Hello Silas,
The action taken really depends on the failure, but it's a learning opportunity for all staff. We do typically document the failure in the staff member's record. If it's something like an incorrectly identified cell, that presents an opportunity to share those pictures to all staff members. If it's a simple mix-up of labeling (i.e.#3 sample was labeled as #1, etc) that would be a different approach more directed to the individual but potentially a good reminder for all staff since that overlook example could happen with patient samples if not taking care.
With any failure, you want to do a complete investigation to see if it was pre-analytic, analytic, or post-analytic issue and delve into what needs done from there.
The other thing to check with numeric responses, even with acceptable results, is bias and differences in the SDI. While it's good to see results on both sides of the peer mean, they shouldn't be too far off the mean. If they are, it's something else to check into. We typically use anything greater than a 1.5 SDI.
As with all of this, regular QC monitoring to peer means (when possible) helps to avoid truly analytical or test quality issues when it comes to PT. I attached our investigation form as a tool we use to help identify the type of error that occurred and guide staff/management to appropriate remedies. I would involve staff in the investigation whenever possible so they can understand the importance and relevance of the PT.
Hope that helps and gives you another source of information to pick from. I'm sure others will have more detail.
Good luck!
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Jonathan Perry, MLS(ASCP)
President
ASCP West Virginia Chapter
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