Overview on patient safety in healthcare and laboratory diagnostics
; Laboratory of Clinical Chemistry and Hematology, Department of Pathology and Laboratory Medicine, University Hospital, Parma, Italy
Ana-Maria Simundic ; University Department of Chemistry, Sestre Milosrdnice University Hospital, Zagreb, Croatia
Camilla Mattiuzzi ; Medical Direction, University Hospital, Verona, Italy
The healthcare context is characterized by a high degree of complexity. Despite eager efforts of the healthcare personnel, sometimes things go wrong and produce unintentional harm to the patients. As such, patient safety must be considered as one of leading healthcare challenges. Some foremost studies have highlighted that serious medical errors might occur rather frequently, jeopardizing patient's health and costing a huge amount of money to the healthcare system. A medical error is traditionally defined as an unintended act, the failure of a planned action to be completed as intended, the use of a wrong plan to achieve an aim when the failure can not be attributed to chance. Medical errors can be classified according to several models, such as the clinical pathway (i.e., diagnostic, treatment, prevention and others), or the resulting harm to the patient (i.e., near misses, no harm or harmful incident). Medical errors can also be classified in skill-based slips and lapses (i.e., errors of action), or rule and knowledge-based mistakes (i.e., errors of intention). According to the source, most errors result from the combination of active failures and latent conditions. It is noteworthy, however, that diagnostic errors have been frequently underestimated in the clinical practice. A laboratory error is any defect occurring at any part of the laboratory cycle, from ordering tests to reporting, interpreting, and reacting to results. Although they have been traditionally identified with analytical problems and uncertainty of measurements, an extensive scientific literature now attests that the vast majority of these arise from the extra-analytical activities of the total testing process. Data from representative studies also show that preanalytical errors are the first cause of variability in laboratory testing. The aim of this article is to provide an overview on the current knowledge about patient safety in healthcare and laboratory diagnostics.
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