Laboratory Error | Reduce Medical Error

Laboratory errors performed by commercial laboratory service in in any medical office setting are very common. There are also many kinds of of mistakes. I am going to describe one common mistake.

Suppose the doctor order lab. tests as follow: Total Cholesterol(TC) and LDL-Cholesterol(LDL-c) but the lab. reports show the results of the Lipid Panel which consists of TC, LDL-c, Triglycerides(Trig.) and HDL-c. The ordering doctor should spot the error right away and call the lab. to correct the mistake by discarding Trig. and HDL-c.

Why should the lab. discard the 2 tests mentioned above? The answer is that the lab. can not bill the patient or the insurance company for any test without a doctor's order.

How can the mistakes described above happen? It can happen in 2 ways. First,it can be the clerical error of the medical office staff by marking the Lipid Panel slot on the lab. requisition sheet instead of marking just TC and LDL-c as ordered. The second scenario is that the medical office staff is correct but the lab technician carelessly does the Lipid Panel instead. The Trig. level must be done after a 12 hours fasting also.

In my office,we always keep a copy of the lab. requisition in a temporary file folder and file it with the actual test result when available. This copy will also serve to verify who makes the error.

This kind of error does no harm to patient but if not spotted early, it can cost money to patient and/or to the insurance company.

How can we prevent this kind of mistake from happening? In my office, we implement the following protocol:

• Keep a copy of the lab. requisition and file it with the test results when available,usually the next day.
• Staff puts the lab. result in my in-box immediately after it's comes in through the printer.
• I check the lab. results as soon as feasible on the same day.
• If there is any lab. error,I will instruct one of my staff to to call the lab to correct the mistake if it is feasible.
• My office staff will log the error in the lab. error log book. The log will indicate the following: a)Our error or lab.service error, b)If it's our error,who committed the error,c) What type of error

Since the implementation of this policy many years ago, we accomplish the following

• This kind of error was reduced to almost nil.
• The performance of the lab. and my staff improved tremendously because there was no dispute as to who made the mistake.
• Increase patient's satisfaction.
• Help decrease one tiny area of of health care waste.

How can a patient spot this kind of error? Usually it's difficult for any patient to do that but you can do the following to reduce your out of pocket payment:

• Check your medical bill as soon as you receive it.
• If you suspect an error as mentioned above,ask your ordering doctor to explain the detail of the bill. Your ordering doctor or his designate should take time to answer your question.