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Effectiveness of minimum retesting intervals in managing repetitive laboratory testing: experience from a Croatian

Ivana Lapić1, Dunja Rogić1, Mirjana Fuček1

  • 1Department of Laboratory Diagnostics, University Hospital Center Zagreb, Zagreb, Croatia.

Biochemia Medica
|October 19, 2019
PubMed
Abstract

Insights

Implementing minimum retesting intervals (MRI) for laboratory tests showed limited success in reducing test repetition and costs. Further improvements are needed to optimize this protocol for inpatient settings.

Area of Science:

  • Clinical Pathology
  • Laboratory Medicine
  • Healthcare Management

Background:

  • Inappropriate laboratory retesting is a significant issue in inpatient settings.
  • Minimum Retesting Intervals (MRI) protocols are a strategy to address unnecessary repeat testing.

Purpose of the Study:

  • To assess the effectiveness of an implemented MRI protocol for inpatient laboratory testing.
  • To evaluate the impact of MRI on test request reduction, cost savings, and alert management.

Main Methods:

  • Applied MRI for 53 laboratory tests over a one-year period.
  • Calculated test request reduction, cost savings, alert frequency, acceptance, and ignorance rates.
  • Evaluated reasons for MRI violations and departmental contributions.

Main Results:

  • 14.8% of requests violated MRI rules, with a 1.9% reduction in overall tests requested.
  • High-volume tests generated most alerts, with >85% ignorance for some.
  • Tumor markers and autoimmunity tests had high cancellation rates (>50%).
  • Annual charge reduction was 62,641 EUR; reagent savings were 11,408 EUR.
  • Intensive care units showed the most ignored alerts; clinical justification was the primary violation reason.

Conclusions:

  • MRI implementation demonstrated limited effectiveness in reducing testing repetition and financial savings.
  • The protocol provides a foundation for future enhancements in laboratory test management.
Keywords:
clinical laboratory servicescost analysisevidence-based practicepre-analytical phase

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