Laboratory utilization in the emergency department – Are the requested tests patient-oriented?

Abstract

Emergency laboratory services are essential for the efficient management of critically ill patients admitted to the emergency department. Characterised by their high priority of processing, analysing and reporting, they serve as a discriminating tool in the triage of medical emergencies, rather than as a diagnostic tool. Optimal and adequate utilisation of laboratory testing greatly contributes to the overall quality and efficiency of laboratory services. From our experience gained through monitoring the ordering habits among physicians at the Emergency Medical Service of the University Hospital Centre Zagreb, non-selective overuse of laboratory tests occurs in practice. The most commonly used laboratory tests are often ordered together and at a negligible variation between physicians, regardless of a widely varied patient population. Patient-oriented laboratory diagnostics can be achieved through limiting the availability of test ordering, an application of test panels based on relevant guidelines and protocols and upkeep of continuous close interaction between clinicians and laboratory experts.