The Impact of Barcode Systems on Specimen Management Quality in Clinical Laboratories in UAE

In clinical laboratories, pre-analytical errors are the most common sources of diagnostic errors, mostly due to specimen misidentification, mislabeling, and manual handling. The use of bar-code-based systems of specimen identification has been actively marketed as the solution to en-hance traceability, efficiency of the workflow, and patient safety, yet, there is little and discontinued empirical evidence of such systems in the United Arab Emirates (UAE) laboratories. The purpose of the study was to synthesize and critically review available international evidence on the effect of barcode systems on quality of specimen management, especially on pre-analytical laboratory operations and applicability to the UAE healthcare environment. Peer-reviewed studies, systematic reviews and international guidelines published after 2010 were used as a narrative literature review. PubMed, Scopus, and Google Scholar databases were searched using keywords to identify studies that reported quantitative measures of specimen misidentification rates, labelling errors, rejection rates, and turnaround times. There was no collection of primary data. Descriptive synthesisation and interpretation of reported outcomes was done against the ISO 15189 quality requirements (Vermeersch et al., 2021; Yeste et al., 2021). In a wide range of healthcare environments, the implementation of barcodes was invariably linked to significant decreases in the rate of misidentification of specimen and pre-analytical errors, commonly over 70% relative reduction in observational research. Systematic reviews demonstrated much more odds of identification errors with non-barcoded workflows. There was also a reported improvement in turnaround time and decrease in incidents related to specimen-related patient-safety often reported, but the effect sizes were inconsistent and depending on the context, baseline error rates, and process changes. The quantitative summaries used depict trends that have been reported in the literature instead of pooled or locally derived estimates. The evidence reviewed shows that specimen identification systems, which are based on barcodes, have become one of the primary contributors to the elevation of pre-analytical quality and patient safety in clinical laboratories. Although there is not much direct empirical data in the UAE, the international results indicate that the adoption of barcodes in line with the ISO 15189 standards may bring similar positive outcomes (Vermeersch et al., 2021). The primary research conducted in the UAE with standardized reporting in the future is necessary to confirm the local impact and inform the national laboratory quality approaches.