Quality improvements in the preanalytical phase: focus on urine specimen workflow.

Despite advances in the performance of analytic systems, there still remains a high level of variability in the total testing process. Most laboratory errors currently occur in the preanalytical phase, which is complex because it consists of numerous steps. To reduce the number of errors in the preanalytical phase and achieve targeted quality improvements, particular attention should focus on process improvement and reduction of unnecessary steps. Using the example of urine specimen collection and processing, major causes of preanalytical variability are identified, as are potential areas of process improvement that significantly impact quality of urine testing. Means of achieving them through application of various Lean techniques are also discussed.