Hospital Initiatives May Reduce Dangerous Lab Mistakes
Hospitals and healthcare groups nationwide, with support from various government and nonprofit organizations, are developing initiatives as part of an effort to reduce the incidence of potentially dangerous lab errors.
The largest effort yet, nine major academic medical centers are participating in a collaborative effort to redesign outdated and error-prone lab practices. The efforts will focus specifically on systems used for collecting, labeling, handling, and interpreting blood and tissue samples.
Studies have shown that some of the most devastating medical mistakes originate in the lab, primarily because of a lack of checks and balances. Lab errors can serious consequences for the patient, possibly leading to a failure to diagnose of misdiagnosis of deadly conditions like cancer.
A study of 335 lab-related medical malpractice claims found that 63 percent involved a false-negative diagnosis of cancer and 22 percent a false-positive diagnosis of cancer. Similar studies have shown that as many as 25 percent of the 300,000 fine needle aspirations – a procedure used to extract cells – conducted annually result in false negatives.
“Tests fail because things can go wrong at every step of the process, and there are no checks and balances in place in pathology to catch these errors,” said Stephen Raab at the University of Pittsburgh Medical Center.
Between three and five percent of the billions of lab specimens taken every year are flawed, primarily because of improperly drawn biopsies or blood samples and also patient mix-ups.
While only one percent of those lead to delayed treatment or serious harm, Raab put this statistic in perspective by saying, “You wouldn’t want to have one percent of all airlines crashing.”
With quality control a central concern, many of the participating medical centers have begun using checklists and automated specimen processing. The new automated systems help reduce all errors, particularly hard-to-detect mislabeled specimens.
Some centers have completely reorganized phlebotomy (blood-drawing) services by providing around the clock technicians to free up nurses and other staff who may be preoccupied with other tasks. Others are requiring a double reading of pathology reports.
Medical malpractice claims arising out of lab-related errors are relatively low in number but are the second-most costly to hospitals, exceeded only by neurology payouts.
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