Abstract
More than three decades ago, George Lundberg first introduced the concept of the brain-to-brain
loop for laboratory diagnostics. According to this pioneering model, the first step
in the loop involves the selection of laboratory tests in the brain of the physician
caring for the patient, and the final step is the transmission of test results back
to the ordering physician. There are several intermediary steps, some of which are
preanalytical (e.g., identification of patient and blood samples, the process of blood
collection, and specimen handling); some are analytical and relate to the actual performance
of the test(s); whereas others are postanalytical and involve release of test results
into the medical record and further steps such as the physician's reaction to laboratory
information, their interpretation of these results, and subsequent appropriate clinical
action. Hemostasis testing should also be viewed within such a paradigm, so that quality
throughout the total testing process can be assured. For hemostasis testing, particular
attention is required to ensure provision of appropriate test samples in the preanalytical
phase. Nevertheless, the timeliness of testing and an appropriate interpretation of
test results are also paramount. This article overviews the concept of quality testing
within hemostasis as critical to ensuring patient safety and optimal clinical and
therapeutic management.
Keywords
patient safety - quality - hemostasis - testing - laboratory errors
