Safe Postanalytic Component of Total Testing Process

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Safe Postanalytic Component of Total Testing Process

Similar to the preanalytic phase, the postanalytic phase can be subdivided into those procedures that are within the laboratory and those outside the laboratory, where the physician receives, interprets, and acts on the laboratory results. Examples of errors that could occur in the postanalytic phase include:
  • Laboratory results not verified before being reported.
  • Improper data entry or typing mistakes causing erroneous information to be reported
  • Critical values not reported, or not reported in a timely manner
  • Laboratory tests not reported or reported to the wrong health provider (For example, poor communication to a patient's physician of the results of laboratory tests that are pending at the time of a patient's discharge)
  • Lack of timeliness of reporting laboratory results (slow turnaround time)
  • Misinterpretation of an alphabetic flag in the result field (eg, using a lower case letter L (l) to indicate "low result." The result could be interpreted as the number "1.")
  • Oral results misunderstood by receiving party- no "read back" requested to confirm that data was correctly received
  • Abnormal test not recognized by the clinician
  • Failure of clinician to order appropriate follow-up testing
  • Failure of clinician to communicate test results and next steps to patient and family
In the postanalytic phase, the test result becomes information that the clinician must act upon. The test information and the action have an effect on the patient--either to benefit or harm the patient's health.
Tracking what occurs after laboratory test results are sent to clinicians is a new concept for clinical laboratorians. However, this mindset is important to truly measure the safety of clinical laboratory services.