The preanalytical phase - from an instrument-centred to a patient-centred laboratory medicine

In order to guarantee patient safety, medical laboratories around the world strive to provide highest quality in the shortest amount of time. A major leap in quality improvement was achieved by aiming to avoid preanalytical errors within the total testing process. Although these errors were first described in the 1970s, it took additional years/decades for large-scale efforts, aiming to improve preanalytical quality by standardisation and/or harmonisation. Initially these initiatives were mostly on the local or national level. Aiming to fill this void, in 2011 the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) working group Preanalytical Phase (WG-PRE) was founded. In the 11 years of its existence this group was able to provide several recommendations on various preanalytical topics. One major achievement of the WG-PRE was the development of an European consensus guideline on venous blood collection. In recent years the definition of the preanalytical phase has been extended, including laboratory test selection, thereby opening a huge field for improvement, by implementing strategies to overcome misuse of laboratory testing, ideally with the support of artificial intelligence models. In this narrative review, we discuss important aspects and milestones in the endeavour of preanalytical process improvement, which would not have been possible without the support of the Clinical Chemistry and Laboratory Medicine (CCLM) journal, which was one of the first scientific journals recognising the importance of the preanalytical phase and its impact on laboratory testing quality and ultimately patient safety.

Automated summary

In order to ensure patient safety and provide high-quality services in a short period of time, medical laboratories worldwide have been striving to minimize preanalytical errors in the total testing process. Efforts to improve preanalytical quality through standardization and harmonization have been made at the local or national level. In 2011, the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) established the working group Preanalytical Phase (WG-PRE) to address this issue. The WG-PRE has made significant contributions, including the development of a European consensus guideline on venous blood collection. The definition of the preanalytical phase has also been expanded to include laboratory test selection, offering opportunities for improvement through the implementation of strategies and the use of artificial intelligence models.