Volume 40 Number 2 | April 2026
Summary
The article explores the tension between speed and accuracy in medical laboratory work, especially in hematology, where complex cases demand careful review. While efficiency supports patient care, rushing can risk missed abnormalities. The author reflects on personal experiences, peer insights, and management literature, emphasizing that balancing turnaround time with thoughtful analysis is essential for patient safety.
Heather R. Parks, MS, MLS(ASCP)CM, Volunteer Contributor
“It’s a fine line between efficiency and accuracy,” my friend observed after I voiced my frustration with blood cell differentials and morphology. It seemed to me, with our digital imaging software, a lot of results were pushed out too quickly. Here I was, new in the department, warned not to “miss anything,” and trying my best to follow complex procedures in a timely manner.
Smudge cells, immature and “blasty” cells, legions of schistocytes and spherocytes seemed to mock me from the microscope stage. I took my time with these patients needing more attention and pathology reviews. Meanwhile, I felt like my co-workers cranked out diffs at warp speed. At the end of the day, I looked unproductive.
I recently queried my online peers, who had plenty to say on this speed versus accuracy topic. Most said they always prioritize quality over speed and teach students to do the same. Some were happy with their efficient workflow. In hematology, some mentioned having few blood smear reviews on their shift, so they had time to work on them. Like me, some said they rely on teammates to handle the easier specimens while they tackle a difficult case. Some mentioned giving preliminary results by phone to help a care team move forward. No one mentioned the other implied speedbumps and interruptions (phones, instrument issues, etc.) that managers may not see.
Granted, with experience, comes speed and efficiency. But you know the ones: those tricky blood smears, vague antibody panels, weird urines, and equivocal cultures. The ones that linger in the mists of your slumber, prompting you awake thinking, “Did I do the right thing?” Okay, maybe that only happens to me. I have heard that the ability to discern clinically significant from fairly normal comes with time. I agree, but in some cases, we need to slow down and look closely. My daughter has special needs, and drawing her blood is very challenging (she resists!). If her CBC warranted a smear review, I would hope the lab scientist would take a few moments to look carefully.
“Over time, a bench scientist may feel like a factory worker on a production line, one where speed is valued over quality.”
What does this have to do with patient safety? A missed leukemia, a weak antibody screen, false critical results from a contaminated tube can all affect patients. We may be encouraged to mind turnaround times, get through the diffs quickly, or clear the plate-reading bench for the next shift. Over time, a bench scientist may feel like a factory worker on a production line, one where speed is valued over quality.
Let me give you some background: I really like working the bench. I like to be up-close and personal with patient specimens. For family reasons, I work PRN, so I am not eligible for our career ladder. For my life situation, the flexibility is priceless. I continue to learn about lab management, but I may never be a manager. I do want a manager’s perspective on this speed-versus-accuracy problem, so I consulted the literature.
Wow! While I’ve been grumbling, researchers have been busily studying this problem for years. My computer AI assistant jumped to life and swirled with terms like quality metrics, turnaround time, Lean and Six Sigma, human workload pressure, automation and error reduction, carefully managed, and properly implemented. Memories of my Lab Management courses and an enthusiastic Six Sigma Black Belt named Vince came flooding back. I recalled our genius Lean Lab redesign that turned our busy, chaotic lab into a clean, spiffy, well-oiled machine. It was great for our core lab and did improve our turnaround times and specimen tracking. But I found myself constantly operating the automated “work cell” instead of doing manual hematology (a job I love, despite my frustrations.) So, I moved to blood bank.
I admit, this problem of speed and quality intrigues me, and I’m excited to check out the latest research. Advances in digital microscopy particularly interest me for hematology, having long preferred the benchtop microscope. I am reminded that turnaround time is important for clinical care decisions and moving patients through emergency departments. So, lab speed is good for patients, right? Not always. I think the fine line between efficiency and accuracy is complicated. What do you think? I would love to hear your ideas.
Heather R. Parks is a Medical Laboratory Scientist at University Hospital and is Adjunct Professor at Alamo Colleges in San Antonio, Texas.