The Access Before Analysis Framework

EXPLORE AN ACCESS BEFORE ANALYSIS PILOT

Establishing a baseline for pediatric diagnostic access

An Access Before Analysis™ pilot helps an organization examine what happens before an ordered blood test produces a specimen—including encounters that are unsuccessful, deferred, abandoned, or escalated.

The pilot is observational. It is designed to document existing conditions without changing clinical care, comparing devices, or evaluating individual staff performance.

A pilot begins with a defined pediatric collection setting and a focused set of observational questions.  Depending on the approved scope, documentation may include:  • Whether a specimen was obtained   • The number and sequence of collection attempts   • Barriers observed before or during collection   • Preparation and support resources used   • Escalation points and additional personnel involved   • Whether testing was completed, deferred, or abandoned   • What happened after no specimen was obtained  The purpose is to identify patterns across encounters, not to judge an individual child, caregiver, or staff member.

A FOCUSED AND PRACTICAL STARTING POINT

A pilot does not need to begin across an entire health system.

A useful starting scope might include:

• One outpatient laboratory
• One pediatric clinic or collection pathway
• A defined observation period
• A limited group of eligible encounters
• A small number of trained observers

The pilot can be designed to minimize workflow burden while still producing meaningful baseline information.

WHAT A PILOT CAN PRODUCE

Depending on the scope and available data, an organization may receive:

• A descriptive baseline of eligible collection encounters
• The proportion of observed encounters resulting in no specimen
• A summary of barriers, support use, and escalation patterns
• Identification of points where collection pathways commonly stop or change
• An assessment of documentation and observation feasibility
• Questions and opportunities for future quality improvement or research

Pilot findings are descriptive. They are not product comparisons, performance rankings, or conclusions about individual patients or staff.

OVERSIGHT, PRIVACY, AND APPROVAL

The purpose and design of a proposed pilot determine whether it is considered quality improvement, program evaluation, or human-subjects research.

Each participating organization retains responsibility for determining the appropriate institutional review, privacy protections, operational approvals, and data-handling requirements before observation begins.

Pilot planning prioritizes:

• Collecting only information necessary for the approved purpose
• Protecting patient, caregiver, and staff privacy
• Reporting findings in aggregate whenever appropriate
• Maintaining clear boundaries between observation and clinical decision-making
• Following all applicable organizational policies and oversight requirements

The purpose and design of a proposed pilot determine whether it is considered quality improvement, program evaluation, or human-subjects research.

Each participating organization retains responsibility for determining the appropriate institutional review, privacy protections, operational approvals, and data-handling requirements before observation begins.

Pilot planning prioritizes:

• Collecting only information necessary for the approved purpose
• Protecting patient, caregiver, and staff privacy
• Reporting findings in aggregate whenever appropriate
• Maintaining clear boundaries between observation and clinical decision-making
• Following all applicable organizational policies and oversight requirements

WHO SHOULD JOIN THE CONVERSATION

The appropriate pilot team will depend on the setting. It may include:

• Laboratory leadership
• Pediatric clinical or operational leadership
• Quality and patient-safety professionals
• Frontline collection representatives
• Child life, behavioral health, or patient-experience partners
• Research, compliance, privacy, or IRB representatives when applicable

Not every pilot requires every role. The first conversation helps identify who should be involved before a scope is proposed.

THE FIRST CONVERSATION

An initial 20-minute conversation explores:

• Your pediatric collection setting
• The access problem you are observing
• What your current data can—and cannot—show
• A possible pilot population and scope
• Relevant operational and oversight considerations
• Whether Access Before Analysis™ is appropriate for your organization

The conversation is exploratory and creates no obligation to proceed.

LET’S FIND OUT WHAT YOUR CURRENT METRICS ARE MISSING

If your organization wants to better understand pediatric blood-draw encounters that never produce a specimen, let’s discuss whether a focused observational pilot could provide a useful starting point.