Navigating Laboratory Errors in the Preanalytical, Analytical, and Postanalytical Phases of Testing (Half Day)

Sunday, July 28, 2024
9:00 AM – 12:00 PM US Central Time
McCormick Place Chicago


Young professionals entering the realm of laboratory medicine are frequently confronted with a myriad of troubleshooting scenarios, many of which they have not previously encountered. With little experience in troubleshooting, some may feel they are navigating the uncharted waters of pre-analytic, analytic and post-analytic issues including challenge specimen issues. During this course, three chemists with 45 years combined experience will discuss problems encountered in the pre-analytic, analytic and post-analytic phases of laboratory testing. Issues involving specimen collection, specimen type, specimen transport, instrument malfunctions, assay interferences, result transcription and result calculation will be addressed. Participants will be presented with strategies for troubleshooting issues, as well as solutions for error prevention. This session will involve a combination of expert lecture, case studies and small group discussion.

Target Audience

This activity is designed for lab supervisors, lab directors (and/or assistant directors), lab managers (supervisory and/or non-supervisory), medical technologists, point-of-care coordinators, toxicologists, and in-training individuals.

Prerequisite Knowledge 

A basic familiarity with LC-MS/MS analysis and/or drugs of abuse interpretation is preferred.

What to Bring

A personal electronic device (phone, tablet, laptop) to participate in polling questions.

Learning Objectives

  • List preanalytical, analytical, and postanalytical conditions that may impact patient results.
  • Develop methods and strategies to identify and remedy suspected laboratory errors.
  • Communicate IT strategies to detect and mitigate the risk of laboratory errors.


Mark Cervinski, PhD, DABCC, FADLM | Dartmouth-Hitchcock Medical Center

Jacqueline Hubbard, PhD, C(ASCP), DABCC, NRCC | Three Rivers Diagnostics

Alison Woodworth, PhD, DABCC, FADLM | CTI Clinical Trials & Consulting

Course Outline

  1. Preanalytical Errors: Case Based Examples and Troubleshooting Tools (50 mins.)
    In this section, real patient cases will be used to illustrate types of errors that occur laboratory testing.  The discussion will focus on types of errors that occur in the preanalytical phase of laboratory testing and provide attendees with practical troubleshooting tips.  This session will specifically focus on identifying and troubleshooting errors in specimen collection, transport, processing and storage.  Further, physiological and drug-induced interferences with laboratory testing will be discussed.  This section will be concluded with a breakout session where attendees will be asked to troubleshoot a variety of errors discovered with Physician Inquiries.

  2. Analytical Errors and Post-Analytical Challenges in LC-MS/MS Analysis (50 mins.)
    In this section, both analytical and post-analytical errors in LC-MS/MS analysis will be discussed. Real examples of sample preparation mistakes, LC-MS/MS instrument errors, and reporting challenges will be presented in a lecture-based format. The impact of those errors and preventative measures to avoid the errors in the future will be suggested. Afterwards, the attendees will be split into small groups and those interested in learning more about challenges in LC-MS/MS analysis will work through cases to identify errors and discuss ways to avoid them in the future.

    Break (15 mins.)

  3. Patient-Based Real-Time Quality Control: Back and Real-World Examples (50 mins.)
    In this section the concept of patient-based quality-control (PBQC) will be introduced, and a brief discussion of how PBQC can provide benefits to the laboratory by detecting analytical error in advance of the next scheduled internal liquid QC event. PBQC techniques discussed will include those actively used in the presenter’s laboratory, as well as techniques developed elsewhere. Real examples of analytical errors detected by PBQC will be shared, as well as cases in which the PBQC failed to detect errors. Throughout the presentation, the audience will have the opportunity to respond to questions posed by the presenter about whether or not they think that the observed shift was a true error detection event or false alarm, as well as ask for the audience’s opinion as to why some errors are detected while others are not.