A critical review of laboratory performance indicators

Eline R. Tsai, Andrei N. Tintu, Derya Demirtas, Richard J. Boucherie, Robert de Jonge, Yolanda B. de Rijke* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

12 Citations (Scopus)
1625 Downloads (Pure)


Healthcare budgets worldwide are under constant pressure to reduce costs while improving efficiency and quality. This phenomenon is also visible in clinical laboratories. Efficiency gains can be achieved by reducing the error rate and by improving the laboratory’s layout and logistics. Performance indicators (PIs) play a crucial role in this process as they allow for performance assessment. This review aids in the process for selecting laboratory PIs—which is not trivial—by providing an overview of frequently used PIs in the literature that can also be used in clinical laboratories. We conducted a systematic review of the laboratory medicine literature on PIs. As the testing process in clinical laboratories can be viewed as a production process, we also reviewed the production processes literature on PIs. The reviewed literature relates to the design, optimization or performance assessment of such processes. The most frequently cited PIs relate to pre-analytical errors, timeliness, resource utilization, cost, and the amount of congestion. Their citation frequency in the literature is used as a proxy for their importance. PIs are discussed in terms of their definition, measurability and impact. The use of suitable PIs is crucial in production processes, including clinical laboratories. By also reviewing the production processes literature, additional relevant PIs for clinical laboratories were found. The PIs in the laboratory medicine literature mostly relate to laboratory errors, while the PIs in the production processes literature relate to the amount of congestion in the process.
Original languageEnglish
Pages (from-to)458-471
Number of pages14
JournalCritical Reviews in Clinical Laboratory Sciences
Issue number7
Early online date8 Aug 2019
Publication statusPublished - 3 Oct 2019


  • UT-Hybrid-D
  • Performance indicators
  • Quality indicator
  • Laboratory medicine
  • Review
  • Performance assessment


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