The feasibility and impact of midnight routine blood draws on laboratory orders and processing time

Objectives: 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 9:00 AM (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.