Enhancing diagnostic accuracy and pre-analytical efficiency: a systematic review of workflow coordination among laboratory specialists, medical laboratory technologists, and patient care technicians
DOI:
https://doi.org/10.65759/zgyhfk81Keywords:
pre-analytical phase, diagnostic accuracy, laboratory workflow, specimen rejection, patient identification, medical laboratory technologistsAbstract
Background: Pre-analytical failures during test ordering, patient identification, specimen collection, labeling, handling, and transport threaten diagnostic accuracy and delay clinical decisions. This review evaluated workflow coordination in laboratory specialists, medical laboratory technologists, and patient care technicians and collectors. Methods: PubMed/MEDLINE, Scopus, Web of Science Core Collection, and the Cochrane Library were searched for studies published from 2000 through Jun 2026. Eligible studies evaluated coordinated interventions or factors linked to specimen identification errors, rejection, hemolysis, turnaround time, or collection knowledge. Findings were synthesized narratively because interventions, settings, denominators, and outcome definitions were heterogeneous. Results: Seventeen original studies were included. Bedside barcode identification, electronic ordering, and mobile specimen-labeling systems produced the most consistent reductions in mislabeled specimens and wrong-blood-in-tube events. Multidisciplinary programs combining standardized procedures, competency assessment, consumable redesign, surveillance, and feedback also reduced rejection and hemolysis. Education improved knowledge more than specimen outcomes, with one quasi-experimental study reporting no significant reduction in rejection. Most studies used uncontrolled before-after or retrospective designs, limiting causal certainty. Conclusions: Closed-loop coordination connecting clinical ordering, bedside collection, immediate labeling, transport, laboratory acceptance, and feedback strengthens pre-analytical performance. Technology achieved greater benefit when integrated with role clarity, monitoring, and recurrent competency assessment. Future controlled studies need standardized indicators and direct measures of diagnostic delay, treatment change, patient harm, and cost.
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