Lab Errors and Human Factors: A Psychological Perspective

In the world of clinical laboratories, we often focus on metrics, SOPs, and compliance checklists to reduce errors. But as any seasoned laboratorian or quality professional knows, mistakes still happen—sometimes even when all the systems are in place. Why? Because at the center of every lab process is a human being. And humans, for all their training and dedication, are not robots. (Even though it seems admin sometimes thinks we are.) As a regulatory affairs manager and laboratorian with a background in psychology, I’ve spent years navigating the intersection between compliance and cognition. Understanding how people think, react, and sometimes err has helped me see lab operations through a different lens. In this post, I want to explore the concept of human factors and how they play a role in lab errors—not to assign blame but to foster a culture of safety, empathy, and improvement. The Cognitive Load We Carry Laboratorians are tasked with high-stakes responsibilities: matching blood types, identifying critical values, and interpreting complex diagnostic results. Add in interruptions, multitasking, and staffing shortages, and the mental bandwidth gets stretched thin. Cognitive overload can lead to slips and lapses. A mislabeled specimen, for example, might result not from negligence but from working memory overload.1 When we acknowledge this, we can begin to design systems that support mental function instead of taxing it. The Role of Confirmation Bias Confirmation bias—the tendency to favor information confirming our beliefs—can creep into lab work. If a pathologist or a technologist “expects” to see a result or a specific pattern, they may inadvertently interpret ambiguous data to match their expectation.2,3 This is not a character flaw but a function of how our brains process information. Peer review, second reads, and built-in verification steps can guard against this type of error. Fatigue, Stress, and Emotional Load We often underestimate the impact of emotional and physical fatigue on performance. Long shifts, personal stressors, or the emotional toll of working in healthcare environments can impair judgment and focus.4,5 Labs prioritizing wellness—through break policies, mental health support, or manageable scheduling—not only show compassion but can contribute to improved performance and fewer mistakes. Designing with Humans in Mind So, how can labs address human factors without compromising accountability? Start by shifting the narrative. Instead of asking, “Who made the mistake?” ask, “What in the system allowed this to happen?” 6 (As a side note, this is the true purpose of a root cause analysis.) Incorporate human factors thinking into root cause analysis. Provide human-centric training that acknowledges common cognitive pitfalls. And most importantly, build a culture where speaking up about near misses is welcomed, not punished. Last Thought Human error isn’t a moral failing; it’s a predictable part of being human. When labs take a psychologically informed approach to error prevention, they open the door to safer practices, stronger teams, and more resilient systems. Understanding human factors doesn’t weaken quality systems—it strengthens them. And perhaps more importantly, it reminds us that the people behind the results matter just as much as the results themselves. References: Reason, J. (1990). Human Error. Cambridge University Press. Nickerson, R. S. (1998). Confirmation bias: A ubiquitous phenomenon in many guises. Review of General Psychology, 2(2), 175-220. Michel, M., Peters, M.A.K. Confirmation bias without rhyme or reason. Synthese 199, 2757–2772 (2021). https://doi.org/10.1007/s11229-020-02910-x Lockley, S. W., et al. (2007). Effects of health care provider work hours and sleep deprivation on safety and performance. The Joint Commission Journal on Quality and Patient Safety, 33(11 Suppl), 7-18. West, C. P., et al. (2009). Association of resident fatigue and distress with perceived medical errors. JAMA, 302(12), 1294-1300. Dekker, S. (2014). The Field Guide to Understanding ‘Human Error’. Ashgate Publishing.