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Arch Pathol Lab Med. 2019 Jun 27. doi: 10.5858/arpa.2019-0011-OA. [Epub ahead of print]

Radio-Frequency Identification Specimen Tracking to Improve Quality in Anatomic Pathology.

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From the Departments of Laboratory Medicine and Pathology (Drs Norgan, Comfere, and Reichard, Messrs Simon, Sedarski, and Yoch, and Ms Feehan), Nursing (Ms Saari), Dermatology (Messrs Doppler and Welder and Dr Comfere), and Radiology (Dr Bartholmai) and the Division of Gastroenterology and Hepatology (Dr Martin), Mayo Clinic, Rochester, Minnesota.



Preanalytic errors, including specimen-labeling errors and specimen loss, occur frequently during specimen collection, transit, and accessioning. Radio-frequency identification tags can decrease specimen identification and tracking errors through continuous and automated tracking of specimens.


To implement a specimen-tracking infrastructure to reduce preanalytic errors (specimen mislabeling or loss) between specimen collection and laboratory accessioning. Specific goals were to decrease preanalytic errors by at least 70% and to simultaneously decrease employee effort dedicated to resolving preanalytic errors or investigating lost specimens.


A radio-frequency identification specimen-tracking system was developed. Major features included integral radio-frequency identification labels (radio-frequency identification tags and traditional bar codes in a single printed label) printed by point-of-care printers in collection suites; dispersed radio-frequency identification readers at major transit points; and systems integration of the electronic health record, laboratory information system, and radio-frequency identification tracking system to allow for computerized physician order entry-driven label generation, specimen-transit-time tracking, interval-based alarms, and automated accessioning.


In the 6-month postimplementation period, 6 mislabeling events occurred in collection areas using the radio-frequency identification system, compared with 24 events in the 6-month preimplementation period (75% decrease; P = .001). In addition, the system led to the timely recovery of 3 lost specimens. Labeling expenses were decreased substantially in the transition from high-frequency to ultrahigh-frequency radio-frequency identification tags.


Radio-frequency identification specimen tracking prevented several potential specimen-loss events, decreased specimen recovery time, and decreased specimen-labeling errors. Increases in labeling/tracking expenses for the system were more than offset by time savings and loss avoidance though error mitigation.


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