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

Am J Clin Pathol. 2018 Feb 17;149(3):247-252. doi: 10.1093/ajcp/aqx156.


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.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Blood Coagulation Tests / economics
  • Blood Coagulation Tests / methods
  • Blood Coagulation Tests / standards
  • Critical Care / economics
  • Critical Care / methods*
  • Critical Care / standards
  • Hematologic Tests / economics
  • Hematologic Tests / methods*
  • Hematologic Tests / standards
  • Humans
  • New York City
  • Prospective Studies
  • Time Factors
  • Unnecessary Procedures* / adverse effects
  • Unnecessary Procedures* / economics