From laboratory metrics to clinical value: linking performance to clinical outcomes

Laboratory performance is commonly assessed using indicators such as turnaround time, analytical quality, workload, and operating costs. These measures are useful for laboratory management, but they do not fully describe the contribution of laboratory services to patient care. A more complete assessment should consider the total testing process, from test requesting and specimen collection to result reporting and clinical interpretation. Pre-analytical problems, analytical failures, delays in the availability of results, and errors in post-analytical communication may affect clinical decision-making and the use of healthcare resources. However, laboratory performance indicators should be interpreted with caution, since changes in individual indicators do not necessarily translate into measurable changes in clinical outcomes. Their interpretation requires clearly defined measures, appropriate targets, trend analysis, and consideration of the clinical and organizational context. Performance dashboards should be used as part of a quality-improvement process, with relevant findings investigated and corrective actions assessed over time. This approach is consistent with value-based laboratory medicine, which considers laboratory performance in relation to clinical care and patient safety. Integration of laboratory data with clinical information, outcome data, and emerging artificial intelligence tools may further improve this assessment, provided that their clinical validity, data quality, interoperability, and safety are adequately addressed.