Did you know that laboratory tests are the most frequently ordered diagnostic procedure, with more than thirteen billion tests performed in over 250,000 certified clinical laboratories each year in the U.S. alone?
Or that inpatient care teams tend to order more laboratory tests than outpatient healthcare providers, “despite having fewer numbers of patients”?
Considering the role that lab results play in confirming (or ruling out) patient diagnoses, informing treatment plans and monitoring efficacy, it’s no wonder that clinical laboratory operations are under constant scrutiny.
Even though the precise influence that test results play in diagnostic accuracy is a point of contention among healthcare leaders, the fact is that the quality of patient care can suffer if data is entered incorrectly into the patient record or entered into the wrong patient record. Reporting delays can also be troublesome, especially considering the frequency with which lab results prompt medical intervention and, subsequently, influence patient outcomes in some capacity.
At the end of the day, lab tests are still the primary diagnostic tool used in nearly every healthcare setting and the actionable intelligence they generate are highly valued – and generally trusted – by clinicians and patients alike. Therefore, lab managers must prioritize investments in technology systems that reduce the risk of testing and reporting errors – and that starts with having the right barcode scanning systems in place.
It was estimated during a 2014 study that “diagnostic errors happen about 12 million times per year in U.S. outpatients”. A year later, the Institute of Medicine concluded that most people will experience at least one diagnostic error in their lives.
Now, how many of those errors can be attributed to mistakes in the lab is heavily debated. Yet, anything you can do to instill confidence in laboratory medicine will prove beneficial, particularly considering how much providers and nurses rely on lab tests to make care decisions or, in many cases, reassure patients that everything is okay. (“Doctor internet” can certainly make one’s head spin with worry, can’t it?)
If you want to reduce the number of diagnostic errors credited to lab-related errors, there are three things you should do:
1. Screen for mistakes stemming from the specimen collection process. These may include everything from incorrectly labeled specimen vials to mishandled specimens (i.e. lack of temperature control). Remember, specimen collection at the point of care is happening at a lightning-fast speed and nurses can be easily distracted. As a result, it can be easy to skip steps or misread orders. It is up to lab technicians to double check that the data on the specimen vials as well as the quality and quantity of specimens indeed match up with the orders submitted in the system.
2. Implement an effective inventory management system. Keeping track of specimens can be challenging considering how many vials may come in during the course of a day. But it is critical to maintain visibility into their location and processing status at all times to reduce the risk of mishandling, which can lead to false test results and waste/reorders.
3. Promptly document results in patient records (or via other preferred physician communication methods) – and verify accuracy of inputs again. The right clinical mobility solution and data management system can make this step simple.
In fact, mobile technologies should be utilized in all three steps, assuming that you are requiring specimen vials to be marked with a barcoded label. With a single trigger pull, a barcode scanner such as Zebra’s DS9900 enables lab technicians to retrieve all records related to that sample and…
1. Automatically verify that the patient data, specimen type and collection time – all of which is documented using that same barcode label at the point of care – match up with the lab requisition you have in front of you on your computer screen. You can also confirm that the requested test indicated via the color-coded label is indeed what the provider ordered.
2. Update the status of each specimen, including the date and time of lab receipt, its storage location, the time it is processed and subsequent actions taken to store or destroy the sample. The name of each person who handled the specimen can also be documented to increase accountability. This can be done by first scanning the labeled specimen and then a barcode on an employee’s ID card, or by manually entering the person’s name. If the specimen is sent out to a third-party lab for processing, the barcode label can also be used to track each transfer and verify that the sample was handled in a safe and efficient manner.
3. Initiate the reporting workflow. Once testing is complete, lab technicians can once again scan the specimen’s label to open the correct patient’s electronic health record (EHR) and input results. Depending on the design of your information systems, an automated transfer of lab data from the testing system to the reporting system may be possible. However, that barcode scan is vital to ensuring the right information is being sent to the right place at the right time (i.e. the minute its accuracy is verified and ready for transmission back to the care team.)
Of course, there may be times when your lab technicians will be the ones printing labels and marking specimens. If that’s the case, this guide may prove highly beneficial to your decisions about which labels, printers and software systems might be best to ensure desired outcomes, including full compliance with patient safety, privacy and care mandates.
If you’re going to HIMSS 2020, our healthcare team would be happy to speak with you about the current design of your lab’s processes and data management systems to see where improvements could be made. Even if you’re already using a barcode scanner to confirm specimen accuracy prior to processing, there are several other areas where that same technology could be applied (or perhaps better utilized) to improve the logistical efficiency, accuracy and accountability of your lab operations.
We can also talk about your hospital’s specimen collection, processing and reporting workflow more holistically to see if any process re-engineering or technology solution modifications should be made to help you obtain better clinical outcomes and improve care team satisfaction with your lab.
Schedule time here to meet with us or, if you’re not going to the show, you can send us a note here and we’ll find a convenient time and place to meet with you.
Rikki Jennings, BSN, RN, CPN is currently the Chief Nursing Informatics Officer (CNIO) at Zebra Technologies where she is responsible for combining her knowledge of patient care, informatics concepts, and change management to effectively address the information and knowledge needs of healthcare professionals and patients to promote safe, effective, and efficient use of IT in clinical settings. She also serves as the strategic liaison for health IT efforts representing nursing and clinician needs.
Early in her nursing career, Rikki recognized a disconnect between purchased technologies and the understanding of their intended value at the bedside by her fellow clinicians and pursued Nursing Informatics. She is passionate about the utilization of technology to support safer, more effective care models. Over the past several years, her work in the healthcare IT industry has provided her an in-depth knowledge of the workflows and utilization of clinical technologies including clinical communication systems, bedside technology solutions, and data analytics tools in hospitals across the country. In 2019, Rikki was recognized in Crain’s Chicago Business’ Notable Women in Healthcare list. Rikki holds a Bachelor of Science in Nursing from University of Iowa.