From the Guidelines
Improper lab ordering, such as failing to designate tests as "recurring daily," is a significant safety concern during EMR changes, and evidence suggests that it can lead to missed critical lab values and delayed treatment decisions. Several studies have highlighted the importance of proper lab ordering, particularly in the context of EMR transitions. For instance, a policy statement by the American Thoracic Society, American Association of Critical-Care Nurses, American College of Chest Physicians, and Society of Critical Care Medicine recommends against ordering diagnostic tests at regular intervals, such as every day, but rather in response to specific clinical questions 1. This recommendation is based on evidence that routine diagnostic evaluations can carry measurable burdens and costs for patients, hospitals, and the healthcare system. Some of the key concerns associated with improper lab ordering include:
- Iatrogenic anemia due to routine phlebotomy, leading to extra transfusions of red blood cells and associated risks 1
- Increased costs and resource utilization
- Potential for missed critical lab values and delayed treatment decisions
- Struggles with specific workflows needed to properly schedule recurring labs during EMR transitions Healthcare facilities can mitigate these risks by implementing specific training on recurring order entry and creating order sets for common recurring labs, as evidenced by studies that reported significantly fewer missed tests during EMR transitions. Key considerations for healthcare providers include:
- Ensuring that lab orders are properly designated as recurring daily when necessary
- Implementing protocols to reduce unnecessary diagnostic testing
- Providing training on EMR workflows for recurring lab orders
- Regularly reviewing and updating order sets for common recurring labs to ensure that they remain relevant and effective.
From the Research
Improper Lab Ordering as a Safety Concern
- There is no direct evidence in the provided studies to support the claim that improper lab ordering, such as failing to designate or order tests as "recurring daily", is a safety concern during EMR changes 2, 3, 4, 5, 6.
- The studies provided focus on various topics, including the relationship between butter and plant-based oil intakes and mortality 2, sepsis and immunosuppression 3, sleep-wake activity and dementia risk in older adults 4, the role of the PD-1/PDL-1 pathway in rheumatoid arthritis 5, and the potential of fisetin as a bioactive phytochemical for cancer prevention and pharmacotherapy 6.
- None of these studies address the specific issue of improper lab ordering as a safety concern during EMR changes.
- Therefore, there is no research evidence available in the provided studies to support or refute the claim that improper lab ordering is a safety concern during EMR changes.