Green laboratory through test ordering appropriateness and innovation

Area of Science:

• Clinical Laboratory Medicine
• Environmental Science
• Healthcare Management

Background:

• Clinical laboratories are essential but resource-intensive, facing challenges from high energy/water use, single-use plastics, and biomedical waste.
• Current practices in clinical laboratory medicine contribute to substantial environmental and economic burdens.

Purpose of the Study:

• To quantify the environmental and economic impact of common, avoidable practices in clinical laboratory medicine.
• Focus on excessive blood collection, inappropriate test ordering, and redundant tube use in pre-analytical workflows.

Main Methods:

• Analysis of real-world data from a Clinical Biochemistry Laboratory (2024).
• Quantification of environmental and economic impact of inappropriate test ordering based on retesting intervals.
• Assessment of pre-analytical practices including redundant sample tube collection and excessive blood volumes.

Main Results:

• Inappropriate retesting generated 2,931 unnecessary tubes (26.7 kg waste).
• Redundant EDTA tubes for specific tests resulted in 356.14 kg excess waste, preventable by sample consolidation.
• Hematology and biochemistry tests generated 2.62 and 36.98 tonnes of waste, respectively.

Conclusions:

• Excessive blood collection and unnecessary test repetition create significant, avoidable environmental and financial burdens.
• Pre-analytical interventions like reducing tube volume and consolidating tests can prevent over 40 tonnes of waste and save >€60,800 annually in a single lab.