using assistants for pre- and post-analytical tasks.
- Invest in professional development with continuing education opportunities that allow staff to see a potential career path and bring new knowledge and skills into the lab.
Overcome automation obstacles
While some larger U.S. laboratories have adopted new technologies, from robotics to Machine Learning, the widespread adoption of automation has been slow. The necessary investment can deter and defer the introduction of automation and AI into the lab.
The prospect of automation carrying out manual tasks and improving testing efficiency and quality is attractive for understaffed labs. Staff is freed up for diagnostic activities and other high-value clinical tasks. For example, automation allows labs to scale up quickly so more samples can run through an analyzer or reduce errors in sorting and labeling specimens.
A Harris Poll for Siemens, Inc. found that 95% of lab professionals agreed that adopting automated technologies would help them improve patient care, and 89% agreed that their laboratory needs automation to keep up with demand.2 The poll also identified several obstacles laboratories face in adopting automation, including cybersecurity/IT-related challenges, fear/hassle of changing the laboratory’s system(s), and lack of available budgeting/funding.2
None of these challenges are insurmountable, particularly when measured against the benefits—90% of lab staff believe fewer manual tasks or the ability to do them faster with automation will allow them to improve patient care.2 And 42% expect they’d be able to increase quality control troubleshooting, and 39% would more efficiently manage the test sample process.2
Collaborate with care team to improve testing continuum
Quality improvement efforts usually focus solely inside the lab, which misses opportunities to address testing-related diagnostic errors outside the lab. Lab professionals are skilled at finding and correcting errors in the analytical phase, but identifying and addressing errors outside the lab requires collaboration with other care team members involved in the pre- and post-analytical phases.
Diagnostic errors can happen when providers order the wrong test or don’t understand the results. Connecting with these groups to educate them on correct test use can help reduce errors (and unnecessary tests). Together, laboratory professionals and providers can set evidence-based decision-making guidelines for test ordering and review test utilization patterns.
Advocate for the profession
Professional societies and associations assume responsibility for supporting regulation changes, encouraging updated standards, and promoting funding that strengthens the clinical laboratory profession and its role in patient outcomes. They may advocate for national board certification entry-level standards, involving laboratories in efforts to address medical workforce shortages or supporting CLIAC recommendations to include laboratories in grant funding opportunities. To succeed, members must add their voices and support these efforts.
Ensure quality despite challenges
Many of the solutions to the challenges laboratories face today will take time to have an impact. In the meantime, laboratories must ensure that quality doesn’t suffer and results are accurate. Many quality and safety strategies are within a lab manager’s control, including educating providers on laboratory testing, strengthening processes, and establishing a culture of quality that encourages staff to report errors and near-misses to identify opportunities for improvement. See LGC’s 5 Best Practices for Best-in-class Clinical Lab Quality Control for more strategies and practices to implement.
Streamlined processes create greater efficiency and increase confidence in patient results. LGC Clinical Diagnostics' independent quality measurement tools, used with LGC’s automated software, can help. The extensive selection of liquid, ready-to-use solutions supports daily quality control needs in clinical biochemistry, molecular testing, serology, next-generation sequencing, urinalysis, and toxicology. They simplify quality control, calibration verification, and linearity data management and help bolster a culture of quality.
LGC Clinical Diagnostics supports the diagnostic testing industry with biological materials to develop, validate, and challenge today’s most trusted molecular and serological infectious disease assays. We are an elite provider of high-quality third-party controls for the clinical laboratory market, with decades of experience designing and manufacturing effective quality control monitoring tools.
Download our white paper for the shocking in-depth review of current research on diagnostic errors, the challenges labs face today, their impact on staff, and ways to address these challenges
References
- Data analysis reveals common errors that prevent patients from getting timely, accurate diagnoses
- Clinical Labs in Critical Condition: What lab professionals reveal about the impact of workforce shortage on patient care
Additional sources
Burden of serious harms from diagnostic error in the USA
Is Education a Means to End the Laboratory Workforce Shortage?