Background: Efficient laboratory service is the cornerstone of modern health care systems. Scientific innovations have contributed to substantial improvements in the field of laboratory science, but errors still prevail. These errors are classified as preanalytical, analytical and postanalytical, depending upon the time of presentation. Methods: The data for 67,438 routine venous blood specimens were scrutinized, and errors were documented over the period of 1 year in the clinical biochemistry laboratory of Govind Ballabh Pant Hospital in Delhi, India. Results: Preanalytical errors were most common, with a frequency of 77.1% followed by postanalytical 15% and analytical 7.9%, respectively. Conclusions: Our study illustrates the importance of proper venipuncture procedures, analytical expertise and correct transcription of numerical data for precise and accurate reporting of results to clinicians. There is an urgent need for close inter-departmental cooperation to meet the goal of ensuring patient well being.

Laboratory analytical turnaround time is a reliable indicator of laboratory effectiveness. Our study aimed to evaluate laboratory analytical turnaround time in our laboratory and appraise the contribution of the different phases of analysis towards the same. The turn around time (TAT) for all the samples (both routine and emergency) for the outpatient and hospitalized patients were evaluated for one year. TAT was calculated from sample reception to report dispatch. The average TAT for the clinical biochemistry samples was 5.5 h for routine inpatient samples while the TAT for the outpatient samples was 24 h. The turnaround time for stat samples was 1 h. Pre-and Postanalytical phases were found to contribute approximately 75% to the total TAT. The TAT demonstrates the need for improvement in the pre-and post-analytical periods. We need to tread the middle path to perform optimally according to clinician expectations.

Objective: To evaluate the leading causes of preanalytical errors in a clinical chemistry laboratory.

Ensuring quality of laboratory services is the need of the hour in the field of health care. Keeping in mind the revolution ushered by six sigma concept in corporate world, health care sector may reap the benefits of the same. Six sigma provides a general methodology to describe performance on sigma scale. We aimed to gauge our laboratory performance by sigma metrics. Internal quality control (QC) data was analyzed retrospectively over a period of 6 months from July 2009 to December 2009. Laboratory mean, standard deviation and coefficient of variation were calculated for all the parameters. Sigma was calculated for both the levels of internal QC. Satisfactory sigma values (>6) were elicited for creatinine, triglycerides, SGOT, CPK-Total and Amylase. Blood urea performed poorly on the sigma scale with sigma <3. The findings of our exercise emphasize the need for detailed evaluation and adoption of ameliorative measures in order to effectuate six sigma standards for all the analytical processes.

Materials and MethodsGovind Ballabh Pant Hospital (GBPH) is a tertiary care hospital serving a wide metropolitan area. The hospital has cardiology, cardiothoracic surgery, neurology, neurosurgery, gastroenterology, gastro surgery, and psychiatry departments. It is a 600-bed hospital offering specialized medical and surgical treatments to about 300000 patients in the Out Patient Department (OPD) and 19000 patients in the general and private wards every year. The clinical biochemistry department is equipped with a state-of-the-art autoanalyser with ISE (Olympus AU 400, Hamburg, Germany), electrolyte analyzer-Ecolyte (Ecshweiler, Germany), automated coagulometer-ACL AbstractObjective: Quality indicators in the clinical laboratory provide a useful tool for continuous improvement of laboratory services. The goal of this study was to design and review quality indicators from time to time in an effort to improve the performance of the laboratory. Methods:The study included an evaluation of different quality indicators collected from the biochemistry laboratory of a tertiary care hospital in New Delhi over a period of 1 year.A total of 84250 samples were processed, and the quality indicators monitored were classified into the following 3 categories: preanalytical, analytical, and post-analytical.Results: Hemolysis (0.7%) was the most common anomaly observed during the assessment of pre-analytical indicators followed by improper samples for coagulation profile (0.34%). In the analytical phase, the frequency for fibrin clots was 1.2%.Conclusion: Working constantly to improve the outcome of these indicators by taking corrective measures over a period of time will definitely help to improve the quality of laboratory services and patient health care.