A substantial amount of rework, diagnostic and therapeutic delay, and patient inconvenience can result from specimen rejection. Patient redraws may result from unlabeled, mislabeled, and incompletely labeled specimens; clotted and/or hemolyzed specimens; or insufficient specimen quantity. By continuously monitoring specimen acceptability, collection, and transport, laboratories can promptly identify and correct problems.
Enrollment in this study may assist the laboratory in monitoring compliance with CAP Laboratory Accreditation Program General Checklist statement GEN.40825: "There is a system to positively identify all patient specimens, specimen types, and aliquots at all times."
Objective
Identify and characterize unacceptable blood specimens that are submitted to the chemistry and hematology/coagulation sections of the clinical laboratory for testing.
Data Collection
This monitor includes all blood specimens submitted for testing to the chemistry and hematology departments of the clinical laboratory. On a weekly basis, participants will record the total number of specimens received, the number of rejected specimens, and the primary reason each specimen was rejected.
Performance Indicator
- Specimen rejection rate (%)
Performance Breakdown
- Breakdown of reasons for rejection (%)
Shipping Schedule
- Shipment A: December 4, 2023
- Shipment B: March 11, 2024
- Shipment C: June 10, 2024
- Shipment D: September 10, 2024
Additional Information
Participants in this program receive:
- User Guide
- Templates and instructions for data collection
- Quarterly reports that include fingerprint clusters, customer-defined groups, and all institution comparisons
- Peer directory
Quality Management Tools activities meet the American Board of Pathology MOC Part IV Practice Performance Assessment requirements.
For Comprehensive Collection of Tools, see Quality Management Tools.
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Preanalytic |
Analytic |
Postanalytic |
Anatomic Pathology |
Clinical Pathology |
Turnaround Time |
Patient Safety |
Microbiology |
Transfusion Medicine |
Chemistry/ Hematology |
Customer Satisfaction |
Q-PROBES |
Non-Physician Care Team Satisfaction With Clinical Laboratory Services (QP231) |
✓ |
✓ |
✓ |
|
✓ |
✓ |
|
|
|
|
✓ |
Technical Competency Assessment of Body Fluid Review (QPB10) |
|
✓ |
|
|
✓ |
|
✓ |
|
|
✓ |
|
Technical Competency Assessment of Peripheral Blood Smears (QPC10/QPC25) |
|
✓ |
|
|
✓ |
|
✓ |
✓ |
|
|
|
Technical Competency Assessment of Gram Stains (QPD10/QPD25) |
|
✓ |
|
|
✓ |
|
✓ |
✓ |
|
|
|
Q-TRACKS |
Patient Identification Accuracy (QT1) |
✓ |
|
|
|
✓ |
|
✓ |
✓ |
✓ |
✓ |
✓ |
Blood Culture Contamination (QT2) |
✓ |
✓ |
|
|
✓ |
|
|
✓ |
|
|
|
Laboratory Specimen Acceptability (QT3) |
✓ |
|
|
|
✓ |
✓ |
✓ |
|
|
✓ |
✓ |
In-Date Blood Product Wastage (QT4) |
|
|
✓ |
|
✓ |
|
|
|
✓ |
|
|
Gynecologic Cytology Outcomes: Biopsy Correlation Performance (QT5) |
✓ |
✓ |
✓ |
✓ |
|
|
✓ |
|
|
|
✓ |
Satisfaction with Outpatient Specimen Collection (QT7) |
✓ |
|
|
|
✓ |
|
✓ |
|
|
|
✓ |
Stat Test Turnaround Time Outliers (QT8) |
|
|
✓ |
|
✓ |
✓ |
✓ |
|
|
✓ |
✓ |
Critical Values Reporting (QT10) |
|
|
✓ |
|
✓ |
|
✓ |
|
|
✓ |
✓ |
Troponin Turnaround Times (QT15) |
✓ |
✓ |
✓ |
|
✓ |
✓ |
✓ |
|
|
✓ |
✓ |
Corrected Results (QT16) |
|
|
✓ |
✓ |
✓ |
|
✓ |
✓ |
✓ |
✓ |
✓ |
Outpatient Order Entry Errors (QT17) |
✓ |
|
|
|
✓ |
✓ |
✓ |
✓ |
|
✓ |
✓ |
*The CAP requires accredited laboratories to have a quality management plan that covers all areas of the laboratory and includes benchmarking key measures of laboratory performance (GEN.13806, GEN.20316, COM.04000). The Joint Commission requires accredited hospitals to regularly collect and analyze performance data (PI.01.01.01, PI.02.01.01). CLIA requires laboratories to monitor, assess, and correct problems identified in preanalytic, analytic, and postanalytic systems (§493.1249, §493.1289, §493.1299).