Authors (including presenting author) :
Lam HS(1), Dr.So CC Jason(1), Wong WS(1), Leung WY(1)
Affiliation :
(1)Pathology, Hong Kong Children's Hospital
Introduction :
The central specimen reception unit has an important role to ensure pre-analytical quality. Send-out requests involve complex tests which often require special handling and thus are at risk of errors. The CRMS provides a user-friendly interface for central reception staff to manage send-out requests.
Objectives :
(1) Guide central reception work processes to reduce pre-analytical problems; (2) Reduce inter-laboratory enquiry time; (3) Enhance specimen traceability; (4) Facilitate downstream quality data analysis; (5) Fulfill accreditation requirements
Methodology :
When send-out requests are handled during reception, the system generates reminders and graphical instructions to assist staff to comply with the specific requirements of individual tests to referral hospital laboratories. All specimens are tracked. Problems during the request handling process are logged for review and improvement. Quality data are captured in real-time for immediate viewing and subsequent analysis.
Result & Outcome :
The system was pilot-run from January 2021 to November 2021. Four send-out cases with pre-analytical error occurred out of 7180 send-out cases (0.06%) during this period. One case was due to per-analytical error occurring in the referral laboratory. One case involved an inexperienced staff in using the system. The remaining two cases revealed insufficient information in the system. Enhancement of staff training and system content was made. The system was subsequently put into 24-hour use in December 2021. From December 2021 to December 2022, 1 send-out case with pre-analytical error occurred out of 8250 send-out cases (0.01%). This case involved non-compliance of staff despite CRMS prompting. The overall pre-analytical error rate for the whole 2-year period was 0.03%. From our experience this was very low compared to the pre-CRMS era, although actual data were not captured at that time. Staff at central reception found this system helpful in smoothening the workflow. Quality data including turn-around-time were easily generated from the system for review in internal management meetings.
CRMS allows laboratory users to manage send-out tests efficiently and effectively. It also has the potential to be applied to in-house laboratory tests for continuous quality improvement.
