Accuracy of send-out test ordering: a College of American Pathologists Q-Probes study of ordering accuracy in 97 clinical laboratories

Arch Pathol Lab Med. 2008 Feb;132(2):206-10. doi: 10.5858/2008-132-206-AOSTOA.


Context: Errors entering orders for send-out laboratory tests into computer systems waste health care resources and can delay patient evaluation and management.

Objectives: To determine (1) the accuracy of send-out test order entry under "real world" conditions and (2) whether any of several practices are associated with improved order accuracy.

Design: Representatives from 97 clinical laboratories provided information about the processes they use to send tests to reference facilities and their order entry and specimen routing error rates.

Results: In aggregate, 98% of send-out tests were correctly ordered and 99.4% of send-out tests were routed to the proper reference laboratory. There was wide variation among laboratories in the rate of send-out test order entry errors. In the bottom fourth of laboratories, more than 5% of send-out tests were ordered incorrectly, while in the top fourth of laboratories fewer than 0.3% of tests were ordered incorrectly. Order entry errors were less frequent when a miscellaneous test code was used than when a specific test code was used (3.9% vs 5.6%; P = .003).

Conclusions: Computer order entry errors for send-out tests occur approximately twice as frequently as order entry errors for other types of tests. Filing more specific test codes in a referring institution's information system is unlikely to reduce order entry errors and may make error rates worse.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Clinical Laboratory Information Systems / standards*
  • Humans
  • Medical Errors / prevention & control
  • Medical Errors / statistics & numerical data*
  • Medical Records Systems, Computerized / standards*
  • Pathology, Clinical / standards*
  • Quality Assurance, Health Care*
  • Retrospective Studies
  • Societies, Medical
  • Surveys and Questionnaires
  • United States