Rejection

Testing requirements are unique to each test performed.

Our goal is to adhere to The Joint Commission (TJC) and the requirements set forth in the #1 Hospital National Patient Safety Goal (NPSG.01.01.01): Identify Patients Correctly.  This standard requires two unique patient identifiers and TJC further specifies that the two identifiers be on both the requisition/order AND the specimen label.  

As part of our OSF quality culture and mission, we are dedicated to following these regulations in order to ensure the highest level of safety for the patients we jointly serve.

Unless the specimen is deemed irretrievable by one of our pathologists/lab leadership staff, specimens lacking the two accurate identifiers (patient's first and last name and Date of Birth) on the specimen label must be rejected.

Irretrievable specimens are specimens that are extremely difficult or impossible to recollect due to the nature of the specimen or due to unique circumstances under which the specimen was obtained.  The following is a current list of irretrievable specimens:

  • Body Fluids (excluding voided urine and sputum)
  • Bone
  • Bone Marrow
  • CSF
  • Meconium
  • Non-gynecological specimens (excluding voided urine and sputum)
  • Post-mortem specimens
  • Synovial fluid
  • Tissue (Pathology)

Samples such as clinical blood samples, urine, swabs, and PAP samples, are not irretrievable in nature and specimen rejection due to labeling errors must occur in order to be compliant with regulations and patient safety goals.

Specimens that are obtained under special or unique circumstances also have the potential to be deemed irretrievable and will be evaluated on an "individual case" basis.  Special circumstances include:

  • Specimens drawn during life-threatening situation (blue alerts)
  • Samples for culture from normally sterile sites where antibiotic therapy has been subsequently started (e.g. blood cultures)
  • Timed drug monitoring specimens, including peak/trough specimens
  • Samples where recollection presents a risk to the patient
  • Samples collected in an acute situation where the clinical status of the patient may have changed (e.g. drug overdose, hypoglycemic episode)
  • Samples collected at specific times for therapeutic and or analytic determinations
  • NICU specimens

Please know that we must adhere to these specimen rejection guidelines in order to fully ensure patient safety.  As you may know, most laboratory errors are not analytic in nature but rather pre-analytic and often linked back to specimen labeling issues.

Assistance in ensuring the best patient care and adherence to regulatory standards is highly appreciated.  Specimen rejection is always difficult, yet if best labeling practices are followed, these situations should be very limited.