[AVBC 2025] Specimen Rejection from Inpatient Wards
Care Process & Redesign
Appropriate & Value-based Care Conference
National Healthcare Group
6 November 2025
To reduce the percentage of blood specimens which are rejected from 0.69% to 0.3% (stretch goal 0.1%), among the samples. The intervention improved patient experience, quality of samples, resource utilization, and reduced system friction, adding value to.
Year Submitted: 2025
Published Date: 06 November 2025
Tags: Care Process ＆ Redesign, Quality Improvement, Workflow Redesign, Productivity, Cost Saving, Clinical Practice Improvement, Value Based Care, Safe Care
About this Content
Aims
To reduce the percentage of blood specimens which are rejected from 0.69% to 0.3% (stretch goal 0.1%), among the samples collected by non-phlebotomists on wards 7A (TTSH) within a 6-month period.
Background
Specimen rejection from inpatient wards is a significant issue, with 1,200 specimens rejected per month. There is variation among wards, with 6-32 rejections per month and 0.3% to 0.95% of specimens being rejected. This has consequences for patients and their clinical management, including repeat specimen collection, delays in analysis, and potential negative impacts on patient safety and treatment.
Methods
Root Cause Intervention was implemented with PDSA cycles to address causes such as lack of awareness of minimum blood collection amounts and accessibility of reference guides. Strategies included visual aids and communication to medical staff to improve awareness.
Results
The intervention led to a reduction in specimen rejection rates, with a predicted further 20% reduction by creating awareness among junior doctors. Cost savings were achieved, with annual savings of $2,700 per ward.
Conclusion
The intervention improved patient experience, quality of samples, resource utilization, and reduced system friction, adding value to patient care.
Lessons Learnt
The importance of asking the right questions, being agile, observing practices, and involving team members was highlighted. Continuous monitoring and further interventions are necessary.
Keywords
Specimen, Rejection, Blood, Laboratory, Nursing, Cost, Quality
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Tan Tock Seng Hospital |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Nursing |
Applicable Specialty or Discipline | Pathology, Phlebotomy |
Project Lead(s) | Yang Huina |
Project Member(s) | Wendy Leong Hui Ling |
Connect with this contributor!
Yang Huina - huina_yang@ttsh.com.sg
Project Attachment
859_TTSH_AVBC_2025_Specimen_Rejection_from_Inpatient_Wards.pdf