In 1998, the Institute of Medicine created an immediate and widespread sense of urgency in healthcare and related industries when it published “To Err is Human”, which attributed at least 44,000 and up to 98,000 deaths per year related to medical errors. This was followed with a 2006 report stating that up to 1.5 million people may be injured each year by medication errors. It is no wonder that the phrase “five rights of medication administration” is widely recognized in healthcare.
Our care providers are taught to verify these “five rights” to help ensure that the right medication is given to the right patient, in the right dosage, via the right route, at the right time.
At Sunquest, we believe that headlines such as “Woman sues over lab test that prompted abortion” and “Lab error deaths may now total five” should provoke care providers to enact and consistently apply a new set of five rights: the Five Rights of Laboratory Testing™. This involves ensuring that the right patient has the right test performed at the right time, for the right indicators, ultimately leading to the right diagnosis™.
Ensuring that the right test is performed on the right patient at the right time is at the heart of your laboratory’s processes. It starts with processing order request information from the enterprise or outreach ordering system. Positive patient identification procedures must occur during specimen collection. Samples need to be tracked throughout the laboratory workflow to ensure none are lost. Lab staff must be alerted to impending overdue collections and procedures. And results must be delivered to the care providers.
Delivering the right results to the right person at the right time– whether that person is a nurse, physician, or physician’s assistant, and the place is the EMR, physical chart, or an inquiry screen – will enable timely diagnostic decisions. This effectively sets up the right indicators for care providers to act upon when ordering follow-up and confirmatory testing.
And finally - deriving the right diagnosis. Care providers want useful, actionable information that provides clear direction for therapeutic decisions. Patients want the information necessary to make the most informed decision about their healthcare in order to weigh the risks of treatment failure, complications, and even mortality.
The concept is easily extended to the act of infusing blood components, the Five Rights of Blood Administration™. Ensuring that the right patient has the right blood product transfused at the right time while maintaining the right vital signs and achieving the right status™ is a fundamental healthcare process. Blood can be considered one of the most customized therapeutic reagents; adherence to these five rights is as crucial as adherence to the five rights of medication administration.
With nearly 70% of diagnostic decisions relying on laboratory data, there is no argument that the laboratory, the people who work there, and the technologies they use all play a vital role in each patient’s diagnosis, treatment, and prognosis. As patients and care providers, we should not only think about these Five Rights, but also demand that laboratories, technologies, and solutions they utilize adhere to the principals of performing the right test on the right patient, at the right time, for the right indicators, ultimately leading to the right diagnosis.
[3] Inquirer (Philadelphia, PA), Aug. 3, 2001