Two sessions at AACC’s premier preanalytical conference, Optimizing Quality in the Clinical Laboratory: Focus on the Preanalytical Phase, delve into the importance of stakeholder communication and identifying and managing interferences to reduce errors in this challenging phase of laboratory science. Conference attendees will learn about best practices and approaches to preanalytical challenges that they can adopt at their own institutions while networking with colleagues interested in improving preanalytical procedures, Stacy Melanson, MD, PhD, chair of the conference organizing committee, and associate medical director of clinical laboratories at Brigham and Women’s Hospital in Boston, told CLN Stat. It’s also a great opportunity to learn novel approaches and innovative technological solutions.

Melanson’s own session, Reducing Preanalytical Errors by Collaborative Case Review, underscores the value of teamwork in improving preanalytical processes. At Brigham and Women’s Hospital, Melanson told CLN Stat, collaborative case reviews among key departments is a staple activity. Laboratory, nursing, clinicians, and other frontline staff, as well as hospital leadership and patient safety, risk management, and informatics personnel all meet to discuss issues, identify solutions, and implement changes.

“Importantly, these collaborative case reviews have fostered relationships and improved communication between the laboratory and our clinical colleagues,” Melanson said. “It is extremely valuable for each party to understand the workflows and challenges in other areas; it can change perspectives and enable change.” Because of these collaborations, several specific preanalytical processes have shown improvements, she added.

For example, nursing staff had a high rate of mislabeled and unlabeled specimens, leading to erroneous reporting of results and the potential for inappropriate clinical actions. In response, “we formed a multidisciplinary group to discuss some options to improve the process,” said Melanson. The team subsequently designed and implemented a novel, integrated electronic specimen collection module. Monitoring its impact, “we achieved a significant reduction in preanalytical errors,” she explained.

Through collaborative case reviews, the team also designed a dashboard that nurses, clinicians, and laboratorians could use to monitor preanalytical errors and guide real-time interventions.

“We continue to review safety reports and identify other areas of opportunity such as timely specimens draws and optimal preanalytical procedures for rapidly decompensating patients (i.e. codes) that may warrant a more formal collaborative case review,” added Melanson.

“Interferences You See and Those You Don’t: Detecting, Managing and Reducing Interferences,” is another can’t-miss discussion in Session 2 of the conference. Nikola Baumann, PhD, co-director of the central clinical laboratory and central processing and assistant professor of laboratory medicine and pathology at the Mayo Clinic in Rochester, Minnesota, will discuss the methods clinical labs should use to identify the easily detectable and not-so-obvious types of interferences. Baumann has lectured and written extensively on this topic in various clinical journals and meetings, including at AACC’s Annual Scientific Meeting & Clinical Lab Expo. In 2018, she co-authored a study which found that a significant percentage of plasma samples from emergency department patients had biotin concentrations at or above the lowest known thresholds for immunoassay interference.

Optimizing Quality in the Clinical Laboratory: Focus on the Preanalytical Phase, which will take place November 11–12 in Alexandria, Virginia, is worth 7.5 ACCENT credits. Register now for AACC’s inaugural conference on the preanalytical phase of testing.