Computer-Assisted Bar-Coding System Significantly Reduces Clinical Laboratory Specimen Identification Errors in a Pediatric Oncology Hospital

Objective

To assess the ability of a bar code-based electronic positive patient and specimen identification (EPPID) system to reduce identification errors in a pediatric hospital’s clinical laboratory.

Study design

An EPPID system was implemented at a pediatric oncology hospital to reduce errors in patient and laboratory specimen identification. The EPPID system included bar-code identifiers and handheld personal digital assistants supporting real-time order verification. System efficacy was measured in 3 consecutive 12–month time frames, corresponding to periods before, during, and immediately after full EPPID implementation.

Results

A significant reduction in the median percentage of mislabeled specimens was observed in the 3-year study period. A decline from 0.03% to 0.005% (P < .001) was observed in the 12 months after full system implementation. On the basis of the pre-intervention detected error rate, it was estimated that EPPID prevented at least 62 mislabeling events during its first year of operation.

Conclusions

EPPID decreased the rate of misidentification of clinical laboratory samples. The diminution of errors observed in this study provides support for the development of national guidelines for the use of bar coding for laboratory specimens, paralleling recent recommendations for medication administration.

Abbreviations: EPPID, Electronic positive patient and specimen identification, PDA, Personal digital assistant