Evaluating the total laboratory testing process and performance via quality indicators in clinical chemistry and hematology laboratories at Pawi General Hospital, Benishangul Gumz, Northwest Ethiopia: a prospective cross-sectional study

Clinical laboratory test results play a critical role in medical decision-making and patient management. It is estimated that over 60–70% of essential clinical decisions; including hospital admissions, prescribing of medications, and patient discharges, depend on these results. However, errors occurring at any stage of the testing process can compromise the accuracy and reliability of the results, thereby adversely impacting clinical decisions. This study aims to evaluate the total laboratory testing process and performance through the application of quality indicators in the clinical chemistry and hematology laboratories at Pawi General Hospital, Benishangul-Gumz Region, Northwestern Ethiopia. A prospective cross-sectional study was conducted at Pawi General Hospital between October 1 and December 30, 2021. All venous blood samples and their corresponding test requests submitted to the clinical chemistry and hematology laboratories during this period were included. Quality assessment was carried out using IFCC-approved guidelines and ISO 15189 standard quality indicators, which were adapted to the local context. Data were entered into EpiData version 3.0 and analyzed using SPSS version 21. A total of 4140 samples were analyzed, of which 14.7% were for clinical chemistry and 85.3% for hematology. The study assessed 136,722 quality indicators, with 24.7% of errors occurring during the total testing process. Errors were distributed across the preanalytical (63.6%), analytical (1.6%), and postanalytical (34.8%) phases. The most common preanalytical errors seen were incomplete information on test request forms and specimen rejection. In the analytical phase, errors were primarily attributed to reagent stock-outs and equipment downtime. Postanalytical errors were mainly associated with prolonged turnaround times. Chi-square analysis revealed a statistically significant difference in the frequency of errors across the three phases (χ2 = 4986, p < 0.0001). The study revealed high error rates in both the pre-analytical and pos-tanalytical phases, underscoring the urgent need for coordinated efforts by all stakeholders to strengthen quality assurance measures and enhance the overall reliability of laboratory services.