Most Extra Tubes of Collected Blood Go Unused

MedicalResearch.com Interview with:
Robert Humble, MS, MD Candidate, 2019

President, EQUAL Med
Governmental Relations Chair, CCOM Student Government
University Iowa
Matthew D. Krasowski, MD, PhD
Department of Pathology
University of Iowa Hospitals and Clinics, Iowa City

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Laboratory testing is a critical tool in clinical decision-making. Clinical laboratories frequently receive “extra” tubes of blood. On collection, they have no testing associated with them. They are stored in the laboratory for a period of time for add-on testing. We sought to analyze patterns of extra tube collection at an academic medical center over an extended period of time, and determine patterns of add-on testing before and after implementation of new laboratory information system (LIS) software (Epic Beaker). Until this study, extra tube collection and utilization had not been quantified at our institution to this extent.

We found that most extra tubes weren’t used for laboratory testing. After collection, the vast majority of these tubes were stored until disposal. Over the period of study our institution moved from a paper ordering protocol to a ‘paperless ordering’ system that printed labels only for tubes needed for testing ordered by providers. After implementation of Epic Beaker, we saw utilization practices improve, though there is still room for improvement. Overall, we’ve seen significant decreases in extra tube collection across the institution.

MedicalResearch.com: What should readers take away from your report?

Response: Our study shows that extra tube collection can be targeted as a means to reduce waste of materials and unnecessary blood draws. At our institution, we observed decreased collection of extra tubes and increased utilization of extra tubes still drawn in inpatient care settings, outpatient clinics, and in the emergency department. In addition, individual patient care areas were responsive to interventions by clinical laboratory staff and by collaborating with them were able to decrease unnecessary blood collection where it was the most widespread. Working with patient care areas we were able to reduce unnecessary blood loss and cut down on wasted supplies. We hope readers will see what we’ve done at the University of Iowa and move to decrease wasteful practices at their institutions.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Working with patient care areas we were able to reduce unnecessary blood loss and cut down on wasted supplies. In the future it would be worthwhile to do a follow-up study to see if effects of previous interventions were maintained over time. In addition, we would like to see our results duplicated at other medical centers.

MedicalResearch.com: Is there anything else you would like to add?

Response: This project was completed as part of the Carver College of Medicine Summer Research Fellowship, with the assistance of Health Care Information Systems.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Humble RM, Hounkponou HG, Krasowski MD. The “Rainbow” of Extra Blood Tubes—Useful or Wasteful Practice?. JAMA Intern Med. Published online November 07, 2016. doi:10.1001/jamainternmed.2016.6834

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Last Updated on November 8, 2016 by Marie Benz MD FAAD