Tag Archives: reference laboratories

“Control Freak”

 The smaller your laboratory organisation is, the more often you will need to send samples outside of it. However most laboratories, regardless of size, will have to send some samples away to another organisation.

There are a few reasons why sending tests (“Sendaways”) to reference labs outwith your own lab organisation can be problematic:

  • Longer turnaround time: The reference laboratory might only be a few hours away but courier timetables and the extra admin/registration required can sometimes add days to the result.
  • Prioritisation: It can be difficult to get priority given to an important sample if it is getting sent outwith your own laboratory network.
  • Different Laboratory Information Systems (LIS): This can lead to problems getting the necessary clinical information to the reference lab and also getting the result back on to your own LIS.
  • Testing criteria: The criteria upon which the test is accepted or rejected by the reference laboratory are not necessarily criteria that you have had input into, and thus may not always be criteria you agree with.

All the above can be problems from time to time, but what I dislike most is the loss of control over the sample. If a complaint comes in from a clinician regarding processing of a sendaway sample, you often feel responsible for what happens to the sample from start to finish. However the reality is that you only have a limited amount of control over what happens to it when it leaves your laboratory. I admit I am a bit of a control freak when it comes to sendaway samples…..

I am fortunate in that the reference labs that my laboratory organisation uses are generally very good, but the key to having a good sendaway service is to have good personal relationships with the reference laboratories and the people who work in them. If this occurs, trust is built up between the labs, and the pain that control freaks like myself suffer when sending samples away is likely to be alleviated somewhat!


“Sending samples into the unknown”

I think In-House audit-trails are pretty sophisticated now. We can more or less tell who did what, how and when for samples that remain within our laboratory. This is particularly true for laboratories that have paperless systems and electronic audit trails.

Where laboratories in general are not so good is when samples get sent away to other laboratories outwith the local network, i.e. reference labs.


The computer systems may be different, interfacing may not be easy, the sample may go to the wrong department, it can be difficult getting the result back etc etc. The reference laboratory may not appreciate the importance or urgency of a particular sample.

Good transit auditing using professional tracking systems, good relationships and sound electronic communication between the referring and reference lab all help to reduce these problems. However at the end of the day, sending samples outwith your own laboratory network is always a leap of faith. You lose an element of control over the sample and establishing audit trails for a particular sample outwith your own laboratory can be frustrating work. In addition these are often some of the most important samples received into the laboratory.

However what you can be sure of is that the referring laboratory will generally get the blame from the requestor if something goes wrong!