Graduation Date


Document Type

Master's Thesis

Degree Name

Master of Science

Department or Program

Clinical Laboratory Sciences

Department or Program Chair

Mary Sevigny, PhD

First Reader

Agripina Brown, CLS

Second Reader

Maria C. DeSousa, JD, MPA, CLS


The pre-analytical phase contributes 60-70% of total error of the total testing process (TTP) (Plebani 2006). The pre-analytical phase can be further divided into two phases; the ‘pre-preanalytical’ and ‘preanalytical’ phases, which commonly includes tasks performed outside of the laboratory walls, and tasks perform within the laboratory’s walls and control, respectively. Additionally, medical care reimbursement policies in the U.S. along with the need to efficiently produce quality results and reduce the costs to clients, has caused the microbiology lab to move from on-site to more resourcefully abundant consolidate labs (Sautter 2014). Serving many satellite facilities, it is of interest to look at the pre-preanalytical phase to ensure specimen accountability when transported over the distance to the core laboratory.

While automation has assisted in reducing errors in all phases of testing, automation in the pre-analytical microbiology laboratory has been slower due to its inherent variation (Mulatero 2011). In addition, the lack of well-defined quality indicators in the pre-preanalytical phase makes it more difficult to monitor possible errors. Plebani encourages the best way to reduce errors in the pre-preanalytical phase is to work interdepartmentally and monitor compliance to standard operating procedures (SOP).

This study utilizes Plebani’s approach to encourage specimen accountability between sending facilities and the core microbiology laboratory. Focusing on the transportation element in the pre-preanalytical phase, common non-compliance issues were identified and used as pre-defined quality indicators to communicate as standardized emails to non-compliant departments over of a course of five months in 2017. By reaching a consensus on adjustment of workflow and duties, quality monitoring data of non-compliance issues had been compiled and communicated to enhance specimen accountability at a consolidated core microbiology lab without the need of automation in the pre-preanalytical phase.