Optimizing Laboratory Processes: A Path to Reduced Sample Rejection in Oncology

Abstract

Background: We aimed to enhance the quality of cancer care by reducing the rate of sample rejection and lowering the incidence of sample mislabeling at the Sultan Qaboos Comprehensive Cancer Care and Research Centre in Muscat, Oman.

Methods: We adopted a one-group pretest-posttest quasi-experimental design from the second quarter of 2022 to the first quarter of 2023, assessing key performance indicators related to sample rejection and mislabeling on quarterly basis before and after implementing targeted interventions. The project utilized the FOCUS PDCA framework for systematic implementation and evaluation. Four FOCUS PDCA sessions were conducted involving a multidisciplinary team of ten participants comprising oncologists, nurses, laboratory technicians, quality management experts, and informatics and cyber security department staff. Ethical clearance was obtained from the Institutional Review Board, ensuring adherence to ethical protocols. Interventions included five educational sessions for nurses and physicians, process modifications, and improved communication protocols.

Results: Analysis revealed a significant decrease in the rate of rejected samples, declining from 20.85% during Pre-Intervention to 6.05% in the Post Intervention phase. Similarly, the mislabeling rate exhibited a substantial reduction, decreasing from 1.68% to 0.25% over the same period. Statistical analysis using ANOVA confirmed significant differences between intervention phases for both the rejected samples rate (F-value = 12.3458, P-value = 0.002) and the mislabeling rate (F-value = 57.1875, P-value < 0.001).

Conclusion: These results underscored the effectiveness of the interventions in improving blood sample collection and management processes, thereby enhancing the reliability of study outcomes.