Modern quality standards for laboratories recommend the use of customer feedback in quality improvement. Spontaneous customer feedback is one method to obtain information from customers. In the present study, we analysed the feedback data from external customers (health centres and other hospitals) to our university hospital laboratory during 2001–2006. The most common subject matters of the feedback, covering 87% of a total of 95 reports, were lacking test results, suspicion of the validity of test results, return of samples in transportation boxes to customers and delays in service. On investigation, errors or defects were revealed in 78 cases. The most common errors were lacking (45 cases; 58%), erroneous (20 cases; 26%) or delayed test results (7 cases; 9%). As much as 68% of these errors took place in the pre-analytical phase of the laboratory process, occurring most commonly during specimen transfer, when entering orders into the laboratory information system at the university hospital or during sample processing. The most common underlying causes for errors were unintended errors and non-compliance with operating instructions. Latent errors were identified in 14% of the cases. Corrective actions were performed in 79% of the reported cases. It is important that the feedback reports are investigated to find out possible errors and their underlying causes so that appropriate corrective actions can be taken. When processed properly, spontaneous customer feedback is a method that can be used supplementarily to other methods to detect errors and defects in clinical laboratories and to aid in quality improvement.

Objective. To find out the satisfaction of clinical units with laboratory services in a university hospital, to point out the most important problems and defects in services, to carry out corrective actions, and thereafter to identify the possible changes in satisfaction.Setting and study participants. Senior physicians and nurses-in-charge of the clinical units at Oulu University Hospital, Finland.Design. Customer satisfaction survey using a questionnaire was carried out in 2001, indicating the essential aspects of laboratory services. Customer-specific problems were clarified, corrective actions were performed, and the survey was repeated in 2004.Results. In 2001, the highest dissatisfaction rates were recorded for computerized test requesting and reporting, turnaround times of tests, and the schedule of phlebotomy rounds. The old laboratory information system was not amenable to major improvements, and it was renewed in 2004-05. Several clinical units perceived turnaround times to be long, because the tests were ordered as routine despite emergency needs. Instructions about stat requesting were given to these units. However, no changes were evident in the satisfaction level in the 2004 survey. Following negotiations with the clinics, phlebotomy rounds were re-scheduled. This resulted in a distinct increase in satisfaction in 2004.Conclusions. Satisfaction survey is a screening tool that identifies topics of dissatisfaction. Without further clarifications, it is not possible to find out the specific problems of customers and to undertake targeted corrective actions. Customer-specific corrections are rarely seen as improvements in overall satisfaction rates.