QUALITY IMPROVEMENT PROJECT ON IMPACT OF A MODIFIED BLOOD COLLECTION PROTOCOL ON HEMOLYSIS RATES AND SAMPLE REJECTION AT APOLLO MULTISPECIALITY HOSPITALS, KOLKATA

Introduction: Hemolysis,caused by rupture of red blood cell membranes and subsequent release of hemoglobin into serum or plasma, is a major pre-analytical error in blood sample collection and a leading cause of sample rejection. Hemolysis was one of the most common pre-analytical errors in laboratory testing.

Objectives: To minimize sample rejection associated with hemolysis and clotting

Methods: This project utilized DMAIC process to implement modified protocol for blood collection to reduce hemolysis rate and sample rejection. Project was conducted at Apollo Multispeciality Hospital from October 2024 to September 2025 into two phase, pre intervention and post intervention phase and data was collected through haemolysis survey report to identify the hemolysis rate and RCA was done to identify the cause of hemolysis. Observation checklist had been done to assess the practice among staff nurses on sample collection process. All blood samples collected by the nurses were taken for the study except paediatric,neonates, disease condition like coagulopathy, pancytopenia, anasarca and patient on anticoagulant. Collected data were analysed through Pareto chart against standards using Root Cause Analysis (RCA). Then modified protocol had been developed, implemented and continuing it in post intervention phase in view to reduce hemolysis rate and the effect of modified protocol. Audit and cross audit had been done to sustain the process and reduce the hemolysis rate.