Tags

Type your tag names separated by a space and hit enter

Seeing Red: Blood Sample Hemolysis Is Associated with Prolonged Emergency Department Throughput.
J Appl Lab Med. 2020 Jul 01; 5(4):732-737.JA

Abstract

INTRODUCTION

Hemolyzed emergency department (ED) blood specimens impose substantial burdens on various aspects of delivering care. The ED has the highest incidence of hemolysis among hospital departments. This study assessed the association and potential impact of hemolyzed blood samples on patient throughput time using ED length of stay (LOS) as the primary outcome measure.

METHODS

This study was a secondary analysis of data collected during a performance improvement project aimed at reducing the incidence of hemolysis in ED blood specimens. The electronic medical record was queried for potassium orders and results and for key patient throughput time points. Throughput times were stratified according to hemolysis, ED disposition (admitted vs discharged), and Emergency Services Index (ESI) triage categorization. Two-tailed t tests were used to compare throughput times for patients with and without hemolysis.

RESULTS

Potassium values were reported for 11 228 patient visits. The mean ED LOS was 287 minutes for patients with nonhemolyzed samples and 349 minutes for patients who had hemolyzed samples, a mean delay of 62 minutes. The mean throughput time for discharged patients was 92 minutes shorter in the group without hemolysis (337 vs 429 minutes). The mean throughput time for admitted patients was 28 minutes shorter in the group without hemolysis (264 vs 292 minutes). The increased LOS for patients with a hemolyzed blood sample was independent of the most commonly encountered ESI levels.

CONCLUSION

Hemolysis of blood samples obtained in the ED is associated with patient throughput via delays in patient disposition, independent of various markers of acuity, such as the patients' ultimate disposition or triage categorization.

Authors+Show Affiliations

Emergency Services Institute, Cleveland Clinic, Cleveland, OH.Emergency Services Institute, Cleveland Clinic, Cleveland, OH.Northeast Ohio Medical University, Rootstown, OH.Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32603446

Citation

Phelan, Michael P., et al. "Seeing Red: Blood Sample Hemolysis Is Associated With Prolonged Emergency Department Throughput." The Journal of Applied Laboratory Medicine, vol. 5, no. 4, 2020, pp. 732-737.
Phelan MP, Hustey FM, Good DM, et al. Seeing Red: Blood Sample Hemolysis Is Associated with Prolonged Emergency Department Throughput. J Appl Lab Med. 2020;5(4):732-737.
Phelan, M. P., Hustey, F. M., Good, D. M., & Reineks, E. Z. (2020). Seeing Red: Blood Sample Hemolysis Is Associated with Prolonged Emergency Department Throughput. The Journal of Applied Laboratory Medicine, 5(4), 732-737. https://doi.org/10.1093/jalm/jfaa073
Phelan MP, et al. Seeing Red: Blood Sample Hemolysis Is Associated With Prolonged Emergency Department Throughput. J Appl Lab Med. 2020 Jul 1;5(4):732-737. PubMed PMID: 32603446.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Seeing Red: Blood Sample Hemolysis Is Associated with Prolonged Emergency Department Throughput. AU - Phelan,Michael P, AU - Hustey,Fredric M, AU - Good,Daniel M, AU - Reineks,Edmunds Z, PY - 2019/09/11/received PY - 2020/04/20/accepted PY - 2020/7/1/entrez PY - 2020/7/1/pubmed PY - 2020/7/1/medline KW - Emergency Medicine KW - hemolysis KW - poor sample KW - pre-analytical KW - rework KW - throughput KW - waste SP - 732 EP - 737 JF - The journal of applied laboratory medicine JO - J Appl Lab Med VL - 5 IS - 4 N2 - INTRODUCTION: Hemolyzed emergency department (ED) blood specimens impose substantial burdens on various aspects of delivering care. The ED has the highest incidence of hemolysis among hospital departments. This study assessed the association and potential impact of hemolyzed blood samples on patient throughput time using ED length of stay (LOS) as the primary outcome measure. METHODS: This study was a secondary analysis of data collected during a performance improvement project aimed at reducing the incidence of hemolysis in ED blood specimens. The electronic medical record was queried for potassium orders and results and for key patient throughput time points. Throughput times were stratified according to hemolysis, ED disposition (admitted vs discharged), and Emergency Services Index (ESI) triage categorization. Two-tailed t tests were used to compare throughput times for patients with and without hemolysis. RESULTS: Potassium values were reported for 11 228 patient visits. The mean ED LOS was 287 minutes for patients with nonhemolyzed samples and 349 minutes for patients who had hemolyzed samples, a mean delay of 62 minutes. The mean throughput time for discharged patients was 92 minutes shorter in the group without hemolysis (337 vs 429 minutes). The mean throughput time for admitted patients was 28 minutes shorter in the group without hemolysis (264 vs 292 minutes). The increased LOS for patients with a hemolyzed blood sample was independent of the most commonly encountered ESI levels. CONCLUSION: Hemolysis of blood samples obtained in the ED is associated with patient throughput via delays in patient disposition, independent of various markers of acuity, such as the patients' ultimate disposition or triage categorization. SN - 2576-9456 UR - https://www.unboundmedicine.com/medline/citation/32603446/Seeing_Red:_Blood_Sample_Hemolysis_Is_Associated_with_Prolonged_Emergency_Department_Throughput L2 - http://jalm.aaccjnls.org/cgi/pmidlookup?view=long&pmid=32603446 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.