LIMS Sample Rejection and Recollection - hmislk/hmis GitHub Wiki

Sample Rejection & Recollection

When a sample is unfit for analysis, the laboratory can reject it and — where appropriate — request that a fresh sample be collected from the patient. This article explains the rejection workflow, the recollection request process, and how to track and complete a recollection.

Common Reasons for Rejection

Reason Description
Haemolysis Red blood cells have broken down, affecting biochemistry results
Insufficient volume Not enough sample to run all ordered tests
Wrong container Sample collected in the incorrect tube type (e.g., EDTA instead of plain)
Clotted blood Coagulation occurred in an anticoagulant tube
Delayed transit Sample arrived too late for the test's stability window
Unlabelled / mislabelled Sticker missing or belongs to a different patient
Lipemia Excessive fat in serum, interfering with certain assays
Contamination Sample contaminated during collection

Rejecting a Sample

  1. Go to Menu > Lab > Receive Samples or the Laboratory Dashboard > Samples tab.
  2. Locate the investigation by scanning the container barcode or searching by patient name or bill number.
  3. Click Reject Sample.
  4. In the rejection dialog, choose one of two options:

Option A: Request Recollection

Select Request Recollection when the test must still be performed and a new sample can be obtained from the patient.

  • The investigation status moves to Recollection Requested.
  • A notification is sent to the collection point (phlebotomy area or collecting centre) indicating that this sample requires recollection.
  • The patient or collection staff will need to arrange a new sample.

Option B: Reject Without Recollection

Select Reject Without Recollection when the test will not be repeated (patient discharged, test no longer required, or clinician advised to cancel).

  • The investigation status moves to Sample Rejected.
  • No further action is expected in the system.
  • The ordering clinician should be informed manually if the test result is clinically urgent.
  1. Enter a rejection reason in the comments field (recommended for audit purposes).
  2. Click Confirm.

Recollection Workflow

Once recollection is requested, the following steps apply:

At the Collection Point

  1. The phlebotomist or collector sees the recollection request in Menu > Lab > Sample Collection — investigations with status Recollection Requested are highlighted.
  2. The patient is called back or informed to return for a repeat sample.
  3. A new barcode sticker is printed for the replacement sample container.
  4. The new sample is collected and the sticker attached.
  5. The collector marks the sample as collected; the status moves to Recollection Pending or Sample Collected depending on configuration.

At the Lab

  1. The replacement sample arrives at the lab reception.
  2. The technician scans the barcode and accepts the new sample.
  3. The investigation status updates to Sample Accepted and the investigation rejoins the normal workflow.

Tracking Rejected and Recollection Requests

To view all pending recollection requests:

  1. Go to Menu > Lab > Sample Management or the Laboratory Dashboard.
  2. Filter by status Recollection Requested or Recollection Pending.
  3. The list shows the patient name, investigation, original rejection reason, and rejection date/time.

To view the complete rejection history for a specific investigation, open the investigation record. The system records each rejection with the technician's name, timestamp, and reason.

Reverting a Rejection

If a sample was rejected in error:

  1. Find the investigation in the sample management screen.
  2. Click Revert (only available to authorised users).
  3. The investigation status returns to the previous state so it can be re-assessed and accepted.

Cancelling a Sample Collection

Once the laboratory has accepted a sample, its bill cannot be cancelled or refunded. If the bill must be cancelled (for example, the wrong test was billed or the patient left before the test was done), a laboratory user with the Lab Revert Sample privilege first cancels the sample collection.

  1. Open the sample. You can do this from either screen:
    • Laboratory Dashboard > Samples tab
    • Lab > Sample Management
  2. Tick the sample.
  3. Enter the Reason for cancelling sample collection.
  4. Click Cancel Sample Collection and confirm.

What this does:

  • The sample goes back to Barcode Generated. Its collected, sent and received details are cleared.
  • Any draft (unapproved) results for the test are discarded.
  • The test no longer counts as accepted, so the bill can now be cancelled or refunded.
  • The action is recorded in the audit log, with the reason.

When it is refused:

  • The report has already been approved or printed.
  • The sample was never collected.
  • No reason was entered.
  • You do not have the Lab Revert Sample privilege. The button stays disabled.

Note: If all samples of a test are rejected, the test no longer blocks cancellation. Its bill can then be cancelled or refunded without cancelling the sample collection.

Tips and Best Practices

  • Always document the rejection reason — this data feeds into quality monitoring reports.
  • For urgent tests (e.g., stat electrolytes), escalate verbally to the clinical team immediately when rejecting, even if a recollection request is sent through the system.
  • Maintain a log of recollection turnaround times. Long delays between rejection and receipt of replacement sample may indicate a process issue at the collection point.
  • If the same investigation is repeatedly rejected for the same reason, inform the lab administrator — there may be a training or equipment issue at the collection point.

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