Armed with this information, we will now observe the process as it is being performed. Sometimes there is a performance gap between "what should be done" and "what is actually done." Observing more than one person or event may reveal person-to-person or event-to-event variations.
Here are some tips that may be helpful when you are observing the preanalytical phase of the process:
- Introduce yourself to the phlebotomist and patient in a very positive way. “Hi. My name is Jon Lee. I’m here to learn more about the great work Abby does. Do you mind if I watch?”
- Watch without offering comments or questions. Comments and questions can make the phlebotomist nervous and may make the patient question the quality of his/her care.
- Thank the patient for letting you observe.
- After leaving the patient's room, ask the phlebotomist questions about what you observed without pointing out any deviation from the written documents. If there are deviations, asking open-ended questions may help you determine the root cause of the problem, eg, deficiencies in the written specimen collection procedure, inadequate phlebotomist training, or competency assessment, random error.
- Do not pass judgment or “educate” the person. Simply thank the phlebotomist for letting you observe. "Thanks Abby. You've helped me understand the process better."