RT Journal Article
SR Electronic
T1 An automated minimum retest interval rejection rule reduces repeat CRP workload and expenditure, and influences clinician-requesting behaviour
JF Journal of Clinical Pathology
JO J Clin Pathol
FD BMJ Publishing Group Ltd and Association of Clinical Pathologists
SP 731
OP 733
DO 10.1136/jclinpath-2014-202256
VO 67
IS 8
A1 Waldron, Jenna L
A1 Ford, Clare
A1 Dobie, Donald
A1 Danks, Graham
A1 Humphrey, Richard
A1 Rolli, Alain
A1 Gama, Rousseau
YR 2014
UL http://jcp.bmj.com/content/67/8/731.abstract
AB Aims Repeat serum C-reactive protein (CRP) measurements on the same day or on consecutive days are of limited clinical value. Minimum retesting intervals are recommended for managing unnecessary repeat testing. As not previously reported, we studied the effect of minimum retesting interval test rejection on laboratory workload and expenditure and on clinician-requesting behaviour. Methods In a prospective study, we evaluated the effect of an automated 48 h CRP minimum retesting interval rule on inpatient and outpatient CRP workload and costs. Control data on inpatient and outpatient serum urea and electrolytes (UE) workload were collected during the study. Results Over 1 year, there was a 7.0% and 12.3% decrease in CRP requests and CRP tests analysed, respectively, following the introduction of the minimum retesting interval rule when compared to the 1 year baseline period. This equated to an estimated annual reduction in revenue costs of £10 500, but cash savings in consumable costs of £3000. There was no significant change in UE requests. Conclusions We report, for the first time, that automated minimum retesting interval rejection rules as a stand-alone strategy are a cheap and sustainable method for reducing unnecessary repeat CRP tests, resulting in small laboratory cash savings, more efficient use of laboratory resources and standardisation of patient care pathways. The minimum retesting interval rejection rule also altered clinician test-requesting behaviour towards more appropriate requesting.