In this guide 6 sections
Track each sample with one barcode from collection tube to released report. Check the label at collection and record every handover with a time and a name. Match analyser results to the barcode, validate before release, and keep the audit trail.
Collection and labelling
Most errors begin before the sample reaches the lab. Print the barcode label at the patient’s side, or at least after registration is confirmed, because hand labelled tubes are where wrong patient errors start.
Check two identifiers with the patient, such as full name and date of birth. Record the collector’s name, the time and the tube type.
Reject a tube with a missing label, a haemolysed sample or the wrong anticoagulant. Log the rejection and the reason. Ask for a recollection.
- Two identifiers confirmed with the patient
- Barcode printed after registration
- Tube type matches the test ordered
- Fasting status noted where it matters
- Collection time and collector recorded
Transport and receiving
Home collection and outside collection centres add a handover that is easy to lose. Use a manifest that lists each tube by barcode along with its temperature requirement.
At the lab, scan each tube on arrival. A tube that was on the manifest but never reached the bench is a flag you want within minutes, not the next morning when the patient phones.
Separate samples by bench. Biochemistry, haematology, microbiology and histopathology each follow their own rules for storage and time limits.
Bench and analyser matching
Connect each analyser to the lab system so the result returns against the barcode instead of through retyping. Manual entry of a haemoglobin value is a quiet source of error.
Run quality control samples at the start of each shift and record the lot and the result. Hold patient results if a control fails.
For tests done by hand, such as a peripheral smear or a culture reading, capture the technician’s name beside the finding.
- Analyser interface to the barcode
- Daily internal quality control with lot number
- Reagent lot and expiry captured per run
- Repeat and dilution logged with reason
- Manual results marked with the technician
Validation and report release
Set reference ranges and critical values in the system. A result beyond a critical limit should stop and call a person. It should not sit in a queue. A person must act.
A pathologist or senior technologist validates before release, and a delta check against the patient’s previous result catches many sample mix ups that no single value would reveal.
Release the report only to the patient, the ordering doctor or the authorised portal. Log who downloaded it and when.
- Critical value alert with callback record
- Delta check against the previous result
- Pathologist sign off with date and time
- Amended report keeps the earlier version
- Release log by user
Storage, audit and the next step
Keep samples for the retention period the lab has agreed with its accreditation body or regulator. Record the rack and shelf, so a repeat test request takes a minute and not an afternoon.
Trace a random report each week from the printed page back to the tube it came from. If any link in that chain is missing, you have found your weakest handover.
Print this list. Trace five samples tomorrow.
Sample trace checklist
A single-page checklist listing one stage per line: collection, transport, receiving, bench, analyser, validation, release and storage. Columns hold the check, the person, the time and a tick for pass or fail. A back block records five traced samples per week with the broken link, if any.
Open a blank worksheet to printQuestions owners ask
Does every sample need its own barcode?
Yes, one per tube. A shared barcode across tubes makes it impossible to trace a single aliquot, especially after splitting a sample.
What should a lab do when a sample is lost?
Log it, inform the ordering doctor, and arrange a recollection. Record the stage where it disappeared, since repeated losses point to one handover.
How often should the trail be audited?
A weekly trace of a few reports is practical for a small lab. A larger lab adds a monthly review of rejections, delays and amended reports.
Can paper registers still work?
For a low volume lab, yes. Once several benches and outside centres are involved, paper makes matching results to patients slow and error prone.