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Unnecessary repeat requesting of tests: an audit in a government hospital immunology laboratory
1Clinical Immunology Division, Department of Pathology, Queen Mary Hospital, Pokfulam Road, Hong Kong. kwoksy@ha.org.hk
Insights
Unnecessary repeat laboratory testing, including immunoglobulin, autoantibody, and tumor marker tests, accounts for 16.78% of workload. This audit highlights significant waste in resources and suggests interventions like computerized reminders to reduce repeat requests.
Area of Science:
- Clinical Laboratory Science
- Health Services Management
Background:
- Unnecessary repeat test requests contribute significantly to laboratory workload.
- Identifying the scope and circumstances of repeat testing is crucial for optimizing laboratory efficiency.
Purpose of the Study:
- To quantify the proportion of repeat test requests in an immunology laboratory.
- To identify factors contributing to repeat test ordering in a tertiary hospital setting.
Main Methods:
- An audit of repeat test requests over 12 months was conducted.
- Data on immunoglobulin, autoantibody, and tumor marker tests were analyzed.
- The Delphic laboratory computer system and a management information system were utilized.
Main Results:
- Repeat requests within 12 weeks constituted 16.78% of the total laboratory workload.
- The estimated cost of these repeat tests was $132,151 USD.
- Significant waste of technician time and reagents was identified.
Conclusions:
- Excessive waste occurs due to unnecessary repeat testing in clinical immunology.
- Interventions such as computerized reminders could potentially reduce repeat test ordering.
- Optimizing laboratory workflows requires addressing the issue of repeat test requests.
Abstract:
Unnecessary repeat requesting of tests can make up a large proportion of a laboratory's workload. This audit set out to establish the size of this problem and to identify the circumstances under which these repeat requests were made in a government tertiary hospital immunology laboratory. The numbers of tests for immunoglobulin measurement, common autoantibodies, and tumour markers that were repeated over a 12 month period were analysed by interrogating the Delphic laboratory computer system using a management information system for raw data enquiry protocol. Repeat requests within 12 weeks of a previous request made up 16.78% of the total workload. The total cost of the tests was estimated at 132 151 US dollars. The waste of technician time and reagents as a result of unnecessary repeat testing is excessive. Many of these tests might be eliminated with the use of interventions such as computerised reminders.
