Impact of blood testing on patient disposition from the emergency department

To determine whether blood test results lead to a change in planned disposition of patients from the ED.

A prospective review of the anticipated and actual disposition of patients from the ED before and after blood test results, including stratification by seniority of medical staff.

There were 256 patients enrolled, 53% had blood tests requested. Expected disposition was not altered by test results in 87% of patients having blood tests. Medical staff were poor at identifying those patients whose disposition would be altered by their blood results (sensitivity 44%, specificity 72%, negative predictive value 89%). Seniority of medical staff was not associated with an alteration in disposition due to the blood results (P = 0.37).

Blood test results have minimal impact on expected patient disposition from the ED. Recognition of this may improve resource utilisation with earlier discharge planning.