Error identification in a high-volume clinical chemistry laboratory: Five-year experience

Lena Jafri, Aysha Habib Khan, Farooq Ghani, Shahid Shakeel, Ahmed Raheem, Imran Siddiqui

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Introduction. Quality indicators for assessing the performance of a laboratory require a systematic and continuous approach in collecting and analyzing data. The aim of this study was to determine the frequency of errors utilizing the quality indicators in a clinical chemistry laboratory and to convert errors to the Sigma scale. Materials and methods. Five-year quality indicator data of a clinical chemistry laboratory was evaluated to describe the frequency of errors. An 'error' was defined as a defect during the entire testing process from the time requisition was raised and phlebotomy was done until the result dispatch. An indicator with a Sigma value of 4 was considered good but a process for which the Sigma value was 5 (i.e. 99.977% error-free) was considered well controlled. Results. In the five-year period, a total of 6,792,020 specimens were received in the laboratory. Among a total of 17,631,834 analyses, 15.5% were from within hospital. Total error rate was 0.45% and of all the quality indicators used in this study the average Sigma level was 5.2. Three indicators-visible hemolysis, failure of proficiency testing and delay in stat tests-were below 5 on the Sigma scale and highlight the need to rigorously monitor these processes. Conclusions. Using Six Sigma metrics quality in a clinical laboratory can be monitored more effectively and it can set benchmarks for improving efficiency.

Original languageEnglish
Pages (from-to)296-300
Number of pages5
JournalScandinavian Journal of Clinical and Laboratory Investigation
Issue number4
Publication statusPublished - 1 Jul 2015


  • Errors
  • Healthcare
  • Laboratory proficiency testing
  • Quality control
  • Quality indicators


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