Write an SOP that includes all the procedures related to sample reception and processing. Make sure it includes at least the following procedures:

• Checking sample integrity and deciding if the sample is accepted or rejected. Sample acceptation/rejection criteria were formulated in the previous activity. Refer to these criteria.
• Introduction into the laboratory register: when the sample is accepted a decision is made which tests need to be performed and the sample is introduced in the laboratory register.
• Sample labeling: when the sample is introduced in the register the sample is labeled. This creates the traceability: sample portions are made traceable to the primary sample by using the same label on all the portions. Moreover, the sample is also connected through the label to the important forms and registers. This in turn ensures that all the sample information is properly recorded.
• Sample processing: review of requests by authorized personnel to decide which examinations must be performed.
• Procedure for processing urgent samples.
• Procedure for dealing with verbal requests (ensuring that all the relevant information is collected by filling-out a Request Form by the laboratory based on the verbal request).
• Periodical review of required sample volumes: sometimes tests change and more or less sample material is needed. It must be prevented that too much sample material is taken (as this unnecessarily increases discomfort for the patient). Therefore the required volumes of samples must be reviewed regularly (once per year).
• Procedure for sample rejection (a Sample Rejection Form will be developed in the next activity).

To start registering the samples a proper sample register must be made. This register must record all the relevant patient information and results of laboratory testing. This enables the possibility to verify the results and perform other quality controls. Include at least the following details:

• Patient name + unique identifier (e.g. social security number (if applicable)/date and place of birth/etc.)
• Patient laboratory ID
• Contact details of the requester
• Type of primary sample
• Date of sample collection
• Date of sample reception
• Date of sample acceptance
• Examination(s) requested
• Results of examinations + name of the laboratory technologists performing the examinations
• Date of reporting
• Identification of person sending the report

A patient register can be maintained either on paper or electronically. It is strongly recommended to use an electronic system. The simplest electronic form is an Excel sheet, however, this is sensitive to making mistakes (such as transcription errors). There are also many Laboratory Information System (LIS) software packages on the market. The advantage of using these systems is that they can give you a lot more control and oversight of performance of the laboratory and are more error-proof. Be careful in chosing which LIS you procure. A LIS should at least be able to:

• Show you the results of all tests requested; a combination of results may pinpoint characteristics of a specific disease which you would miss if you only see single results on specific tests
• Give you easy oversight in historic dossiers of specific patients (showing you not only what has been requested now but also in the past which may give you important information of disease development
• Easily assess the percentage of events in which the TAT was exceeded
• Investigate the positivity rate for specific tests (this is a parameter that is highly important for surveillance of disease development or requester behavior)

In the right-hand column background information from the WHO Laboratory Quality Management System (LQMS) handbook is provided on sample processing and the patient register.