Phlebotomy, stat testing and laboratory organization: an intriguing relationship

Stat or urgent testing is a conventional circumlocution, which is used to designate timely or “ rush ” performance of laboratory tests. The term “ stat ” is literally derived from the Latin word “ statim ” , which actually means “ immediately ” . In the daily practice, this concept is used to defi ne a series of activities or processes required to obtain rapid test results for the immediate management of life-threatening conditions, and thereby involves typically rapid access information on blood gases, glucose, electrolytes, coagulation tests, enzymes of acute cytolysis (e.g., alanine aminostransferase or lipase) and cardiac troponins, among others. It thereby designates the highest degree of medical priority, so that the laboratory staff should ideally interrupt what they are doing to run the test immediately. In a broader perspective, this definition can be enlarged to embrace all those conditions – even when not really life-threatening – that would require rapid diagnostic or therapeutic decision, either clinically or organizationally driven. Typical cases may be those of patients urging therapeutic adjustment or rapid diagnostic testing before undergoing surgery, or requiring fast test results for being discharged from the emergency department (ED) or intensive care unit (ICU). The ideal – although not really exclusive – stakeholders of stat testing are thereby the emerging physicians (and/or nurses) working in EDs or ICUs, whereby time is always critical for both clinical (i.e., serious pathologies) and organizational (i.e., overcrowding) issues. While in the past laboratory professionals have often overlooked timeliness as an important attribute, clinicians often judge the adequacy of laboratory services by the speed with which results are reported. In the last decades, however, both for the developments of point-of-care (POC) technologies and reorganization of acute care in hospitals, laboratory professionals have considered this important issue more in-depth.

[1]  A. Šimundić,et al.  Laboratory networking and sample quality: a still relevant issue for patient safety , 2012, Clinical chemistry and laboratory medicine.

[2]  P. Janssens,et al.  Reducing the number of clinical stat phlebotomy orders: feasible or not? , 2012, Clinical chemistry and laboratory medicine.

[3]  G. Lippi,et al.  Primary blood tubes mixing: time for updated recommendations , 2012, Clinical chemistry and laboratory medicine.

[4]  G. Lippi,et al.  Appropriate labelling of blood collection tubes: a step ahead towards patient’s safety , 2011, Clinical chemistry and laboratory medicine.

[5]  M. Plebani,et al.  Pneumatic tube delivery systems for patient samples: evidence of quality and quality of evidence , 2011, Clinical chemistry and laboratory medicine.

[6]  A. Šimundić,et al.  Preanalytical quality improvement: from dream to reality , 2011, Clinical chemistry and laboratory medicine.

[7]  M. Salinas,et al.  Article in press-uncorrected proof Letter to the Editor Stat laboratory timeliness management according to clinician needs , 2011 .

[8]  D. Giavarina,et al.  Stat laboratory testing: integration or autonomy? , 2010, Clinical chemistry and laboratory medicine.

[9]  Mario Plebani,et al.  The “hospital central laboratory”: automation, integration and clinical usefulness , 2010, Clinical chemistry and laboratory medicine.

[10]  G. Lippi,et al.  Laboratory testing in pharmacies , 2010, Clinical chemistry and laboratory medicine.

[11]  G. Lippi,et al.  Improving the post-analytical phase , 2010, Clinical chemistry and laboratory medicine.

[12]  A. Šimundić,et al.  Total quality in laboratory diagnostics. It’s time to think outside the box. , 2010 .

[13]  A. Šimundić,et al.  Self reported routines and procedures for the extra-analytical phase of laboratory practice in Croatia - cross-sectional survey study , 2010 .

[14]  G. L. Salvagno,et al.  Recommendations for collection of venous blood | Raccomandazioni per il prelievo di sangue venoso , 2008 .

[15]  The skilled phlebotomist. , 2006, Archives of pathology & laboratory medicine.

[16]  G. Lippi,et al.  Preanalytical variability: the dark side of the moon in laboratory testing , 2006, Clinical chemistry and laboratory medicine.

[17]  G. Lippi,et al.  Phlebotomy issues and quality improvement in results of laboratory testing. , 2006, Clinical Laboratory.

[18]  K. Blick.  No more STAT testing. , 2005, MLO: medical laboratory observer.

[19]  R. Simpson,et al.  Improving access to diagnostics: an evaluation of a satellite laboratory service in the emergency department. , 2004, Emergency medicine journal : EMJ.

[20]  Mario Plebani,et al.  Process Control Reduces the Laboratory Turnaround Time , 2002, Clinical chemistry and laboratory medicine.

[21]  P. J. Howanitz,et al.  Laboratory results. Timeliness as a quality attribute and strategy. , 2001, American journal of clinical pathology.

[22]  E. Kilpatrick,et al.  Use of computer terminals on wards to access emergency test results: a retrospective audit , 2001, BMJ : British Medical Journal.

[23]  S J Steindel,et al.  Evaluating stat testing options in an academic health center: therapeutic turnaround time and staff satisfaction. , 1998, Clinical chemistry.

[24]  R. Gräsbeck,et al.  Recommendation for collection of venous blood from children, with special reference to production reference values. , 1990, Scandinavian journal of clinical and laboratory investigation.

[25]  Standardization of blood specimen collection procedure for reference values. International Committee for Standardization in Haematology (ICSH). , 1982, Clinical and laboratory haematology.