Patient Safety Indicators in Clinical Laboratories: An Exploratory Survey among Costa Rican Laboratory Professionals

Daniel Quesada-Yamasaki, Johan Alvarado-Ocampo, Ana Lucía Chinchilla-Ureña, Edgardo Arce-Soto
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Abstract

Introduction: Patient safety indicators (PSIs) focus on the prevention of complications and minimization of unnecessary patient risk. Using the methodology known as SMART, the most suitable indicators may be selected by the evaluation of five essential criteria (i.e., specificity, measurability, attainability, relevance, and timeliness).Therefore, the current study aimed to collect and analyze information regarding PSIs related to clinical laboratories in order to support organizations in the process of indicator selection. Materials and Methods: The most widely accepted PSIs for clinical laboratories were identified through a literature review. The indicators were evaluated by conducting a survey on a deliberate sample of 77 laboratory professionals. The answers were analyzed in terms of the frequency of responses for sensitivity, measurability, attainability, relevance, and timeliness. The overall performance of the indicators was assessed using a composite score encompassing the five SMART criteria. Results: The indicators with the best overall performance were tests without internal controls, internal controls with unacceptable performance, critical values communicated in time, unacceptable performance in external controls, and requests with errors concerning patient identification. Significant differences were observed among the top-, mid-, and bottom-performing groups of indicators. Conclusion: The results of the present study revealed the importance of the active participation of the professional community as an essential activity to determine the most appropriate PSIs. In the case of this study in Costa Rica, this community seems to value quality control processes and pre-analytical requirements as key indicators to monitor patient safety in clinical laboratories.
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临床实验室患者安全指标:哥斯达黎加实验室专业人员的探索性调查
患者安全指标(psi)侧重于并发症的预防和患者不必要风险的最小化。使用称为SMART的方法,可以通过评估五个基本标准(即特异性、可测量性、可获得性、相关性和及时性)来选择最合适的指标。因此,本研究旨在收集和分析与临床实验室相关的psi信息,以支持组织在指标选择过程中。材料和方法:通过文献综述确定了临床实验室最广泛接受的psi。这些指标是通过对77名实验室专业人员进行抽样调查来评估的。根据响应的频率、敏感性、可测量性、可获得性、相关性和及时性对答案进行分析。使用包含五个SMART标准的综合分数来评估指标的总体表现。结果:综合表现最佳的指标为无内部控制、内部控制表现不合格、及时沟通的临界值、外部控制表现不合格、患者识别有错误的要求。在指标的高、中、低表现组之间观察到显著差异。结论:本研究的结果揭示了专业社区积极参与作为确定最合适的psi的基本活动的重要性。在哥斯达黎加的这项研究中,这个社区似乎重视质量控制过程和分析前要求,将其作为监测临床实验室患者安全的关键指标。
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