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Impact of blood testing on patient disposition from the emergency department
Jonathan C Knott1, Alastair D McR Meyer
1Emergency Department, Royal Melbourne Hospital, Parkville, Victoria, Australia. jonathan.knott@mh.org.au
Objective:
To determine whether blood test results lead to a change in planned disposition of patients from the ED.
Methods:
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.
Results:
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).
Conclusions:
Blood test results have minimal impact on expected patient disposition from the ED. Recognition of this may improve resource utilisation with earlier discharge planning.