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Unnecessary repeat requesting of tests: an audit in a government hospital immunology laboratory

Clinical Immunology Division, Department of Pathology, Queen Mary Hospital, Pokfulam Road, Hong Kong

Correspondence to:
Dr J Kwok
Department of Pathology, Queen Mary Hospital, Pokfulam Road, Hong Kong; kwoksy{at}ha.org.hk
ABSTRACT
Unnecessary repeat requesting of tests can make up a large proportion of a laboratory’s workload. This audit set out to establish the size of this problem and to identify the circumstances under which these repeat requests were made in a government tertiary hospital immunology laboratory. The numbers of tests for immunoglobulin measurement, common autoantibodies, and tumour markers that were repeated over a 12 month period were analysed by interrogating the Delphic laboratory computer system using a management information system for raw data enquiry protocol. Repeat requests within 12 weeks of a previous request made up 16.78% of the total workload. The total cost of the tests was estimated at US$ 132 151. The waste of technician time and reagents as a result of unnecessary repeat testing is excessive. Many of these tests might be eliminated with the use of interventions such as computerised reminders.

Abbreviations: ADNA, anti-double stranded DNA antibodies; AENA, anti-extractable nuclear antigen antibodies; AFP, fetoprotein; AGPC, anti-gastric parietal cell antibodies; AMA, antimitochondrial antibodies; ANA, antineutrophil antibodies; ASM, anti-smooth muscle antibodies; CEA, carcinoembryonic antigen; PSA, prostate specific antigen; RF, rheumatoid factor

Keywords: Hong Kong; immunology laboratory; cost; intervention; unnecessary repeat

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