ABSTRACT
Introduction:
The clinical laboratory is part of the group of actors in health systems that are under increasing pressure by users and administrators to increase their productivity in order to respond efficiently to the increased volume of patients, optimizing costs and professional time. This pressure forced laboratories to perform a full review of their procedures and develop technical, logistical and computational tools to enable excellent response times.
Objective:
This study aimed to evaluate the implementation of the automated blood cell counter autoverification process and its impact on the safety of patients.
Methods:
Verification rules were designed in the connectivity software, based on manual validation criteria for laboratory professionals, according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI) Guideline Auto10-A and the International Consensus Group for Hematology Review (ISLH). The autoverification percentage was established, and non-conforming product (NCP) percentages were estimated before and after the procedure. Pilot tests were also performed in different days so as to adjust the process.
Results:
53.4% of automated blood cell counters autoverification were achieved, and, subsequently in the audit of 18 months, 60% was reached due to verification adjustments in the delta programmed filter. The NCPs rose from 0.065% to 0.0036% from the beginning to the end of the process.
Conclusion:
The autoverification process enabled to reduce the variability associated with human intervention, therefore the professional is able to focus on the pathological report analysis, reducing the risk of errors and advocating greater importance on patient safety.
Key words:
algorithms; interphase; automated data processing; blood cell count; patient safety; laboratory tests
This figure shows the different phases of autoverification implementation process.CBC: complete blood counter; PSM: Process System Manager.
Please note the increase in autoverified results (NEG) when finishing pilot tests.RBC: red blood cells; WBC: white blood cells; HB: hemoglobin; HTO: hematocrit; MCV: mean corpuscular volume; MCH: mean corpuscular hemoglobin; MCHC: mean corpuscular hemoglobin concentration; RDW: red cell distribution width; MPV: mean platelet volume; NEUT#: absolute neutrophils count; NEUT%: percentage of neutrophils; LINF#: absolute lymphocytes count; LINF%: percentage of lymphocytes; MONO#: absolute monocytes count; MONO%: percentage of monocytes; EOS#: absolute eosinophils count; EOS%: percentage of eosinophils; BASO%: percentage of basophils; LOW: low result; DELTA: difference between results; CAR: articulated set of rules; NEG: negative; HIGH: high result.
More than 50% of the automated CBC processed in a day was autoverified.LIS: laboratory information system; CBC: complete blood counter.
The improvement in the organization’s workflow allowed skipping the differential counts typing by an individual, thus resulting in more time allocated to the pathological results.CBC: complete blood counter.