Responsible Pathology Requesting

The responsible requesting initiative will start on 17 September 2012.  It aims to reduce repeated and unnecessary pathology testing, minimise harm to patients and save valuable resources.  In the table below, the minimum re-test intervals are listed.  Test requests that breach the minimum frequency threshold will not be processed.  It is recognised that repeat testing more frequently may be necessary if there is an overriding clinical need.  In such cases there is a simple override procedure which is detailed below.

If you have any concerns with the minimum frequency testing and its impact on patient care even after reference to the ability to override then please discuss this with your lead clinician or clinical director.

Table of Minimum Re-Test Intervals

 Test Name Test Interval 
 Full Blood Count (FBC) 12 Hours 
 Urea and Electrolytes (U+E) 12 Hours 
 C Reactive Protein (CRP) 24 Hours 
 Liver Function Test (LFT) 1.5 Days 
 Calcium Profile / Phosphate (Ca / PO4) 1.5 Days 
 Magnesium (Mg) 1.5 Days 
 Erythrocyte Sedimentation Rate (ESR) 7 Days 
 Serum Vitamin B12 56 Days 
 Folate 21 Days 
 Ferritin 21 Days 
 Progesterone 7 Days 
 Prolactin 7 Days
 Oestradiol 7 Days 
 Luteinizing Hormone (LH) 7 Days 
 Follicular Stimulating Hormone (FSH) 7 Days
 Anti Neutrophil Cytoplasmic Antibodies (ANCA) 14 Days 
 Anti Nuclear Antibodies (ANA) 20 Days 
 Immunoglobulins (Ig) 28 Days 
 Glycosylated Hb / Haemoglobin A1C (HbA1C) 40 Days 
 Vitamin D 28 Days 
 Lipids           28 Days 
 Ca125 13 Days 
 C100 13 Days 
 Alpha-fetoprotein (AFP) 6 Days 
 Prostate Specific Antigen (PSA) 13 Days 
 Insulin Like Growth Factor (IGF-1) 14 Days 
 Autoantibody Screen 90 Days 
 Complement C3,C4 90 Days 
 Protein Electrophoresis 180 Days 
   
   
   
   
   
   
   

 

Override Procedure in the event of urgent clinical need

Clearly write "OVERRIDE" on the request form making it clear to which test this applies.  We will assume that such requests are authorised by the name on the request card.  If this is not the case, please write a legible name next to "OVERRIDE".  We will audit this process to ensure the system is used responsibly.

Once tests have been rejected (because the minimum re-test interval has been exceeded) it is still possible for the lab to process them, should there be an urgent clinical need to do so. There is a declaration form for this purpose which must be completed in full and sent to the laboratory.

 

      Dr Mike Bosomworth                                      Professor Mark Wilcox                                     Dr A B Gill
Lead Clinician - Blood Sciences                         Clinical Director - Pathology                          Deputy Medical Director                    

 


Page updated: 17/09/2012  | Updated by: Michael O'Sullivan

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