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Editor-in-chief
Maria Stella Graziani

Deputy Director
Martina Zaninotto

Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

EIC Assistant
Francesco Busardò

International Advisory Board Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
Giuseppe Lippi Italy
Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
Maria Willrich USA
Paul Yip Canada


Publisher
Biomedia srl
Via L. Temolo 4, 20126 Milano

Responsible Editor
Giuseppe Agosta

Editorial Secretary
Chiara Riva
Biomedia srl
Via L. Temolo 4, 20126 Milano
Tel. 0245498282
email: biochimica.clinica@sibioc.it

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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091



BC: Articoli scritti da A. Tomei

Applicazione del Sistema Toyota alla fase pre-analitica come azione di miglioramento a seguito di un evento avverso: l'esperienza del Laboratorio Analisi dell'Istituto Fiorentino di Cura e Assistenza (IFCA)
Pre-Analitycal phase optimization through Lean Principles as a reaction to an adverse event: the experience of the laboratory service of the Istituto Fiorentino di Cura e Assistenza (IFCA)
M. Matera  |  A. Tomei  |  M. Vezzosi  |  F. Balboni  | 
<p>Introduction: incident reporting and risk analysis are pivotal activities in the clinical laboratory to ensure patient safety. This paper describes an adverse event that occurred in February 2021 in the clinical laboratory of the Istituto Fiorentino Cura e Assistenza (IFCA) relating to a SARS-CoV-2 testing. Briefly, patients need a negative molecular test on a sample taken 2 days pre-operatively, but in one occasion a number of tests were not done on time due to a failure of the laboratory organization, and the surgery was postponed.<br />Methods: the subsequent analysis of the event showed that a rethinking of the entire pre analytical phase was necessary and the Toyota Production System (TPS) was used to establish a completely revised work flow.<br />Results: with the involvement of the entire laboratory staff and the support of a TPS specialist, the pathway was entirely redesigned: tubes colour codes were defined, dedicated working areas were implemented in order to obtain a space where the staff members can verify, at a glance, the status and the results of each step of the workflow.<br />Discussion: the application of the Toyota system to the pre-analytical phase of the laboratory has created a tidy and clean environment, with dedicated spaces for all the samples. The involvement of the staff in the improvement process has guaranteed the compliance of the operators to the new organisation.</p>
Biochimica Clinica ; 46(1) 045-050
Contributi Scientifici - Scientific Papers
 
Sicurezza del paziente e rischio clinico nel processo ematologico di laboratorio
Patient safety and clinical risk in the clinical laboratory haematological process
<p>&nbsp;Patient safety, defined as the prevention of harm to patients, is the ultimate goal for medical laboratories. Risk management principles should therefore be considered an integral part of laboratory processes, especially of those activities directly impacting on patient care. This work aims to identify the most critical phases of haematological process and the risk reduction actions that improve patient safety. Risk analysis of the laboratory haematological process was carried out through Failure Mode, Effects and Analysis Criticality methodology. A form including the phases of the process, error modes and their possible effects, errors occurrence, detectability and severity scores and risk index (RI), has been prepared and sent to eight Italian laboratories. A multidisciplinary team performed the analysis in each laboratory, then two team leaders of the project comprehensively analysed the collected data. The process was divided in 8 phases (medical prescription, request acceptance, sample collection, transportation, reception and processing, results reporting and validation), 25 activities (17 pre-analytical, 4 intra-analytical, 4 post-analytical) and 43 failure modes. RI, calculated for each activity, ranged from 11 to 33. The most critical topics (RI &gt;25) were: patient identification, peripheral blood smear review, interpretative comments and report validation. Staff training plays a central role in the entire laboratory haematological process and in the phases identified as critical. An effective management related to the attainment and maintenance of skills represents the best action in order to reduce risks of adverse events for patients. The promotion of procedures aimed to harmonize the interpretative comments and peripheral blood smear review is also pivotal</p><p>&nbsp;</p>
Biochimica Clinica ; 42(4) 300-312
Contributi Scientifici - Scientific Paper
 
La gestione del rischio clinico in medicina di laboratorio: risultati del questionario congiunto SIBioC-Medicina di Laboratorio e Società Italiana di Ergonomia (SIE) inviato ai laboratori della Regione Toscana
Misidentification in laboratory medicine: results of the Tuscany survey of the Clinical Risk Management Study Group SIBioC and the Italian Society of Ergonomy (SIE)
<p>In the year 2016 the Study Group on Clinical Risk Management of the SIBioC-Laboratory Medicine Society issued a joint survey with the Italian Society of Ergonomics (SIE); the survey was sent to all the clinical laboratories of the Tuscany Region in Italy. This survey had the aim to understand the level of awareness of the clinical laboratory about the clinical risk management, particularly in the patient misidentification field. The results show a very variable consciousness of the problem among different laboratories, with a very multi-faced approach to this important topic. More than the 93% of the participants state that the errors on misidentification are always registered and in the 80% the consequent actions are tracked.</p>
Biochimica Clinica ; 42(2) 141-145
Contributi Scientifici - Scientific papers
 
Gestire il rischio clinico in medicina di laboratorio: un’inaspettata piastrinopenia
Clinical risk management in laboratory medicine: an unexpected thrombocytopenia
<p>It is acknowledged that the risk management strategy is cardinal to maintain safety in health care organisations. Clinical risk assessment and management is a continuous and dynamic process aimed to evaluate risks and to develop appropriate plans to reduce them. Internationally, there is an increasing recognition of the need to collect and analyse data on patient safety incidents to facilitate cultural growth and to develop appropriate solutions. The practice of reporting is commonly used, and several countries have established national reporting systems to facilitate large scale monitoring and analysis of data. This activity provides information on the extent, types and causes of errors, adverse events and near misses, supporting healthcare workers in the activity of reporting errors. This case shows how a non-optimal communication between laboratory and clinicians has caused an adverse advent and which corrective actions have been undertaken.</p>
Biochimica Clinica ; 41(1) e1-e3
Casi Clinici - Case Report