Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec;16(4):307-309.
doi: 10.1097/PTS.0000000000000363.

Essential and Nonessential Blood Testing in the Clinical Teaching Unit

Cody Sherren  1 , Andrew Day  2 , Roy Ilan  3
Affiliations

Essential and Nonessential Blood Testing in the Clinical Teaching Unit

Cody Sherren et al. J Patient Saf. 2020 Dec.

Abstract

Objectives: The aim of the study was to evaluate the essential and nonessential blood tests ordered on the internal medicine clinical teaching units (CTUs) at Kingston General Hospital. Our aim was to establish a baseline performance measure identifying appropriate use of laboratory tests that could be used to inform improvement over time.

Methods: For an 8-week period, 14 CTU attending physicians at Kingston General Hospital were surveyed. They were asked for each of their patients, "What blood tests do you consider to be essential for tomorrow morning to maintain appropriate care for this patient?" The following day, blood tests that were ordered were compared with the "essential" list previously given by the attending physicians.

Results: Of 291 processed blood tests, 148 (51%) had not been considered essential by attending physicians; of the 203 tests considered essential, 60 (30%) were not ordered. Total agreement between "essential" and processed tests was poor (κ = 0.51; confidence interval, 0.45-0.56).

Conclusions: Inadequate use of blood tests for CTU patients is common. Quality improvement initiatives should aim to address the lack of observed consensus between attending physicians' views and the ordered tests and to streamline decision-making and the ordering/communication processes. Clinical standards and guidelines regarding ordering of laboratory tests should be clearly defined.

PubMed Disclaimer

References

    1. Driskell OJ, Holland D, Hanna FW, et al. Inappropriate requesting of glycated hemoglobin (hb A1c) is widespread: assessment of prevalence, impact of national guidance, and practice-to-practice variability. Clin Chem. 2012;58:906–15.
    1. About the Campaign [Choosing Wisely web site]. Available at: http://www.choosingwisely.org. Accessed August 8, 2016.
    1. Thavendiranathan P, Bagai A, Ebidia A, et al. Do blood tests cause anemia in hospitalized patients? The effect of diagnostic phlebotomy on hemoglobin and hematocrit levels. J Gen Intern Med. 2005;20:520–4.
    1. Attali M, Barel Y, Somin M, et al. A cost-effective method for reducing the volume of laboratory tests in a university-associated teaching hospital. Mt Sinai J Med. 2006;73:787–94.
    1. Weydert JA, Nobbs ND, Feld R, et al. A simple, focused, computerized query to detect overutilization of laboratory tests. Arch Pathol Lab Med. 2005;129:1141–3.

Publication types

LinkOut - more resources