Optimizing Laboratory Processes: A Path to Reduced Sample Rejection in Oncology

Background: We aimed to enhance the quality of cancer care by reducing the rate of sample rejection and lowering the incidence of sample mislabeling at the Sultan Qaboos Comprehensive Cancer Care and Research Centre in Muscat, Oman.
Methods: We adopted a one-group pretest-posttest quasi-experimental design from the second quarter of 2022 to the first quarter of 2023, assessing key performance indicators related to sample rejection and mislabeling on quarterly basis before and after implementing targeted interventions. The project utilized the FOCUS PDCA framework for systematic implementation and evaluation. Four FOCUS PDCA sessions were conducted involving a multidisciplinary team of ten participants comprising oncologists, nurses, laboratory technicians, quality management experts, and informatics and cyber security department staff. Ethical clearance was obtained from the Institutional Review Board, ensuring adherence to ethical protocols. Interventions included five educational sessions for nurses and physicians, process modifications, and improved communication protocols.
Results: Analysis revealed a significant decrease in the rate of rejected samples, declining from 20.85% during Pre-Intervention to 6.05% in the Post Intervention phase. Similarly, the mislabeling rate exhibited a substantial reduction, decreasing from 1.68% to 0.25% over the same period. Statistical analysis using ANOVA confirmed significant differences between intervention phases for both the rejected samples rate (F-value = 12.3458, P-value = 0.002) and the mislabeling rate (F-value = 57.1875, P-value < 0.001).
Conclusion: These results underscored the effectiveness of the interventions in improving blood sample collection and management processes, thereby enhancing the reliability of study outcomes.

1. Cadamuro J, Simundic AM, Ajzner E, Sandberg S (2017). A pragmatic ap-proach to sample acceptance and rejec-tion. Clin Biochem, 50(10-11):579-81.
2. Christian SG, Moore-Igwe BW, Jacob RB, Odinga T, Eze EM (2021). Quality indi-cator measures as it affects turnaround time (TAT) in a molecular laboratory in Port Harcourt, Rivers State. Eur J Clin Med, 2(4):6-9.
3. McPherson RA, Pincus MR (2017). Henry's Clinical Diagnosis and Management by Laboratory Methods E-Book. Elsevier Health Sci.
4. Raab SS, Grzybicki DM (2010). Quality in cancer diagnosis. CA Cancer J Clin, 60(3):139-65.
5. Haroun A, Al-Ruzzieh MA, Hussien N, et al (2021). Using failure mode and effects analysis in improving nursing blood sampling at an international specialized cancer center. Asian Pac J Cancer Prev, 22(4):1247-54.
6. Xie C, Zhang J, Luo J, et al (2022). FOCUS-PDCA can effectively optimize the crit-ical value of test items. J Med Biochem, 41(3):347-54.
7. Bolton-Maggs PH, Wood EM, Wiersum-Osselton JC (2015). Wrong blood in tube–potential for serious outcomes: can it be prevented? Br J Haematol, 168(1):3-13.
8. Saxena S, Ramer L, Shulman IA (2004). A comprehensive assessment program to improve blood-administering practices using the FOCUS–PDCA model. Transfu-sion, 44(9):1350-6.
9. Plebani M (2010). The detection and pre-vention of errors in laboratory medi-cine. Ann Clin Biochem, 47(Pt 2):101-10.
10. Misganaw AS, Worku M, Bashea C, et al (2019). Pre-analytical errors in the HIV anti-retroviral therapy (ART) laboratory of teaching referral hospitals in Addis Ababa, Ethiopia. Int J Virol AIDS, 6:057.
11. Ayyad M, Ayaad O, Alkhatatbeh H, et al B (2024). The effectiveness of gabapentin in treating overactive bladder: a quasi-experimental study. Immunopathol Persa, 10(1):e40574.
12. Al-Ruzzieh MA, Eddin R, Ayaad O, et al (2024). Examining nurse and patient fac-tors before and after implementing an oncology acuity tool: a mixed methods study. J Nurs Meas, 32(1):38-46.
13. Ayaad O, Al-Dewiri R, Kasht L, et al (2022). Adopting lean management in quality of services, cost containment, and time management. Asian Pac J Cancer Prev, 23(8):2835-42.
14. Haroun A, Ayaad O, Al-Ruzzieh M, Ayyad M (2022). The role of total quality man-agement in improving patient experi-ences and outcomes. Br J Healthc Manag, 28:1-8.
15. Al-Ruzzieh MA, Ayaad O, Qaddumi B (2020). The role of e-health in improv-ing control and management of COVID-19 outbreak: current perspec-tives. Int J Adolesc Med Health, 34(4):139-45.
16. Sharikh E, Shannak R, Suifan T, Ayaad O (2020). The impact of electronic medical records’ functions on the quality of health services. Br J Healthc Manag, 26:1-13.
17. Ayaad O, Haroun A, Yaseen R, et al (2019). Improving nurses’ hand-off process in oncology setting using lean management principles. Asian Pac J Cancer Prev, 20(5):1563-70.
18. Al-Ruzzieh MA, Ayaad O (2021). Impact of nurses' emotional intelligence on the implementation of a professional prac-tice model in cancer care. Br J Nurs, 30(19):1110-1116.
19. Ayaad O, Al-Ruzzieh MA, Qaddumi B, et al (2022). Outsourcing services in the healthcare sector: balancing risks and benefits. Br J Healthc Manag, 28(3):96-103.
20. Al-Ruzzieh MA, Al Rifai A, Ayaad O (2022). Organisational citizenship behaviour in the healthcare workplace: a scoping re-view. Br J Healthc Manag, 28(6):1-7.
21. Majed M, Ayaad O, AlHasni NS, et al (2024). Reducing the Risk of Fall among Oncology Patients using Failure Modes and Effects Analysis. Asian Pac J Cancer Prev, 25(2):689-97.

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Issue	Vol 54 No 1 (2025)
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Keywords
Rejected samples Occupation mislabeling Oman

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AlSheidi S, Ayaad O, Ibrahim R, AlDhahli SN, Majed M, AlWaheibi HM, Al Zadjali ROA, Al Awor O, Al Faliti BHS, Osman A, AlAwaisi HS, A Turkomani AM, Al Haddabi IH, Al Baimani K. Optimizing Laboratory Processes: A Path to Reduced Sample Rejection in Oncology. Iran J Public Health. 2025;54(1):.155-165.

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