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Repeating Critical Hematology and Coagulation Values Wastes Resources, Lengthens Turnaround Time, and Delays Clinical Action
Abstract
OBJECTIVES: To determine the need and impact of repeating critical values in hematology and coagulation. METHODS: We prospectively evaluated the need for repeating critical values. The cost of this practice was estimated using a workflow analysis. Retrospective chart review before and after removal of this process was performed to assess the clinical impact of removing this practice. RESULTS: Over 95% of the repeated values remained critical and all but one of the repeats were within the expected analytical precision of the assays. The practice of repeating critical values delayed turnaround time for these results and wasted resources, most notably manpower. The delay associated with repeating hematology critical values resulted in delayed administration of blood product (RBC units). CONCLUSIONS: Repeating critical hematology and coagulation results was found to be an unnecessary process that wasted laboratory resources and lengthened turnaround time, delaying clinical intervention.
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References 8 · Cited by 13
Research works printed but not linked: 8
- Lundberg, 1990, Critical (panic) value notification: an established laboratory practice policy (parameter), JAMA, 263, 709, 10.1001/jama.1990.03440050103044 · DOI
- Lehman, 2014, Utility of repeat testing of critical values: a Q-probes analysis of 86 clinical laboratories, Arch Pathol Lab Med, 138, 788, 10.5858/arpa.2013-0140-CP · DOI
- Chima, 2009, Is it necessary to repeat critical values in the laboratory? Today’s technology may have the answers, Lab Med, 40, 453, 10.1309/LMMY883OKBZQQBKU · DOI
- Deetz, 2012, An examination of the usefulness of repeat testing practices in a large hospital clinical chemistry laboratory, Am J Clin Pathol, 137, 20, 10.1309/AJCPWPBF62YGEFOR · DOI
- Toll, 2011, Does routine repeat testing of critical values offer any advantage over single testing, Arch Pathol Lab Med, 135, 440, 10.5858/2010-0025-OA.1 · DOI
- Onyenekwu, 2014, The impact of repeat-testing of common chemistry analytes at critical concentrations, Clin Chem Lab Med, 52, 1739, 10.1515/cclm-2014-0331 · DOI
- Niu, 2013, Utility and necessity of repeat testing of critical values in the clinical chemistry laboratory, PLoS One, 8, e80663, 10.1371/journal.pone.0080663 · DOI
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Metadata
- Authors
- Sun, S.-C. P., Garcia, J., & Hayden, J. A.
- Affiliations
- Healthcare and Laboratory Advisors, Miami, FL
- Weill Cornell Medicine (US)
- Corresponding author
- Hayden, Joshua A
- ORCID
- Hayden, Joshua A
- Venue
- American Journal of Clinical Pathology
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-02-07
- Volume
- 149
- Issue
- 3
- Pages
- 247-252
- ISSN
- 0002-9173 (ISSN-L)
- 1943-7722
- OpenAlex
- W2790724388
- Cited by
- 13
- References
- 8
- Citations by year
- 2026: 2 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 1
- FWCI
- 0.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Clinical Pathology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Medical Laboratory Technology › Clinical Laboratory Practices and Quality Control
- Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
- Social Sciences › Decision Sciences › Management Science and Operations Research › Healthcare Operations and Scheduling Optimization
- Keywords
- critical values, hematology, coagulation, turnaround time, laboratory workflow, resource waste, blood product administration, analytical precision
- MeSH terms
- Adult, Blood Coagulation Tests, Critical Care, Hematologic Tests, Humans, New York City, Prospective Studies, Time Factors, Unnecessary Procedures
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- CoChat. (2026). Citation check: Repeating Critical Hematology and Coagulation Values Wastes Resources, Lengthens Turnaround Time, and Delays Clinical Action. https://app.cochat.ai/papers/10.1093/ajcp/aqx156
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- Sun, S.-C. P., Garcia, J., & Hayden, J. A. (2018). Repeating Critical Hematology and Coagulation Values Wastes Resources, Lengthens Turnaround Time, and Delays Clinical Action. American Journal of Clinical Pathology. https://doi.org/10.1093/ajcp/aqx156
