Sustainable Laboratory-Driven Method to Decrease Repeat, Same-Day WBC Differentials at a Tertiary Care Center.

Area of Science:

• Clinical Laboratory Science
• Health Informatics
• Healthcare Management

Background:

• Complete Blood Count (CBC) with White Blood Cell (WBC) differential testing is frequently ordered when a CBC alone suffices.
• Unnecessary WBC differentials contribute to increased laboratory costs and inefficient resource allocation.

Purpose of the Study:

• To implement a laboratory middleware algorithm to automatically cancel repeat, same-day WBC differentials.
• To achieve sustainable improvements in laboratory resource utilization and cost savings.

Main Methods:

• A middleware algorithm was developed to identify and cancel redundant, same-day WBC differentials.
• The algorithm was initially trialed in intensive care units before hospital-wide implementation.
• Retrospective review of CBC with differential orders pre- and post-implementation was conducted.

Main Results:

• The algorithm achieved a monthly cancellation rate of 5.40% for WBC differentials, totaling 10,195 cancellations.
• An estimated $0.99 CAD in savings per canceled differential and 1,060 minutes of technologist time were realized.
• Over 99.9% of canceled differentials remained canceled, with minimal patient impact.

Conclusions:

• A middleware algorithm offers a simple and sustainable solution for optimizing laboratory utilization.
• Automated cancellation of repeat WBC differentials leads to significant cost savings and improved efficiency.
• This approach demonstrates lasting improvements in laboratory resource management.