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Emerg Med J. 2007 May; 24(5): 372.
PMCID: PMC2658505

Reviewing blood test results: a worthwhile chore or a waste of time?

It has previously been the practice of many emergency departments (ED) in the UK to routinely review the blood test results of all discharged patients. This time‐consuming job is usually performed by a middle grade doctor to act as a safety net in case significantly abnormal blood tests were not acted upon at the time of presentation. We looked at all the blood test results of discharged patients over an 18‐month period in a UK ED to see whether discontinuing this practice could be justified. Of the 940 tests evaluated, 128 (13.6%) were abnormal and of these 9 (0.96%) were deemed significantly abnormal—that is, outside the normal range—with the potential to have a clinical effect, and did not have appropriate action documented in the notes by the ED doctor. These nine results were followed up by means of a telephone conversation with the patient's general practitioner. No harm to any patient was demonstrated as a result of the ED attendance. Three patients required further blood tests, all of which confirmed that the initial abnormal result had normalised without treatment. One patient required an outpatient ultrasound scan that confirmed the ED diagnosis of gall stones. Given our results, we concluded that the manual checking of all abnormal blood test results is not worthwhile and our department has discontinued this practice. It has, instead, been emphasised to all doctors that they must review all results of tests that they have requested in patients who are discharged directly from the ED. The responsibility of this lies entirely with the requesting doctor. The middle grade doctors will be eternally grateful at being able to relinquish the task and will also be more likely to benefit patients by spending their additional time on the shop floor.

Footnotes

Competing interests: None declared.


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