re: The Right Specimen

Scott Warner — Thu, 25 Jun 2009 08:37:01 GMT

Ryan,

I too worry about the errors we don't catch. And I'm amazed at anger over a rejection of an unlabeled specimen, when the reaction should be, "How did that happen and how can we fix it?" Surely, obvious errors imply undetectable errors.

I think there's a tendency to assume we all have the same standards. Thus, while the lab finds it unacceptable to mislabel any samples, another department may assume its unsatisfactory performance is average and conclude the laboratory must be hiding its own errors. One silo may not fix an obviously broken process in which specimens are not labeled in front of the patient, because it doesn't believe it can be fixed even in the face of clear evidence. Or there may be an attempt to make a painfully simple process i.e. putting a sticker on a tube in front of a patient much more complicated than it really is to explain away errors.

The least rational argument, probably, is that analyzing an unlabeled or mislabeled specimen saves the patient a stick. It's hard to believe any healthcare professional would think this way, but the arrogance of work silos can lead to all sorts of bizarre behavior.

A hospital-wide identification policy can make sure standards really are the same. The laboratory can offer to directly observe another department's process, which can help break down silos. And those doing the labeling can talk to each other without management present. Simply rejecting mislabeled specimens doesn't fix it, really.

re: The Right Specimen

Ryan — Mon, 22 Jun 2009 14:04:27 GMT

The scary thing, in addition to the ones that are caught, are the ones that AREN'T caught!!

I wonder how many go by each day from outpatient sites, nurse draws, nursing home draws, phleb draws and especially ED draws that are mislabeled that we don't catch because they may not flag, delta check or cross our benches as 'suspicious'.

Do the people that take lax standards when dealing with patient samples understand the implications that this can have on the people behind the sample they are (mis)labeling? ... or do they just not care and only want results to give the practitioner?

I know it angers those that get called on the carpet when they do not follow laboratory guidelines for specimen collection and handling, BUT those guidelines are obviously there for a reason -to protect the patient.