Abstracts from the 2025 ADLM Preanalytical Phase Conference—Advancing Preanalytics: From Innovative Breakthroughs to Practical Applications

The preanalytical phase of laboratory testing remains a critical and persistently complex component of the total testing process. Unlike the analytical phase, which benefits from robust quality control systems, the preanalytical phase is inherently less amenable to traditional quality assurance strategies due to the multitude of variables that can affect specimen integrity. Factors include patient preparation, specimen collection, handling, transport, and processing. This phase is further complicated by the involvement of a diverse array of practitioners, including phlebotomists, nursing staff, clinicians, and couriers. Adding further complexity is the desire to increase access to laboratory testing by placing specimen collection into homes and other unconventional, non-healthcare settings, performed by the patient themselves. The distributed responsibility introduces additional complexity and variability, underscoring the need for ongoing education, collaboration, and process improvement (1). Challenges maintaining a competent and robust workforce contribute to vacancies for laboratory professionals ranging up to 25%, with some specialties and regions experiencing even higher shortages (2). These staffing shortages have direct implications for laboratory quality and patient care, including increased turnaround times, risk of errors, and reduced access to timely diagnostics. Many institutions faced with staffing shortages and budget constraints are having to do more with less, which has ushered in an era of desire to increase automation and use digital tools to help alleviate the clerical burden with the hope of improving staff satisfaction and retention as well as the quality of the testing process. The integration of informatics, automation, and artificial intelligence offers promising avenues for error reduction, yet also introduces new challenges that require vigilant oversight and continuous innovation (3). The 2025 Association for Diagnostics & Laboratory Medicine (ADLM) Preanalytical Phase Conference, held in Providence, RI, continued a tradition of addressing the ever-present and evolving challenges in the preanalytical phase of laboratory medicine. Building on previous conferences in Alexandria and Philadelphia (Table 1), ADLM welcomed about 130 attendees from 11 countries and 30 US states. This year’s program brought together leading experts to explore practical solutions and future innovations to improve and expand specimen collection opportunities as well as technological advancements. Title, venue and dates of the four Association for Diagnostics & Laboratory Medicine (ADLM) preanalytical conferences. 2019 AACC Preanalytical Phase Conference “Optimizing Quality in the Clinical Laboratory: Focus on the Preanalytical Phase.” Alexandria, VA. November 11–12, 2019 2022 AACC Preanalytical Phase Conference “Reducing Errors and Improving Quality in the Preanalytical Phase: The Role of the Laboratory.” Alexandria, VA. June 3–4, 2022 2023 AACC Preanalytical Phase Conference “Implementing Preanalytical Tools That Improve Patient Care.” Philadelphia, PA. October 21, 2023 2025 ADLM Preanalytical Phase Conference “Advancing Preanalytics: From Innovative Breakthroughs to Practical Applications.” Providence, RI. October 23–24, 2025 The conference opened with a keynote presented by Mark A. Zaydman, MD, PhD from Washington University in St. Louis, MO, focusing on the transformative potential of artificial intelligence in preanalytical processes. Session 1 continued the innovation theme with presentations focused on new and novel ways and places to collect clinical specimens (Table 2), with an emphasis on expanding patient access to laboratory testing. Session 2 addressed preanalytical issues with specimens collected for hematology, coagulation, molecular, and urinalysis testing (Table 2). Session 3 transitioned to the very practical, dealing with essentials in preanalytics aimed at addressing errors which most laboratories struggle with, including minimizing draw volumes, optimizing hemolysis, and designing dashboards to monitor preanalytical quality metrics (Table 2). The closing keynote presented by Frederick Strathmann, PhD, MBA, DABCC (MOBILion Systems) taught the audience about different personality styles and how this knowledge of ourselves and others can be used for effective communication to build successful multidisciplinary teams. Program and faculty for the 2025 ADLM Preanalytical Conference. Breakout sessions provided interactive opportunities for participants to engage with conference faculty, which included a rousing game of “Phlebotomy Jeopardy” and even a “Serum vs Plasma Showdown” in addition to effective communication strategies, work flow analysis and sample routing, assessing fairness in preanalytics, and handling of remotely collected samples (Table 2). The conference also featured 28 peer-reviewed posters submitted by conference participants, which we are pleased to share in this edition of JALM (see Supplemental Material). These posters addressed improvements in specimen collection practices, reduction of hemolysis and contamination, detection, evaluation and mitigation of preanalytical interferences, optimization of transport and processing work flows, and the use of informatics and automation to support quality improvement. Collectively, the poster presentations illustrated the robust and ongoing efforts across institutions to strengthen preanalytical reliability, expand innovative collection models, and enhance the overall quality of diagnostic testing. The 2025 ADLM Preanalytical Phase Conference exemplifies the field’s commitment to advancing laboratory medicine through collaboration, innovation, and education. By convening experts to address persistent and emerging challenges—from hemolysis and interferences to the integration of artificial intelligence and remote collection models—the conference fostered a desire to learn from