A successful experiment to use secondary laboratory tests consequently ordered by clinical pathologists

Cha, Young Joo; Chae, Seok Lae

Abstract

BACKGROUND
Because laboratory tests are important elements of medical practice and many new tests using new technologies are being developed, the effective use of laboratory tests and services is clearly the joint responsibility of clinicians and clinical laboratory. Clinical laboratory is needed to adopt more active approach to advocating test strategy and interpreting results. We evaluated the reflex testing algorithms, consequently ordering the secondary tests by clinical pathologists.
METHODS
We decided 36 test items, which can be odered consequently by clinical pathologists, working with communication between the laboratory and the clinic. In our laboratory, clinical pathologists consequently ordered the secondary tests after interpreting the primary screening test results, analyzed them with the same samples, and reported on the same day. We applied this consequently ordering system to the hospitalized patients.
RESULTS
Consequently ordered secondary tests were 5,060 (17.8%) among 28,494 tests performed on 36 items during 6 months, which comprised 0.5% of total laboratory tests. Consequently ordering system was a successful attempt to improve the effectiveness of test utilization, in which we generated laboratory informations sequentially, reduced the turn-around time and played an active role in assuring effective utilization of the laboratory tests.
CONCLUSIONS
Laboratory information including optimal test selection, development of methods to insure that the resulting data are utilized properly, and interpretation of test results, which can be provided more actively by clinical pathologists, should be used in assuring superior patient care. Consequently ordering system by clinical pathologists may be considered to be a means of providing patient services more efficiently.