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Area of Science:

  • Transfusion Medicine
  • Clinical Pathology
  • Healthcare Economics

Background:

  • Clinical laboratory testing in the US incurs significant annual costs, with a substantial portion attributed to inappropriate test utilization.
  • While evidence-based transfusion practices are studied, data on the financial and clinical impact of inappropriate pretransfusion testing remain limited.

Purpose of the Study:

  • To evaluate the prevalence and implications of duplicative type and screen (TS) testing within a transfusion medicine service.
  • To identify specific clinical services with high rates of inappropriate TS ordering for targeted interventions.

Main Methods:

  • A 24-month retrospective review at a tertiary care center identified duplicate TS tests performed within 72 hours.
  • Inappropriate duplicative testing was defined by predetermined criteria, and cost analysis was conducted.
  • Underordering of TS was assessed via an electronic event reporting system.

Main Results:

  • The mean rate of inappropriate, duplicative TS orders was 4.13%, varying significantly across clinical services (0.01% to 15.5%).
  • Inappropriate testing incurred laboratory costs of $80,434 and phlebotomy costs of $45,469 during the study period.
  • Eight cases of delayed blood delivery resulted from a lack of a valid TS, highlighting the risks of underordering.

Conclusions:

  • Inappropriate TS ordering presents considerable financial and clinical burdens.
  • Analysis of inappropriate TS rates by clinical service pinpoints areas for focused educational and technological improvements.
  • Reducing unnecessary pretransfusion testing can optimize resource allocation and enhance patient safety in transfusion medicine.