Conference Abstract | Volume 9 (ConfProc7): Abstract 084 | Published: 05 Oct 2026
Gideon Oteng1,&, Bernard Nkrumah2, Gifty Boateng3, Richard Kutame3, Christopher Nkrumah4
1Global Laboratory Leadership Program, National Public Health and Reference Laboratory, Ghana Health Service, Accra, Ghana, 2African Field Epidemiology Network, Accra, Ghana, 3National Public Health and Reference Laboratory, Ghana Health Service, Accra, Ghana, 4Johns Hopkins Program for International Education in Gynecology and Obstetrics, Accra, Ghana
&Corresponding author: Gideon Oteng, Global Laboratory Leadership Program, National Public Health and Reference Laboratory, Ghana Health Service, Accra, Ghana, Email: gokorankye86@gmail.com
Received: 29 Aug 2025, Accepted: 28 Oct 2025, Published: 05 Oct 2026
Domain: Laboratory System Strengthening
This is part of the Proceedings of the 8th Ghana FELTP Scientific Conference and FELTP Competency Graduation, Accra, Ghana, 10 – 11 December, 2025
Keywords: Quality indicator, specimen rejection, pre-analytical errors, ISO 15189:2022, quality management system
©Gideon Oteng et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Gideon Oteng et al. Implementing specimen rejection quality indicator at the Kumasi South Hospital Laboratory, Ghana, October 2025. Journal of Interventional Epidemiology and Public Health. 2026;9(ConfProc7):084. https://doi.org/10.37432/JIEPH-CONFPRO7-0084
Pre-analytical errors account for most laboratory mistakes, which pose a risk to patients and often result from inconsistent specimen handling and unharmonized rejection practices. At Kumasi South Hospital Laboratory (KSHL), variations in specimen acceptance and rejection criteria highlighted the need for standardization consistent with ISO 15189:2022 requirements. This study aimed to implement a specimen rejection quality indicator through the development of a standardised operating procedure (SOP), structured staff training, and uniform documentation tools.
A quality improvement implementation design was adopted. Interventions included defining specimen rejection criteria, revising and disseminating specimen acceptance and rejection SOP, creating a specimen rejection logbook and feedback forms, and training laboratory staff. Implementation progress and consistency in applying rejection criteria were monitored through logbook audits, documentation reviews, and staff observations. Pre- and post-training assessments measured knowledge improvement.
Standardized rejection criteria and feedback mechanisms were established. Training was completed by 82.4% (28/34) of staff, of whom 54% (15/28) were females and 46.4% (13/28) were laboratory technicians. Post-training knowledge scores improved significantly, with a mean increase of 20.2 percentage points (95% CI: 16.8–23.6; p < 0.001). Logbook audits and observations indicated improved uniformity in applying rejection criteria.
The intervention successfully standardized specimen rejection criteria and established a structured feedback mechanism between the laboratory and clinicians in alignment with ISO 15189:2022 standards. Full rejection rate trend analysis was not feasible within the implementation period due to the limited study period. However, SOPs, documentation tools, and training enhanced process consistency and staff awareness. This could offer a scalable model for reducing pre-analytical errors in similar settings.
Menu