Uncovering the cause of pre-analytical errors in the blood sampling process: a framework

Abstract: Since laboratory tests influence as much as 70% of the medical decisions, errors throughout the blood sampling process may jeopardize the safety of the patient. Research has shown that the pre-analytical phase of the blood sampling process is where the most errors occur. Moreover, this phase is said to be the most influential part of the total testing process, due to maximal involvement of humans. In this study, the pre-analytical errors in the blood sample handling process and their causes were investigated. Therefore, a literature study was performed, and first-hand data was collected through interviews. A total of 8 interviews was conducted in Sweden, Belgium, and the Netherlands. From these interviews, qualitative data was collected and analysed with a thematic approach. The 5 themes that were obtained are: nurse vs. lab technician, sample identification, logistics, location dependency of sample quality, and hospital management. Each theme included multiple observations and conclusions. One specific observation was a lack of communication and knowledge management amongst nurses and lab technicians. To minimize this gap between nurse and lab technician from a knowledge transfer perspective, a conceptual framework was constructed. This framework can be used both from an academic and practical point of view. This research has both academic and practical implications. Within the academic perspective, empirical data is gathered among hospitals in three different countries, which is compared to data found in academic literature. Moreover, with the analysis of the empirics gathered in this study and the framework that is proposed, a contribution is made to knowledge management within hospitals. From a practical perspective, a contribution is made in helping to minimise the pre-analytical errors in their blood sampling process, while giving the hospital a better understanding of the lack of communication and knowledge management amongst their key employees. By strengthening the communication and knowledge transfer, errors can be avoided. This would not only benefit the speed and accuracy of the diagnose process, but also benefit the nurses and lab technicians in workload.