TY - JOUR
T1 - Increased specimen minimum volume reduces turnaround time and hemolysis
AU - Qavi, Abraham J.
AU - Franks, Caroline E.
AU - Grajales-Reyes, Gary
AU - Anderson, Jeanne
AU - Ashby, Lori
AU - Zohner, Kimberly
AU - Gronowski, Ann M.
AU - Farnsworth, Christopher W.
N1 - Publisher Copyright:
© 2022
PY - 2023/5
Y1 - 2023/5
N2 - Quantity not sufficient (QNS) specimens with minimal blood volume for testing are common in clinical laboratories. However, there is no universal definition of minimum volume for a QNS specimen and little data is available addressing the impact of QNS / low volume specimens on turnaround time (TAT) and sample hemolysis. We compared the TAT and hemolysis index from samples ≤1.0 mL to all specimens received and quantified the number of specimens with reduced blood volume. A new QNS policy requiring ≥1.5 mL of sample in a blood tube for laboratory analysis was implemented and the results were assessed by sample hemolysis and TAT. The median laboratory TAT for samples with ≤1.0 mL of blood was 61 min (Interquartile Range, IQR: 50–82), in contrast to 28 min (26–34) for all samples. The hemolysis index for samples ≤1.0 mL was 112 (65–253) and 15 (8–29) for all samples. Requirement of a minimum volume of 1.5 mL of blood resulted in the proportion of samples with TAT ≥ 60 min to decrease from 10.4% to 4.24% in the ED, and for specimens cancelled due to hemolysis to decrease from 4.24% to 3.38%. This policy was introduced hospital wide with similar effects. Together, we correlate limited specimen volume with an increase in laboratory TAT and hemolysis. Implementation of a QNS policy of ≥1.5 mL and provider education provided a significant and durable reduction in TAT and specimen hemolysis.
AB - Quantity not sufficient (QNS) specimens with minimal blood volume for testing are common in clinical laboratories. However, there is no universal definition of minimum volume for a QNS specimen and little data is available addressing the impact of QNS / low volume specimens on turnaround time (TAT) and sample hemolysis. We compared the TAT and hemolysis index from samples ≤1.0 mL to all specimens received and quantified the number of specimens with reduced blood volume. A new QNS policy requiring ≥1.5 mL of sample in a blood tube for laboratory analysis was implemented and the results were assessed by sample hemolysis and TAT. The median laboratory TAT for samples with ≤1.0 mL of blood was 61 min (Interquartile Range, IQR: 50–82), in contrast to 28 min (26–34) for all samples. The hemolysis index for samples ≤1.0 mL was 112 (65–253) and 15 (8–29) for all samples. Requirement of a minimum volume of 1.5 mL of blood resulted in the proportion of samples with TAT ≥ 60 min to decrease from 10.4% to 4.24% in the ED, and for specimens cancelled due to hemolysis to decrease from 4.24% to 3.38%. This policy was introduced hospital wide with similar effects. Together, we correlate limited specimen volume with an increase in laboratory TAT and hemolysis. Implementation of a QNS policy of ≥1.5 mL and provider education provided a significant and durable reduction in TAT and specimen hemolysis.
KW - Hemolysis
KW - Short samples
KW - Turn-Around-Time
UR - http://www.scopus.com/inward/record.url?scp=85127330593&partnerID=8YFLogxK
U2 - 10.1016/j.clinbiochem.2022.03.008
DO - 10.1016/j.clinbiochem.2022.03.008
M3 - Article
C2 - 35351449
AN - SCOPUS:85127330593
SN - 0009-9120
VL - 115
SP - 137
EP - 143
JO - Clinical Biochemistry
JF - Clinical Biochemistry
ER -