Patient Safety Indicators in Clinical Laboratories: An Exploratory Survey among Costa Rican Laboratory Professionals

Document Type : Original Article


1 Laboratorios Cartin, Alajuela, Costa Rica.

2 Department of Parasitology, Faculty of Microbiology, University of Costa Rica, San José, Costa Rica

3 Clinical Laboratory, “Tomás Casas Casajús” Hospital, Caja Costarricense de Seguro Social, Ciudad Cortés, Puntarenas, Costa Rica.

4 Specialized Studies & Research Laboratory, National Children’s Hospital, Caja Costarricense de Seguro Social, San José, Costa Rica.


Patient safety indicators (PSIs) focus on the prevention of complications and minimization of unnecessary patient risk. Using the methodology known as SMART, the most suitable indicators may be selected by the evaluation of five essential criteria (i.e., specificity, measurability, attainability, relevance, and timeliness).Therefore, the current study aimed to collect and analyze information regarding PSIs related to clinical laboratories in order to support organizations in the process of indicator selection.
Materials and Methods:
The most widely accepted PSIs for clinical laboratories were identified through a literature review. The indicators were evaluated by conducting a survey on a deliberate sample of 77 laboratory professionals. The answers were analyzed in terms of the frequency of responses for sensitivity, measurability, attainability, relevance, and timeliness. The overall performance of the indicators was assessed using a composite score encompassing the five SMART criteria.
The indicators with the best overall performance were tests without internal controls, internal controls with unacceptable performance, critical values communicated in time, unacceptable performance in external controls, and requests with errors concerning patient identification. Significant differences were observed among the top-, mid-, and bottom-performing groups of indicators.
The results of the present study revealed the importance of the active participation of the professional community as an essential activity to determine the most appropriate PSIs. In the case of this study in Costa Rica, this community seems to value quality control processes and pre-analytical requirements as key indicators to monitor patient safety in clinical laboratories.


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