The feasibility and impact of midnight routine blood draws on laboratory orders and processing time.
OBJECTIVE
To evaluate the feasibility of midnight routine blood draws and assess their impact on test result availability and stat laboratory orders.


METHODS
We changed the timing of routine blood draws from early morning to midnight on five inpatient wards during the period November 16 to 30, 2011.


RESULTS
For the entire institution, of all orders placed each day, laboratory test orders placed from 4:00 to 8:00 am decreased from 55% to 39%, and those placed from 12:00 to 4:00 am increased from 12% to 30%. Stat orders per day decreased during the intervention period (301 ± 53 vs 344 ± 55, P = .04). Morning specimens were more likely to be available by 9:00am (78.1% vs 58.9%, P < .001), and their turnaround time improved by 25.8 minutes (158 vs 184 minutes, P < .001). Patient survey revealed potential preference for midnight blood draws.


CONCLUSIONS
Midnight is a feasible alternative for the timing of routine blood draws. Redesigning inflow of laboratory orders improved efficiency of laboratory processing and reduced stat orders.
From the Departments of Medicine.
Atsushi
A
Sorita
Psychiatry, apatterson@chpnet.org.
Aaron
A
Patterson
Neurology.
Patrick
P
Landazuri
Family Medicine.
Stacy
S
De-Lin
Nursing.
Colleen
C
Fischer
Emergency Medicine, and.
Gregg
G
Husk
Executive Administration, Mount Sinai Beth Israel, New York, NY. Dr Sorita is currently with the Division of Preventive Medicine, Mayo Clinic, Rochester, MN, and Dr Landazuri is with the Department of Neurology, University of Kansas Medical Center, Kansas City.
Latha
L
Sivaprasad
D001800:Blood Specimen Collection / Q000379:methods* / Q000706:statistics & numerical data; D003625:Data Collection; D004526:Efficiency; D005240:Feasibility Studies; D006801:Humans; D007755:Laboratories, Hospital / Q000592:standards*; D017063:Outcome Assessment, Health Care; D011786:Quality Control; D013997:Time Factors; D014481:United States
Flow management; Laboratory turnaround times; Routine blood draws; Stat laboratory test orders