Assessment of Clinical Hematology Laboratory Performance Using Sigma Metrics and Associated Factors in Total Testing Process at the Dessie Comprehensive Specialized Hospital, Northeast, Ethiopia: A Cross‐Sectional Study

TL;DR

This study assesses the performance of a hematology lab in Ethiopia and finds significant errors, especially during sample preparation.

Contribution

The study evaluates hematology lab performance using sigma metrics and identifies factors contributing to errors in the testing process.

Findings

12.44% of errors occurred in the total testing process, mostly in the pre-analytical phase.

The overall sigma value of 2.7 indicates substandard lab performance.

Training and adherence to procedures are recommended to reduce errors.

Abstract

Clinical laboratory test results play a fundamental role in clinical decision making, influencing approximately 70% of medical decisions. Numerous studies have shown that errors can occur throughout the total testing process. This study aimed to assess the performance of the Clinical Hematology Laboratory and identify associated factors using sigma metrics across the total testing process at Dessie Comprehensive Specialized Hospital.

A cross‐sectional study was conducted from July1, 2023, to September 30, 2023. The study included all eligible laboratory samples and corresponding test requests during the study period using a consecutive sampling technique. Data for each variable were collected using a pre prepared checklist and record formats by trained laboratory professionals. The data were entered into EPI data version 3.1 and exported to Stata version 17 for analysis. Logistic regression analysis was performed, and the laboratory's total testing process performance was evaluated using the sigma scale.

The overall prevalence of clinical hematology laboratory errors in the total testing process was 12.44%. Most errors occurred during the pre‐analytical phase (77.8%), followed by the post‐analytical phase (19.77%) and the analytical phase (2.36%). The overall sigma value of the hematology laboratory was 2.7, indicating substandard performance. The sigma values for the pre‐analytical, analytical, and post‐analytical phases were 2.6, 3.2, and 2.8, respectively.

This study found that errors in the clinical hematology laboratory were common, and overall performance was below the acceptable sigma threshold. Therefore, hospital administration should provide need‐based training for all staff involved in hematology laboratory sample collection and processing. Strengthening adherence to standard operating procedures and implementing continuous quality improvement strategies are essential to enhance laboratory performance and reduce errors.