Evaluating the total laboratory testing process and performance via quality indicators in clinical chemistry and hematology laboratories at Pawi General Hospital, Benishangul Gumz, Northwest Ethiopia: a prospective cross-sectional study

Abstract Background Clinical laboratory test results play a critical role in medical decision-making and patient management. It is estimated that over 60–70% of essential clinical decisions; including hospital admissions, prescribing of medications, and patient discharges, depend on these results. H...

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Main Authors: Nigatu Tarekegn, Aklilu Getachew Mamo, Kedir Abdella Abdulsemed, Seid Abrar Abdlshikure, Zeleke Mekonnen
Format: Article
Language:English
Published: Springer Nature 2025-07-01
Series:Discover Health Systems
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Online Access:https://doi.org/10.1007/s44250-025-00260-4
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author Nigatu Tarekegn
Aklilu Getachew Mamo
Kedir Abdella Abdulsemed
Seid Abrar Abdlshikure
Zeleke Mekonnen
author_facet Nigatu Tarekegn
Aklilu Getachew Mamo
Kedir Abdella Abdulsemed
Seid Abrar Abdlshikure
Zeleke Mekonnen
author_sort Nigatu Tarekegn
collection DOAJ
description Abstract Background Clinical laboratory test results play a critical role in medical decision-making and patient management. It is estimated that over 60–70% of essential clinical decisions; including hospital admissions, prescribing of medications, and patient discharges, depend on these results. However, errors occurring at any stage of the testing process can compromise the accuracy and reliability of the results, thereby adversely impacting clinical decisions. Objective This study aims to evaluate the total laboratory testing process and performance through the application of quality indicators in the clinical chemistry and hematology laboratories at Pawi General Hospital, Benishangul-Gumz Region, Northwestern Ethiopia. Methods A prospective cross-sectional study was conducted at Pawi General Hospital between October 1 and December 30, 2021. All venous blood samples and their corresponding test requests submitted to the clinical chemistry and hematology laboratories during this period were included. Quality assessment was carried out using IFCC-approved guidelines and ISO 15189 standard quality indicators, which were adapted to the local context. Data were entered into EpiData version 3.0 and analyzed using SPSS version 21. Results A total of 4140 samples were analyzed, of which 14.7% were for clinical chemistry and 85.3% for hematology. The study assessed 136,722 quality indicators, with 24.7% of errors occurring during the total testing process. Errors were distributed across the preanalytical (63.6%), analytical (1.6%), and postanalytical (34.8%) phases. The most common preanalytical errors seen were incomplete information on test request forms and specimen rejection. In the analytical phase, errors were primarily attributed to reagent stock-outs and equipment downtime. Postanalytical errors were mainly associated with prolonged turnaround times. Chi-square analysis revealed a statistically significant difference in the frequency of errors across the three phases (χ2 = 4986, p < 0.0001). Conclusion The study revealed high error rates in both the pre-analytical and pos-tanalytical phases, underscoring the urgent need for coordinated efforts by all stakeholders to strengthen quality assurance measures and enhance the overall reliability of laboratory services.
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spelling doaj-art-57178fe12e324e52a030729e840beeb22025-08-20T03:43:11ZengSpringer NatureDiscover Health Systems2731-75012025-07-014111410.1007/s44250-025-00260-4Evaluating the total laboratory testing process and performance via quality indicators in clinical chemistry and hematology laboratories at Pawi General Hospital, Benishangul Gumz, Northwest Ethiopia: a prospective cross-sectional studyNigatu Tarekegn0Aklilu Getachew Mamo1Kedir Abdella Abdulsemed2Seid Abrar Abdlshikure3Zeleke Mekonnen4Pawi General HospitalSchool of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma UniversitySchool of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma UniversityDepartment of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wolkite UniversitySchool of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma UniversityAbstract Background Clinical laboratory test results play a critical role in medical decision-making and patient management. It is estimated that over 60–70% of essential clinical decisions; including hospital admissions, prescribing of medications, and patient discharges, depend on these results. However, errors occurring at any stage of the testing process can compromise the accuracy and reliability of the results, thereby adversely impacting clinical decisions. Objective This study aims to evaluate the total laboratory testing process and performance through the application of quality indicators in the clinical chemistry and hematology laboratories at Pawi General Hospital, Benishangul-Gumz Region, Northwestern Ethiopia. Methods A prospective cross-sectional study was conducted at Pawi General Hospital between October 1 and December 30, 2021. All venous blood samples and their corresponding test requests submitted to the clinical chemistry and hematology laboratories during this period were included. Quality assessment was carried out using IFCC-approved guidelines and ISO 15189 standard quality indicators, which were adapted to the local context. Data were entered into EpiData version 3.0 and analyzed using SPSS version 21. Results A total of 4140 samples were analyzed, of which 14.7% were for clinical chemistry and 85.3% for hematology. The study assessed 136,722 quality indicators, with 24.7% of errors occurring during the total testing process. Errors were distributed across the preanalytical (63.6%), analytical (1.6%), and postanalytical (34.8%) phases. The most common preanalytical errors seen were incomplete information on test request forms and specimen rejection. In the analytical phase, errors were primarily attributed to reagent stock-outs and equipment downtime. Postanalytical errors were mainly associated with prolonged turnaround times. Chi-square analysis revealed a statistically significant difference in the frequency of errors across the three phases (χ2 = 4986, p < 0.0001). Conclusion The study revealed high error rates in both the pre-analytical and pos-tanalytical phases, underscoring the urgent need for coordinated efforts by all stakeholders to strengthen quality assurance measures and enhance the overall reliability of laboratory services.https://doi.org/10.1007/s44250-025-00260-4Clinical chemistryHematologyTotal laboratory testing process Quality indicator
spellingShingle Nigatu Tarekegn
Aklilu Getachew Mamo
Kedir Abdella Abdulsemed
Seid Abrar Abdlshikure
Zeleke Mekonnen
Evaluating the total laboratory testing process and performance via quality indicators in clinical chemistry and hematology laboratories at Pawi General Hospital, Benishangul Gumz, Northwest Ethiopia: a prospective cross-sectional study
Discover Health Systems
Clinical chemistry
Hematology
Total laboratory testing process 
Quality indicator
title Evaluating the total laboratory testing process and performance via quality indicators in clinical chemistry and hematology laboratories at Pawi General Hospital, Benishangul Gumz, Northwest Ethiopia: a prospective cross-sectional study
title_full Evaluating the total laboratory testing process and performance via quality indicators in clinical chemistry and hematology laboratories at Pawi General Hospital, Benishangul Gumz, Northwest Ethiopia: a prospective cross-sectional study
title_fullStr Evaluating the total laboratory testing process and performance via quality indicators in clinical chemistry and hematology laboratories at Pawi General Hospital, Benishangul Gumz, Northwest Ethiopia: a prospective cross-sectional study
title_full_unstemmed Evaluating the total laboratory testing process and performance via quality indicators in clinical chemistry and hematology laboratories at Pawi General Hospital, Benishangul Gumz, Northwest Ethiopia: a prospective cross-sectional study
title_short Evaluating the total laboratory testing process and performance via quality indicators in clinical chemistry and hematology laboratories at Pawi General Hospital, Benishangul Gumz, Northwest Ethiopia: a prospective cross-sectional study
title_sort evaluating the total laboratory testing process and performance via quality indicators in clinical chemistry and hematology laboratories at pawi general hospital benishangul gumz northwest ethiopia a prospective cross sectional study
topic Clinical chemistry
Hematology
Total laboratory testing process 
Quality indicator
url https://doi.org/10.1007/s44250-025-00260-4
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