Quality and Safety in Outpatient Laboratory Testing

Clinicians in practice depend on laboratory testing to assist in diagnos-ing, treating, and monitoring their patients. Family physicians order labora-tory tests on approximately 29 % of the patients they see; internists order tests on 38 % [1]. Although an increasing number of tests are performed in physicians ’ offices by their own staff, physicians still depend on outside laboratories for most of their testing needs. When it comes to the total test-ing process, most laboratory personnel have limited knowledge of the steps taken by physicians ’ offices, and similarly, most physicians and staff in phy-sicians ’ offices have limited knowledge about the laboratory. We believe that improving testing quality begins with eliminating some of this ignorance. Key points for improving quality are as follows: Most laboratory errors originate in the pre- and postanalytic phases The greatest opportunity for improvement in quality exists in pre- and postanalytic processes Critical areas include specimen collection, labeling, transport, data entry, and communication of results Gains in quality can be achieved by collaboration between clinicians and laboratorians Most ‘‘laboratory errors’ ’ originate outside of the laboratory. They occur Clin Lab Med 28 (2008) 295–303not in the analytic phase but in the pre- and postanalytic phases. Almost two * Corresponding author