colleagues and take away practical solutions to common problems, as well as providing a venue to explore the future of preanalytics. Its established position within ADLM underscores the importance of the preanalytical phase in ensuring the high quality which diagnostic laboratory medicine provides. As laboratory medicine continues to adapt to new technologies and care models, the insights and strategies shared at this conference will be instrumental in shaping the future of preanalytics and enhancing patient outcomes. The success of the 2025 ADLM Preanalytical Phase Conference reflects the dedication and expertise of its faculty, the thoughtful leadership of the organizing committee and ADLM staff, the generous support of our industry sponsor, and the active engagement of each attendee and poster presenter. Poster #1 Reducing procedural variability: A standardised approach to phlebotomy training Poster #2 Associations between elevated red blood cell parameters and hemoglobin A1c levels in type II diabetes Poster #3 Lab redefines cancel culture through targeted educational lessons for nursing units Poster #4 Implementation and evaluation of pre-analytical indicators in arterial blood gas analysis: experience from two hospital laboratories Poster #5 Evaluation of capillary blood self-collection devices for EDTA whole blood: sample adequacy and user experience Poster #6 Two years of serial hs-cTnT from 9 Edmonton and Calgary hospitals demonstrate Barricor’s™ highly significant preanalytical error reduction Poster #7 Reducing rainbow draws through laboratory stewardship: A preanalytical quality improvement initiative targeting unnecessary blood collections Poster #8 Improving pre-analytical processes through post phlebotomy time-out Poster #9 You're so vein: A comparative analysis of capillary collection devices Poster #10 Optimizing intra-lab and extra-lab preanalytic workflows to improve morning lab testing Poster #11 Evaluating EDTA contamination thresholds for ALP in an academic medical center Poster #12 Reducing recollection of laboratory specimens in the neonatal intensive care unit while improving communication and collaboration Poster #13 Laboratory specimen collection method has a direct impact on stability and analytical results Poster #14 Optimizing specimen collection practices to improve accuracy of blood gas results: A collaborative quality project between nursing and laboratory Poster #15 Improving sample integrity: preclinical evaluation of a hemolysis-reducing blood collection device Poster #16 Evaluation of blood collection tube performance in pooled vs individually collected venous serum samples Poster #17 Data-driven optimization of tube fill requirements for PT and PTT on the automated CS-5100 coagulation analyzer Poster #18 Large-scale retrospective evaluation of hemolysis, icterus, and lipemia index reproducibility on Roche cobas analyzers Poster #19 The impact of hemolysis on high-sensitivity troponin testing: Key insights & implications Poster #20 Lipid and bilirubin cross-interference on hemolysis detection on GEM Premier 7000 with iQM3 Poster #21 Piecing together the potassium puzzle: Utilization of a standardized laboratory flow chart to distinguish true hyperkalemia from pseudohyperkalemia Poster #22 Influence of iodinated contrast media on gel separator performance and clinical laboratory tests Poster #23 Hemolysis severity is correlated with patient race and social vulnerability at the population level. Poster #24 Evaluation of hemolysis thresholds for potassium results in a tertiary-care pediatric hospital Poster #25 Impact and frequency of samples with insufficient volume on laboratory testing Poster #26 Keep calm and carry on: Centralizing testing from an OR satellite lab Poster #27 Evaluation of the performance of BD Vacutainer® Rapid Serum Tubes for barrier integrity pre- and post-simulated transport Poster #28 Evaluating Large language models for automated mapping of laboratory test names to LOINC Supplemental material is available at The Journal of Applied Laboratory Medicine online. Author Contributions: The corresponding author takes full responsibility that all authors on this publication have met the following required criteria of eligibility for authorship: (a) significant contributions to the conception and design, acquisition of data, or analysis and interpretation of data; (b) drafting or revising the article for intellectual content; (c) final approval of the published article; and (d) agreement to be accountable for all aspects of the article thus ensuring that questions related to the accuracy or integrity of any part of the article are appropriately investigated and resolved. Nobody who qualifies for authorship has been omitted from the list. Darci Block (Conceptualization-Lead, Writing—original draft-Lead, Writing—review & editing-Supporting), Raffick Bowen (Conceptualization-Supporting, Writing—review & editing-Equal), Stacy Melanson (Conceptualization-Supporting, Writing—review & editing-Supporting), and Anna Merrill (Conceptualization-Supporting, Writing—review & editing-Equal) Authors’ Disclosures or Potential Conflicts of Interest: Upon manuscript submission, all authors completed the author disclosure form. Research Funding: None declared. Disclosures: D. Block received funding from ADLM for conference registration, hotel, and meal expenses incurred to attend the ADLM Preanalytical Phase meeting October 23–24, 2025, and royalties from the sales of “Quick Guide to Body Fluid Testing” from Elsevier. R. Bowen received funding from ADLM for travel and hotel expenses related to the conference. A. Merrill received honorarium and consulting fees from Diagnostica Stago, Inc.; financial support from ADLM for 2025 annual meeting, 2023 preanalytical phase meeting, and 2025 preanalytical phase meeting; and honorarium and financial support for 2024 annual meeting from the Association for Molecular Pathology. A. Merrill is an Associate Editor for The Journal of Applied Laboratory Medicine, ADLM.

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