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Repeating Critical Hematology and Coagulation Values Wastes Resources, Lengthens Turnaround Time, and Delays Clinical Action

Objectives
To determine the need and impact of repeating critical values in hematology and coagulation.


Methods
We prospectively evaluated the need for repeating critical values. The cost of this practice was estimated using a workflow analysis. Retrospective chart review before and after removal of this process was performed to assess the clinical impact of removing this practice.


Results
Over 95% of the repeated values remained critical and all but one of the repeats were within the expected analytical precision of the assays. The practice of repeating critical values delayed turnaround time for these results and wasted resources, most notably manpower. The delay associated with repeating hematology critical values resulted in delayed administration of blood product (RBC units).


Conclusions
Repeating critical hematology and coagulation results was found to be an unnecessary process that wasted laboratory resources and lengthened turnaround time, delaying clinical intervention.