Analysis of blood tests in the emergency department of a tertiary care hospital
Rifat Rehmani, Siraj Amanullah
Emergency
Department, The Aga Khan University Hospital, Stadium Road, PO Box
3500, Karachi 74800, Pakistan
Accepted 26 April 1999
There is ample evidence that many investigations sent
from the accident and emergency department are inappropriate, thus
affecting the quality of patient care. A study was designed to address
this issue in the emergency department of a tertiary care hospital of a
large city. A prospective cross-sectional study was carried out during
the 3-month period 1 December 1996 to 28 February 1997. A set of
guidelines was used to assess the appropriateness of different blood
tests for the initial assessment of the patients presenting with common
clinical conditions, although any investigation could be done if
considered important for patient management. All other blood tests were
considered inappropriate. A total of 6401 patients were seen in the
emergency department and 14 300 blood tests were done on 3529 patients
with diagnoses covered by the guidelines. Of these 62.2% were found to
be inappropriate. Of the total 22 655 investigations done on all the
6401 patients seen, only 3.8% influenced the diagnosis, 3.0%
influenced patient care in the emergency department, and 4.0%
influenced the decision to admit or not. Amylase and arterial blood
gases were found to be the most appropriate investigations. Analysis of
reasons for unnecessary use of emergency tests suggested that improving
supervision, decreasing the utilization of the emergency department as
a phlebotomy service for the hospital, and abolition of routine blood
tests would help to improve patient care.
Keywords: blood tests; accident and emergency medicine
© 1999 by The Fellowship of Postgraduate Medicine
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Miyakis, S., Karamanof, G., Liontos, M., Mountokalakis, T. D
(2006). Factors contributing to inappropriate ordering of tests in an academic medical department and the effect of an educational feedback strategy. Postgrad. Med. J.
82: 823-829
[Abstract] [Full Text]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
