Increased specimen minimum volume reduces turnaround time and hemolysis

Abraham J. Qavi, Caroline E. Franks, Gary Grajales-Reyes, Jeanne Anderson, Lori Ashby, Kimberly Zohner, Ann M. Gronowski, Christopher W. Farnsworth

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
JournalClinical Biochemistry
DOIs
StateAccepted/In press - 2022

Keywords

  • Hemolysis
  • Short samples
  • Turn-Around-Time

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