Journal article
Impact of add-on laboratory testing at an academic medical center: a five year retrospective study
BMC clinical pathology, Vol.15(1), pp.11-11
06/07/2015
DOI: 10.1186/s12907-015-0011-7
PMCID: PMC4458334
PMID: 26052250
Abstract
Background: Clinical laboratories frequently receive orders to perform additional tests on existing specimens ('add-ons'). Previous studies have examined add-on ordering patterns over short periods of time. The objective of this study was to analyze add-on ordering patterns over an extended time period. We also analyzed the impact of a robotic specimen archival/retrieval system on add-on testing procedure and manual effort.
Methods: In this retrospective study at an academic medical center, electronic health records from were searched to obtain all add-on orders that were placed in the time period of May 2, 2009 to December 31, 2014.
Results: During the time period of retrospective study, 880,359 add-on tests were ordered on 96,244 different patients. Add-on testing comprised 3.3 % of total test volumes. There were 443,411 unique ordering instances, leading to an average of 1.99 add-on tests per instance. Some patients had multiple episodes of add-on test orders at different points in time, leading to an average of 9.15 add-on tests per patient. The majority of add-on orders were for chemistry tests (78.8 % of total add-ons) with the next most frequent being hematology and coagulation tests (11.2 % of total add-ons). Inpatient orders accounted for 66.8 % of total add-on orders, while the emergency department and outpatient clinics had 14.8 % and 18.4 % of total add-on orders, respectively. The majority of add-ons were placed within 8 hours (87.3 %) and nearly all by 24 hours (96.8 %). Nearly 100 % of add-on orders within the emergency department were placed within 8 hours. The introduction of a robotic specimen archival/retrieval unit saved an average of 2.75 minutes of laboratory staff manual time per unique add-on order. This translates to 24.1 hours/day less manual effort in dealing with add-on orders.
Conclusion: Our study reflects the previous literature in showing that add-on orders significantly impact the workload of the clinical laboratory. The majority of add-on orders are clinical chemistry tests, and most add-on orders occur within 24 hours of original specimen collection. Robotic specimen archival/retrieval units can reduce manual effort in the clinical laboratory associated with add-on orders.
Details
- Title: Subtitle
- Impact of add-on laboratory testing at an academic medical center: a five year retrospective study
- Creators
- Louis S Nelson - Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USAScott R Davis - Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USARobert M Humble - Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USAJeff Kulhavy - Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USADean R Aman - Hospital Computing Information Services, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USAMatthew D Krasowski - Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USA
- Resource Type
- Journal article
- Publication Details
- BMC clinical pathology, Vol.15(1), pp.11-11
- DOI
- 10.1186/s12907-015-0011-7
- PMID
- 26052250
- PMCID
- PMC4458334
- NLM abbreviation
- BMC Clin Pathol
- ISSN
- 1472-6890
- eISSN
- 1472-6890
- Publisher
- BioMed Central; London
- Language
- English
- Date published
- 06/07/2015
- Academic Unit
- Pathology
- Record Identifier
- 9984046925502771
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