Exploring Preanalytical Errors in Hematology from the Ground Up in a Tertiary Care Center of North India

Background: Quality assurance in the hematology laboratory is essential for providing users with test results that are both precise and accurate. Despite significant advancements in hematology practices, pre-analytical errors continue to pose challenges for pathologists. This study aims to assess the types and frequency of pre-analytical errors occurring in the hematology laboratory. Materials and Methods: This analytic study was conducted over a period of one year (August 2023–July 2024) in the Hematology Laboratory of Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, India. The pre-analytical variables that hampered the results were classified as insufficient samples, clotted samples, inappropriate vials, labeling errors, hemolyzed samples, diluted samples, excessive samples, and delays in sample transfer. Results: Samples received from OPD were 48,300 (66.6%), while samples from IPD were 24,228 (33.4%). Pediatric age group samples were 9,432 (13%), and 150 (1.6%) samples showed pre-analytical errors, while adult samples were 63,096 (87%), and only 752 (1.0%) samples showed errors. A total of 72,528 samples were received, and 902 (1.24%) samples showed pre-analytical errors. The most common error was insufficient samples (53.4%), followed by hemolyzed, clotted, excessive, and diluted samples, inappropriate vials, delays in transfer to the lab, and labeling errors. Conclusion: Insufficient samples, followed by hemolyzed samples, represent the majority of pre-analytical issues. Errors due to insufficient and diluted samples are most frequently seen in pediatric patients. Following best practices in the laboratory, including the use of pediatric vials, can substantially decrease these pre-analytical errors. Addressing these issues can be effectively managed through regular staff education and training.