Built from the encounters traditional data never captured
Access Before Analysis™ began with a straightforward question:
What happens to an ordered blood test when a child cannot complete the collection?
The order exists. The clinical question exists. But when no specimen is obtained, the encounter may leave little usable information about what prevented diagnostic access.
Traditional laboratory metrics generally begin with specimens received. Access Before Analysis extends the inquiry upstream—examining whether specimen acquisition was achievable, what barriers arose, what supports were used, and what happened when collection could not be completed.
The framework was created to make those encounters visible, measurable, and available for responsible study and improvement.
FROM FRONTLINE OBSERVATION TO A RESEARCH QUESTION
Access Before Analysis™ emerged from direct work with children during blood collection and behavioral support.
Across pediatric encounters, Franchesca Kelly observed that the children who experienced the greatest distress or access barriers were often the least visible in conventional outcome data. When no specimen was obtained, the laboratory could not analyze it—and the reasons the encounter failed were rarely documented in a structured way.
What appeared downstream as an absent result could represent an important event upstream:
• A child overwhelmed by sensory or procedural demands
• A collection pathway that lacked appropriate preparation or support
• An encounter that escalated or ended before completion
• A family required to return, seek another setting, or abandon testing
• A clinical question left unanswered
Access Before Analysis™ transforms that frontline observation into a structured question that healthcare organizations can examine.
ABOUT THE FOUNDER
Franchesca Kelly, PBT(ASCP), MLA(AMT), RBT
Franchesca Kelly is a pediatric healthcare professional, writer, speaker, and researcher whose work spans pediatric blood collection, behavioral support, special education, and healthcare access for neurodivergent and highly anxious children.
She has more than nine years of pediatric blood-collection experience and continues to work directly with neurodivergent children as a Registered Behavior Technician. That combination of laboratory and behavioral experience shapes her approach to pediatric diagnostic access.
Franchesca founded Access Before Analysis™ to study the encounters that disappear before conventional measurement begins. She also founded Poke Pals™, a child-centered preparation initiative helping children, families, and healthcare teams approach difficult medical procedures differently.
Her writing has appeared in:
• ASCP Critical Values
• Contemporary Pediatrics
• Clinical Lab Products
She speaks to laboratory, healthcare, education, and school-health audiences about pediatric diagnostic access, medical trauma, behavioral preparation, and the children our systems fail to count.
https://clpmag.com/diagnostic-technologies/pediatric-testing-problems-labs-arent-measuring/
THE PRINCIPLE BEHIND THE WORK
Missing data should not end the inquiry. It should change the question.
Access Before Analysis™ does not begin by asking what is wrong with the child, the caregiver, or the person attempting the procedure.
It asks:
What conditions made access possible—or prevented it?
That shift creates room for better documentation, more useful research questions, and improvement efforts grounded in what actually happened.
RELATED WORK
Related writing on communication and access
Beyond the Card: When Visual Supports Stop Supporting — Autism Spectrum News
https://autismspectrumnews.org/beyond-the-card-when-visual-supports-stop-supporting/
POKEPALS™
Poke Pals helps children prepare for blood draws and other medical procedures through predictable, developmentally appropriate, and sensory-aware support.
Where Access Before Analysis measures the access gap, Poke Pals helps families and healthcare teams respond to it.
A descriptive, device-agnostic overview outlining pediatric access feasibility sequencing and structured observational guardrails.
Framework Overview (pdf)
DownloadAccess Before Analysis™ is an observational framework in active research development. It does not provide medical advice or replace clinical judgment.
Founded by Franchesca Kelly
franchesca@accessbeforeanalysis.com
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