Pre-Analytic Specimen Error Reduction

Most downstream problems start before the lab ever sees the sample. Handwritten labels, partial identifiers, and late or missing custody events create avoidable re-collections, delays, and risk. Tightening identification and labeling at the start is the single highest-leverage change you can make.

• Correct patient–specimen pairing on the first attempt
• Fewer relabels, redraws, and mixed-up samples
• Labels that scan the first time in receiving and accessioning
• Temperature-appropriate handling confirmed before transport
• Searchable, audit-ready evidence for quality reviews

Most specimen errors start before the lab ever sees the tube. Handwritten notes, hard-to-scan labels, skipped wristband checks, and manual logging create gaps that lead to relabels, redraws, and preventable risk. The goal is not “more steps.” It is fewer but better steps that are easy to do in the moment and automatically visible to the lab.

1) Positive patient identification at collection

• Verify two identifiers at the bedside or chair.
• Use scan-to-select for orders rather than free-typing MRNs.
• Enforce hard stops for mismatches.

2) Print the right label, the right way

• Print on demand at the bedside or draw area to avoid handwritten relabels.
• Use human-readable text plus a 2D barcode for reliable scans.
• Add a passive RFID label at print/collection and encode a non-PHI key that links to the LIS order number.
• Follow placement guidance so labels do not cover fill lines or interfere with caps and so barcode and RFID both read reliably.
• For items that require cooling or freezing, include a simple visual cue and storage class on the label to reduce handling errors.

3) Associate once, use everywhere

• If using pre-encoded RFID labels, pair the tag UID to the LIS order with a combo barcode/RFID handheld at the moment of print/collection.
• Keep PHI in the LIS. The RFID carries only the non-PHI key.

4) Make exceptions visible, not invisible

• One-tap “correction event” for reprints, re-labels, or damaged containers with reason codes.
• Route exceptions to a lab queue automatically, so receiving knows what to expect.
• Keep PHI in the LIS and EHR. Labels and any auxiliary tags carry a non-PHI key that links back to the order.

Barcodes and 2D codes
Lowest cost and remain the clinical identifier for documentation and accessioning.

Passive RFID labels
Battery-free, add automated custody and last-seen zones and enable fast recovery even through sealed containers and inside refrigerators/freezers.

Handhelds (barcode + RFID)
Use at collection for association and later for proximity search and point-of-work corrections.

Fixed read zones
Overhead at unit exits, dispatch hubs, pneumatic-tube entry/exit, and lab receiving. Spot reads at cold storage for arrival confirmation.

Mobile computing
Combine scan, secure messages, and checklists in one device to reduce steps.

Pack and associate
Scan or tap specimens to a bag or cooler ID before leaving the unit. Short checklists confirm cap on, seal verified, temperature class, and container ID captured.

Depart the unit
Pass through a unit exit read zone to start an expected-arrival timer for the route.

Arrive and reconcile
Cross a receiving threshold read zone for automated arrival. Reconcile expected vs received by LIS order and open a task for any missing or unexpected items.

Cold-chain evidence
Record pass or fail for cooled or frozen items alongside custody events.

• Single, shared policy for media, encoding rules, and placement guidance across units and clinics.
• Role-based access with audit logs; PHI remains in LIS.
• Routine signal health checks on read rates and exception trends.
• Short, role-based training that focuses on scan-to-select, print, apply, pack, and depart.

• Re-labels per 1,000 orders
• Handwritten label rate
• Collection-to-receipt turnaround by priority class
• Custody completeness percentage
• Median time to recover misplaced items
• Cold-chain pass rate for cooled or frozen classes
• Exception volume and time-to-close (partial receipt, overdue routes, corrections)