title: Autovalidation rates in an outpatient coagulation laboratory.
abstract: BACKGROUND
  To determine the rates of autovalidation in our outpatient coagulation laboratory.
  
  
  METHODS
  We retrospectively identified all coagulation tests analyzed during the month of January 2014 from our laboratory information system (LIS) (N = 16 116), from around 800 000 active members of Clalit Health Services (a health maintenance organization). The integrated system includes a single centrifugation of all collection tubes, analyzers that rerun or reflex tests according to the test results, and a laboratory information system that sends orders to the analyzer, autovalidates test results, and automatically sends critical value results to a list for immediate physician communication. Reasons for technician validation are tests rerun for confirmation or because of analyzer errors and test results that require reflex testing. All other test results are sent automatically to the laboratory information system without the need for technician review.
  
  
  RESULTS
  There were 362 test results with analyzer errors, 91 results rerun for confirmation (thrombophilia test results outside the reference interval), and 50 tests with mixing studies and reflex testing for factor XI activity levels (total = 3.1%, 503/16116), resulting in an autovalidation rate of 96.9% (95% confidence interval - 96.6-97.2%).
  
  
  CONCLUSIONS
  We conclude that an integrated system can result in a high autovalidation rate in a high-volume outpatient coagulation laboratory.
authors.affiliation: Regional Laboratory, Haifa and Western Galilee, Clalit Health Services, Nesher, Israel.
authors.forename: P
authors.initials: P
authors.lastname: Froom
authors.affiliation: Regional Laboratory, Haifa and Western Galilee, Clalit Health Services, Nesher, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Saffuri-Elias
authors.affiliation: Regional Laboratory, Haifa and Western Galilee, Clalit Health Services, Nesher, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Barak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001777:Blood Coagulation; D001780:Blood Coagulation Tests / Q000592:standards*; D005260:Female; D006801:Humans; D007755:Laboratories, Hospital / Q000592:standards*; D008297:Male; D008490:Medical Informatics / Q000379:methods; D008875:Middle Aged; D010045:Outpatients; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results; D012189:Retrospective Studies; D057188:Workflow; D055815:Young Adult
keywords: Blood coagulation; clinical laboratory technicians; operations research; work flow