Impact of intervention on preanalytical errors assessed by six sigma and Pareto’s principle

Introduction: Preanalytical steps are the major sources of error in the clinical laboratory. The analytical errors can be corrected by quality control procedures but there is a need for stringent quality checks in the preanalytical area as these processes are done outside the laboratory. Sigma value...

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Main Authors: Sweta Kulkarni, S. Vinothini, Wilma Delphine Silvia CR
Format: Article
Language:English
Published: Al Ameen Medical College 2025-07-01
Series:Al Ameen Journal of Medical Sciences
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Online Access:https://ajms.alameenmedical.org/ArticlePDFs/5%20AJMS%20V18.N3.2025%20p%20180-186.pdf
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author Sweta Kulkarni
S. Vinothini
Wilma Delphine Silvia CR
author_facet Sweta Kulkarni
S. Vinothini
Wilma Delphine Silvia CR
author_sort Sweta Kulkarni
collection DOAJ
description Introduction: Preanalytical steps are the major sources of error in the clinical laboratory. The analytical errors can be corrected by quality control procedures but there is a need for stringent quality checks in the preanalytical area as these processes are done outside the laboratory. Sigma value depicts the performance of the laboratory and its quality measures. Hence in the present study, six sigma and Pareto principle were applied to preanalytical quality indicators to evaluate the impact of the intervention. Materials and Methods: The present analytical interventional study was conducted in a tertiary care hospital after obtaining Institute’s ethical waiver. A total of 31,003 samples before intervention and 31,114 samples after intervention were screened for preanalytical errors in sample collection like Hemolysed, clotted, inadequate sample, Lipemic from clinical biochemistry section over a period of one year. Six sigma values were calculated using the Westgard online formula. Results: The clotted and inadequate samples were the major preanalytical errors with a sigma value of 3.5 and after intervention sigma value was 4.6 and 4.7 respectively. The Pareto`s chart (80/20 rule) also depicted the same results. Conclusion: The interventions like training and providing standard operating procedures to laboratory technicians and nursing staff reduces the frequency of preanalytical errors and improves the sigma value.
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spelling doaj-art-ea73a3d763cd4e71968396fa19af214f2025-08-20T03:17:44ZengAl Ameen Medical CollegeAl Ameen Journal of Medical Sciences0974-11432025-07-011803180186Impact of intervention on preanalytical errors assessed by six sigma and Pareto’s principleSweta Kulkarni0S. Vinothini1Wilma Delphine Silvia CR2Department of Biochemistry, Indira Gandhi Medical College and Research Institute, Vazhudavur Road, Kathirkamam, Puducherry-605009, IndiaDepartment of Biochemistry, Asian Institute of Medical Academy, Near BSNL Office, Vandavasi-604408, Tamil Nadu, IndiaDepartment of Biochemistry, Akash Institute of Medical Sciences and Research Centre, Prasannahalli Road, Devanahalli, Bengaluru-562110, Karnataka, IndiaIntroduction: Preanalytical steps are the major sources of error in the clinical laboratory. The analytical errors can be corrected by quality control procedures but there is a need for stringent quality checks in the preanalytical area as these processes are done outside the laboratory. Sigma value depicts the performance of the laboratory and its quality measures. Hence in the present study, six sigma and Pareto principle were applied to preanalytical quality indicators to evaluate the impact of the intervention. Materials and Methods: The present analytical interventional study was conducted in a tertiary care hospital after obtaining Institute’s ethical waiver. A total of 31,003 samples before intervention and 31,114 samples after intervention were screened for preanalytical errors in sample collection like Hemolysed, clotted, inadequate sample, Lipemic from clinical biochemistry section over a period of one year. Six sigma values were calculated using the Westgard online formula. Results: The clotted and inadequate samples were the major preanalytical errors with a sigma value of 3.5 and after intervention sigma value was 4.6 and 4.7 respectively. The Pareto`s chart (80/20 rule) also depicted the same results. Conclusion: The interventions like training and providing standard operating procedures to laboratory technicians and nursing staff reduces the frequency of preanalytical errors and improves the sigma value.https://ajms.alameenmedical.org/ArticlePDFs/5%20AJMS%20V18.N3.2025%20p%20180-186.pdfsix sigmapreanalyticalquality indicatorspareto’s chartintervention
spellingShingle Sweta Kulkarni
S. Vinothini
Wilma Delphine Silvia CR
Impact of intervention on preanalytical errors assessed by six sigma and Pareto’s principle
Al Ameen Journal of Medical Sciences
six sigma
preanalytical
quality indicators
pareto’s chart
intervention
title Impact of intervention on preanalytical errors assessed by six sigma and Pareto’s principle
title_full Impact of intervention on preanalytical errors assessed by six sigma and Pareto’s principle
title_fullStr Impact of intervention on preanalytical errors assessed by six sigma and Pareto’s principle
title_full_unstemmed Impact of intervention on preanalytical errors assessed by six sigma and Pareto’s principle
title_short Impact of intervention on preanalytical errors assessed by six sigma and Pareto’s principle
title_sort impact of intervention on preanalytical errors assessed by six sigma and pareto s principle
topic six sigma
preanalytical
quality indicators
pareto’s chart
intervention
url https://ajms.alameenmedical.org/ArticlePDFs/5%20AJMS%20V18.N3.2025%20p%20180-186.pdf
work_keys_str_mv AT swetakulkarni impactofinterventiononpreanalyticalerrorsassessedbysixsigmaandparetosprinciple
AT svinothini impactofinterventiononpreanalyticalerrorsassessedbysixsigmaandparetosprinciple
AT wilmadelphinesilviacr impactofinterventiononpreanalyticalerrorsassessedbysixsigmaandparetosprinciple