A laboratory-leadership view of how specimen identification, paper requisitions, clarification delays, status calls, barcode tracking, and LIS integration shape the accessioning workload before testing can even begin.
Audience: Laboratory Leaders
Countries: 3
Completion Rate: 77.8%
SGID: 8949574
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Before testing starts, the accessioning team has to make the order, patient identity, specimen label, container, location, and workflow all agree. When any one of those elements arrives incomplete or inconsistent, the laboratory absorbs the exception.
Current standards make that pre-analytic handoff a patient-safety issue as much as an efficiency one: CLSI PRE01 places ordering, registration, specimen identification, labeling, transport, and handling at the center of the preexamination process, CAP’s 2025 accreditation updates continue to emphasize safety and quality as labs adopt newer technology, and ASTP/ONC’s 2025 interoperability work examines data standards from ordering through results exchange. The MDForLives data shows why those priorities converge at accessioning: most respondents are not on paper and many already have smart tracking, yet labeling problems, paper exceptions, slow clarification, status calls, and imperfect LIS integration still create manual work around the digital core.
71.4% identify mislabeled, unlabeled, or mismatched specimen tubes or containers as the most frequent cause of rejection or processing delays.
Improper collection, tube type, or volume accounts for the other 28.6%. The contrast matters because the leading failure happens at the identity handoff, where a specimen can be physically present yet unusable or unsafe to progress until the mismatch is resolved, which is why CLSI PRE01 and CAP guidance treat identification and labeling as core controls rather than downstream checks.
57.1% describe a majority-electronic intake model in which paper requisitions still represent 15%-30% of orders.
Only 28.6% report nearly fully digital intake, while 14.3% still rely heavily on printed or faxed requisitions, so the word “electronic” hides the burden of the hybrid model: paper orders still have to be read, matched, entered, checked, and corrected inside the same area handling the physical specimen. A minority of volume can carry a disproportionate share of the exception work.
42.9% report clarification taking 15-60 minutes, and another 42.9% report 1-4 hours.
Only 14.3% resolve the problem in under 15 minutes through real-time messaging or a portal, so the delay is less about accessioning itself than about waiting on the ordering clinician to close an information gap. A held specimen then adds queue management, follow-up, and turnaround uncertainty on top of the original order.
57.1% say inbound calls from doctors, nurses, or clinic staff have a moderate impact on accessioning focus.
57.1% say every sample is scanned on receipt with automated LIMS confirmation.
Another 28.6% use barcodes but still need manual confirmation or double-entry, and 14.3% are planning or evaluating, so teams are not starting from zero. The stronger opportunity is making tracking reliable across every handoff, label generation, receiving, routing, send-outs, and status visibility, since barcode adoption alone does not guarantee the scan removes work.
Only 14.3% describe LIS integration with ordering systems as seamless, while 57.1% say the connection is fair and 28.6% describe it as poor.
Asked for the single change that would most improve pre-analytic efficiency, 57.1% choose smart barcode or RFID scanners linked to real-time tracking and 42.9% choose automated order verification with digital requisition intake. The open-ended comments echo the theme, unscannable label placement, handwritten identifiers, specimens lost in a busy receiving area, and poor LIS integration with third-party vendors on send-outs, so laboratory leaders are thinking about continuity across the workflow rather than technology in isolation.
The survey describes labs that already use electronic ordering, barcodes, and LIS connectivity, yet still depend on people to resolve the gaps between those systems: labeling errors lead the rejection question, paper requisitions persist in otherwise electronic workflows, clarification can take hours, status calls interrupt the team, and LIS interfaces work but not seamlessly.
That changes the improvement question for laboratory leaders: the goal is not to install more technology but to reduce the moments where staff must stop, interpret, re-enter, chase, or locate information by hand. The strongest survey priorities point the same way, real-time tracking, digital requisition intake, scannable standardized labels, and stronger integration across internal and external systems.
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