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Reduction in the Number of Reported Laboratory Results for an Adult Intensive Care Unit by Effective Order Management and Parameter Selection on the Blood Gas Analyzers

de Bie, Prim PhD; Tepaske, Robert MD, PhD; Hoek, Arthur; Sturk, Auguste PhD; van Dongen-Lases, Edmée PhD

Point of Care: The Journal of Near-Patient Testing & Technology: March 2016 - Volume 15 - Issue 1 - p 7–10
doi: 10.1097/POC.0000000000000087
Original Articles

Within the Academic Medical Center, the Adult Intensive Care Unit (ICU) is one of the departments with the highest number of requests for laboratory analyses per patient per year. Most of the laboratory analyses for the ICU are performed with 1 of 3 blood gas analyzers at the ICU location under the responsibility of the Department of Clinical Chemistry. Until 2013, these were set to measure and report every available parameter. The majority of the centrally measured laboratory tests are requested according to medical protocols that dictate frequent laboratory analyses using a fixed panel of parameters available in the order management system. In a bid to reduce the number of redundant reported testing results arising from both the centrally performed analyses and the decentralized blood gas analyzers, we used 3 approaches, used in concert, to achieve a more purposeful utilization of those laboratory investigations. (1) Protocols for all ICU laboratory investigations were refined. (2) Six different presets were installed on the blood gas analyzers that, in an easy and convenient way, allowed to selectively measure only the required analytes. (3) Through an elaborate training program, the medical and nursing staff was stimulated to apply a standardized and effective way of order management and a selective usage of the blood gas analyzers. Taken together, these approaches have resulted in a marked reduction in the number of reported assay results (24% centralized, 36% decentralized) and thus a more effective and uncluttered overview of the results of a patient's laboratory investigation.

From the *Department of Clinical Chemistry and †Adult Intensive Care Unit, Academic Medical Center, Amsterdam, The Netherlands.

Reprints: Edmée van Dongen-Lases, PhD, Department of Clinical Chemistry, Academic Medical Center, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands. E-mail:

The authors declare no conflict of interest.

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