Investigation of the Effect of Autoverification Process on Hematology Laboratory Workflow

Abstract

Investigation of the effect of autoverification on hematology laboratory workflowA computer-based laboratory result approval support system, or an autoverification process, is an application that applies user rules, minimizes errors, saves time in laboratory operations, and assists the laboratory specialist. It can be used in clinical chemistry, immunoassay, hematology, and urine analysis, and is now included in laboratory and diagnostic guides. Laboratory device manufacturers and laboratory information system (LIS) software companies have conducted pioneering work in this field. Machine-learning algorithms and complex statistical functions have been used to reform procedures to recognize common pre-analytical errors [1].Autoverification permits the release of clinical laboratory results without manual human intervention [2]. There are many scientific studies on the use of approval support systems. A rules-based system based on the quality of laboratory in-strumentation and quality of the results generated has been described to help decide if a laboratory should pursue the advantages of autoverification [3]. Basic rule sets for autoverification have not significantly changed for most laboratories and laboratory information systems for the past 20 years. The increasing use of new informatics tools and the general expansion of networks, client servers, and middleware have made new capabilities for autoverification universally available. The technological development of analyzers, control of the pre-analytic and analytic phase, and the precision of qualitative and quantitative hemogram data enable a laboratory specialist to be more and more efficient in detecting hematologic diseases [4]. The French-Speaking Cellular Haematology Group (GFHC) has proposed a standardization of professional practices with recommendations for quantitative and/or qual-Objectives: The aim of this study was to evaluate the effect of an autoverification process on test turnaround time (TAT), sample rejection rate, and the sample test repetition rate. Methods: The study was carried out in the core laboratory of İstanbul Kanuni Sultan Suleyman Training and Research Hospital. Sysmex XN9000 series middleware (Sysmex Corp., Kobe, Japan) was used to perform the autoverification. The rate of test rejection, test repetition, and TAT of the 3 months preceding use of autoverification were compared with those of a 3-month period following initiation of use of the Sysmex hematology analyzer autoverification process. Results: A total of 612,639 test results of complete blood count profiles performed between January 2019 and March 2019 were collected to determine the distribution intervals. The sample rejection and test repetition rates and the TAT were significantly reduced (21.18%, 49.62%, and 23.9%, respectively) after implementation of the new analyzer. Reflex testing rates, such as peripheral smear and reticulocyte count, were significantly increased. Conclusion: Autoverification improved laboratory performance parameters. The hematology lab workflo...