Utilidad del análisis modal de fallos y efectos para la detección de errores en el transporte de muestras al laboratorio clínico / Modal failure analysis and effects in the detection of errors in the transport of samples to the clinical laboratory

Objetivo. Debido a un descenso en la concentración del parámetro bioquímico glucosa en algunas muestras procedentes de los centros externos de extracción y el riesgo para la seguridad del paciente que supone, se decidió aplicar una adaptación de la herramienta «Análisis Modal de Fallos y Efectos Aplicada a los Servicios de Salud» (HFMEA) para la gestión del riesgo en la fase preanalítica del transporte de muestras desde centros externos al laboratorio clínico. Material y métodos. Estudio retrospectivo de los valores del parámetro bioquímico glucosa, durante 2 meses consecutivos. Análisis en sus diferentes fases: identificación del problema, formación de equipo, descripción gráfica del proceso, análisis de riesgos, diseño de la intervención e indicadores y responsables para la implementación. Resultados. Los resultados del parámetro glucosa en una de las rutas de transporte fueron significativamente inferiores (p = 0,006). Se analizaron los fallos y las causas potenciales de este problema. Se aplicaron criterios de criticidad y detectabilidad (puntuación ≥ 8) en el árbol de decisión y se decidió intervenir en: el desarrollo del sistema gestor documental, la reorganización de las extracciones en algunos centros y rutas de transporte, los acumuladores de frío de los contenedores de muestra, y el control de tiempos y temperaturas de transporte. Conclusiones. Para la etapa preanalítica, se proponen indicadores de calidad para el control de tiempo y temperatura de las muestras transportadas. La revisión periódica de determinados parámetros analíticos puede ayudar a detectar problemas en el transporte de muestras. La técnica HFMEA es de gran utilidad para el laboratorio clínico (AU)

Objective. Owing to the decrease in values of biochemical glucose parameter in some samples from external extraction centres, and the risk this implies to patient safety; it was decided to apply an adaptation of the «Health Services Failure Mode and Effects Analysis» (HFMEA) to manage risk during the pre-analytical phase of sample transportation from external centres to clinical laboratories. Materials and methods. A retrospective study of glucose parameter was conducted during two consecutive months. The analysis was performed in its different phases: to define the HFMEA topic, assemble the team, graphically describe the process, conduct a hazard analysis, design the intervention and indicators, and identify a person to be responsible for ensuring completion of each action. Results. The results of glucose parameter in one of the transport routes, were significantly lower (P = .006). The errors and potential causes of this problem were analysed, and criteria of criticality and detectability were applied (score ≥ 8) in the decision tree. It was decided to: develop a document management system; reorganise extractions and transport routes in some centres; quality control of the sample container ice-packs, and the time and temperature during transportation. Conclusions. This work proposes quality indicators for controlling time and temperature of transported samples in the pre-analytical phase. Periodic review of certain laboratory parameters can help to detect problems in transporting samples. The HFMEA technique is useful for the clinical laboratory (AU)

[Modal failure analysis and effects in the detection of errors in the transport of samples to the clinical laboratory]. / Utilidad del análisis modal de fallos y efectos para la detección de errores en el transporte de muestras al laboratorio clínico.

OBJECTIVE: Owing to the decrease in values of biochemical glucose parameter in some samples from external extraction centres, and the risk this implies to patient safety; it was decided to apply an adaptation of the «Health Services Failure Mode and Effects Analysis¼ (HFMEA) to manage risk during the pre-analytical phase of sample transportation from external centres to clinical laboratories. MATERIALS AND METHODS: A retrospective study of glucose parameter was conducted during two consecutive months. The analysis was performed in its different phases: to define the HFMEA topic, assemble the team, graphically describe the process, conduct a hazard analysis, design the intervention and indicators, and identify a person to be responsible for ensuring completion of each action. RESULTS: The results of glucose parameter in one of the transport routes, were significantly lower (P=.006). The errors and potential causes of this problem were analysed, and criteria of criticality and detectability were applied (score≥8) in the decision tree. It was decided to: develop a document management system; reorganise extractions and transport routes in some centres; quality control of the sample container ice-packs, and the time and temperature during transportation. CONCLUSIONS: This work proposes quality indicators for controlling time and temperature of transported samples in the pre-analytical phase. Periodic review of certain laboratory parameters can help to detect problems in transporting samples. The HFMEA technique is useful for the clinical laboratory.