Blood Sample Rejections by Clinical Laboratory in a Multispecialty Hospital: A Study to Evaluate the Causes with Ward-wise Data Analysis

Background: A clinical laboratory deals with human samples to generate valuable data in the form of reports. These reports are then studied by the physicians, who interpret the data in conjunction with the patient’s clinical history and examination. More than 70% of the major clinical decisions, such as diagnosis, therapy, admission, and discharge, are arrived at with the help of various diagnostic tests. The accuracy of laboratory results heavily depends upon the integrity and quality of the blood samples. Aim: Through this study, we observe the incidence of sample rejections in an NABL and NABH-accredited multispecialty hospital in a tier II city in North India. Once we understand the area-wise incidence of the root cause(s), we can get insight into finding the applicable measures for risk reduction and appropriate corrective and preventive actions. Methodology: This descriptive, cross-sectional study was conducted in a multispecialty hospital-based clinical laboratory in a tier 2 city in India. Sample rejection data is routinely recorded by the Lab’s Quality Department in a specially designed record. The retrospective and prospective data collected over a period of 22 months from January 2023 to October 2024 were analyzed. Results: A total of 336,530 samples were received in our laboratory over a period of 22 months of this study. Of these, 1,715 samples were rejected as per the criteria for sample rejection. Conclusions: In our study, the overall rejection rate observed was 0.51%. Of the rejected samples, hemolysed samples contributed to the highest percent incidence (54.05%), followed by clotted samples (34.52%). The areas with the highest rejection rates included inpatient department wards (26.29%), emergency (20.41%), and surgical intensive care unit + high dependency unit (16.03%).