Loading...
Analysis of risks associated with laboratory error rates of Covid-19 testing at the NHLS Paarl Laboratory
Author(s)
Singh, Natasha
Date Issued
2023
Type
Thesis
Publisher
Cape Peninsula University of Technology
Abstract
This study was conducted at the National Health Laboratory Services (NHLS) in Paarl, located
in the Western Cape region, a renowned diagnostic testing laboratory. In the wake of the
COVID-19 pandemic’s emergence in 2020, healthcare systems were faced with
unprecedented challenges, as laboratory testing was the primary means of diagnosing COVID-
19 in patients. The NHLS Paarl laboratory was mandated to test high volumes of samples in a
short timeframe (within 12 hours), so patients would receive their results and follow isolation
protocols promptly if required. This situation brought to light a multitude of laboratory errors,
which impacted the COVID-19 testing and resulting process. The primary objective of this
research study was to meticulously analyse and identify root causes of these errors, with the
aim of reducing and ultimately eliminating them, thus enhancing the quality of patient
healthcare.
The conceptual framework underpinning this research employs the application of quality
management tools such as: Pareto analysis, Ishikawa diagrams, the 5 Whys analysis, and the
Failure Modes and Effects Analysis (FMEA). These tools are firmly rooted in the recognised
quality management cycle known as the Plan Do Check Act (PDCA) model. The objective is
to develop an optimised pre-analytic process enriched with preventative measures that
ensures reduced laboratory errors in COVID-19 testing.
The research methodology adopted for this research is a mixed methods approach, whereby
both quantitative and qualitative data was collected and analysed. The quantitative data was
collected by means of TrakCare rejection reports during the period 1st January 2021 until 31st
December 2021. The qualitative data was collected by means of conducting semi-structured
interviews with key stakeholders in the NHLS, namely, the regional quality assurance
manager, the business manager, and the head phlebotomist. The quantitative data was
analysed using the quality tools: pareto analysis, Ishikawa diagram, the 5 whys analysis, and
FMEA. The qualitative data was analysed by using the ATLAS.ti software.
The study’s findings revealed deficiencies in the pre-analytical COVID-19 testing process
which needed improvement. This research found that vital processes needed to be
implemented at specific steps in the pre-analytical COVID-19 testing process, as well as the
appointment of key personnel at specified stages to overcome the errors found in this area.
Consequently, this research led to the development of an optimised pre-analytical COVID-19
testing process, aimed to enhance the quality and reliability of test results. This study advocates for the implementation of pre-analytic process procedures and a
structured deployment of training and education to health care professionals. Furthermore, it
underscores the necessity of establishing check points at various stages, namely: check points
prior to specimen collection, specimen and request form labelling, specimen handling, and
specimen transportation to reduce and eliminate pre-analytical errors. Additionally, the study
recommends annual performance reviews for nurses and clinicians and annual audits of the
pre-analytic testing process. These mechanisms are deemed essential for achieving and
sustaining continuous process improvement in healthcare.
in the Western Cape region, a renowned diagnostic testing laboratory. In the wake of the
COVID-19 pandemic’s emergence in 2020, healthcare systems were faced with
unprecedented challenges, as laboratory testing was the primary means of diagnosing COVID-
19 in patients. The NHLS Paarl laboratory was mandated to test high volumes of samples in a
short timeframe (within 12 hours), so patients would receive their results and follow isolation
protocols promptly if required. This situation brought to light a multitude of laboratory errors,
which impacted the COVID-19 testing and resulting process. The primary objective of this
research study was to meticulously analyse and identify root causes of these errors, with the
aim of reducing and ultimately eliminating them, thus enhancing the quality of patient
healthcare.
The conceptual framework underpinning this research employs the application of quality
management tools such as: Pareto analysis, Ishikawa diagrams, the 5 Whys analysis, and the
Failure Modes and Effects Analysis (FMEA). These tools are firmly rooted in the recognised
quality management cycle known as the Plan Do Check Act (PDCA) model. The objective is
to develop an optimised pre-analytic process enriched with preventative measures that
ensures reduced laboratory errors in COVID-19 testing.
The research methodology adopted for this research is a mixed methods approach, whereby
both quantitative and qualitative data was collected and analysed. The quantitative data was
collected by means of TrakCare rejection reports during the period 1st January 2021 until 31st
December 2021. The qualitative data was collected by means of conducting semi-structured
interviews with key stakeholders in the NHLS, namely, the regional quality assurance
manager, the business manager, and the head phlebotomist. The quantitative data was
analysed using the quality tools: pareto analysis, Ishikawa diagram, the 5 whys analysis, and
FMEA. The qualitative data was analysed by using the ATLAS.ti software.
The study’s findings revealed deficiencies in the pre-analytical COVID-19 testing process
which needed improvement. This research found that vital processes needed to be
implemented at specific steps in the pre-analytical COVID-19 testing process, as well as the
appointment of key personnel at specified stages to overcome the errors found in this area.
Consequently, this research led to the development of an optimised pre-analytical COVID-19
testing process, aimed to enhance the quality and reliability of test results. This study advocates for the implementation of pre-analytic process procedures and a
structured deployment of training and education to health care professionals. Furthermore, it
underscores the necessity of establishing check points at various stages, namely: check points
prior to specimen collection, specimen and request form labelling, specimen handling, and
specimen transportation to reduce and eliminate pre-analytical errors. Additionally, the study
recommends annual performance reviews for nurses and clinicians and annual audits of the
pre-analytic testing process. These mechanisms are deemed essential for achieving and
sustaining continuous process improvement in healthcare.
Additional information
Thesis (MEng (Quality))--Cape Peninsula University of Technology, 2023
File(s)![Thumbnail Image]()
Loading...
Name
Singh_Natasha_214290093.pdf
Size
3.06 MB
Format
Adobe PDF
Checksum
(MD5):2f449881667138aff8925b6b796f5e30