Transcriptional or clerical errors include mistakes made during the transfer of information from the test readout to the worksheet, and from the worksheet to the computer or report form. These type of errors probably account for the majority of errors in the laboratory. Possible mechanisms include having a second technologist to check the final result and the supervisor to check the results before releasing.
G. Reporting of Results
In the case of HIV testing, the handling of the results must be controlled so that the confidentiality of all persons tested is protected. A policy decision on the handling of HIV test results must be established and uniformly enforced in the laboratory. When an indeterminate result is reported, care should be taken to ensure that the clinician understands the significance of such a result and the importance of a follow-up specimen.
H. Interaction with Physicians
The relationship between laboratory personnel and physicians should be one of mutual trust and respect.
I. Storage of specimens for follow-up testing
Once a specimen has been tested, it should be stored at -20oC in the appropriate vial. An organized serum or other specimen bank should be available
J. Laboratory Efficiency
The aim is to provide turnaround time for submitted samples. Certain items must be periodically evaluated to increase efficiency in the laboratory.
- are the best available and economical tests being used?
- are newer tests being continually evaluated?
- Is the laboratory budget properly divided and utilized?
K. Total Quality Management
TQM refers to a comprehensive organizational approach that is focused on continually improving the quality and efficiency with which the laboratory operates. QA is a defined program that is focused on maximizing detection of laboratory error, while TQM aims to assist in this process by maximizing efficiency. TQM is not only concerned with the monitoring of the QC/QA program, but should also include other technical or administrative considerations that may indirectly influence the quality and efficiency of the laboratory operation. This includes the evaluation of the laboratory staff and continuing education.