Background This project was initiated because of the observation that serology rejection rates were increasing incrementally. The quality indicator displayed this; therefore, an intervention was necessary to reduce the amount of wastage of samples, patient recalls, supplies, and manpower. The aim of this project was to reduce the number of rejected samples, reduce recalls of patients and redraw of the samples, and to provide the best service to our customers.

Methods

• Using the quality indicators for the statistical measuring of the amount of serology samples rejected.

• PDCA (plan–do–check–act) cycle.

• Quality indicator:

  • Numerator is serology rejected tests (lithium heparin and SST);

  • Denominator is serology total tests done (lithium heparin and SST);

  • International benchmark value 0.56%;

  • Baseline quality indicator was measured and then monitoring was done after implementation of interventions.

• Interventions:

  • Contact nursing education about the training of collection procedures, especially with the wards that have high rejection specimen rates;

  • The educational session conducted in receiving and outpatient department staff expanded to all other hospital departments;

  • Collection procedure changed from four tubes to one lithium heparin tube according to insert sheet, which was a simplified procedure.

Results The quality indicator in the first 6 months showed that 0.8% of the serology samples were rejected. After the intervention using the various strategies, nurse education sessions, change of procedure, and specimen test menu information, 0.36% of the total samples were rejected, therefore showing a significant improvement in the rejection rates in serology. The continual improvement was recommended to be sustained by implementing the long-term use of the strategies used in the study.

Conclusion The project was done to improve workflow and minimize wastage in terms of time and cost, and to improve patient outcomes. This intervention was successful in the overall aims and objective of the project. The lesson learnt was that the educational session conducted as part of the intervention plan improved the skills and techniques used by nurses when performing the procedures. The altered procedure helped to significantly reduce the number of rejected specimens. The overall aim of the project was to implement a process that could be applied across all sections in the Department of Pathology and Laboratory Medicine. This was to improve patient safety, care, and outcomes.