{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:19:18Z","timestamp":1740136758100,"version":"3.37.3"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T00:00:00Z","timestamp":1664928000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Tube shortage laboratory stewardship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Manufacturer recalls and altered supply chains during the coronavirus disease 2019 (COVID-19) pandemic caused a nationwide shortage of blue-top tubes (BTTs). Most non\u2013point-of-care coagulation tests use these tubes, leaving laboratories and health care facilities in short supply. The Department of Pathology and Laboratory Medicine at Cedars-Sinai Medical Center implemented interventions to conserve supply without sacrificing patient safety.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In a retrospective quality improvement analysis, we examined coagulation testing and BTT utilization over the 3-month interval during which our interventions were applied. Our study assessed the interventions\u2019 effectiveness by evaluating changes in BTT utilization, coagulation testing volume, and patient impact.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Average daily use (ADU) of BTT before and after the intervention were 476 and 403, respectively\u2014a 15.2% reduction. Notably, the Emergency Department had a reduction in ADU of 43.3%. Average daily volumes of coagulation assays performed decreased from 949 to 783\u2014a 17.5% reduction. No adverse events from the Pharmacy Department were identified during the study period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Interventions resulting in significant reductions were in divisions with effective management and supervision. Success in navigating the BTT shortage stemmed from timely announcements, action, and effective communication. Our recommendations established more effective coagulation assay utilization, decreased overall BTT use, and prevented patients with coagulopathic disorders from experiencing adverse consequences.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajcp\/aqac121","type":"journal-article","created":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T17:30:05Z","timestamp":1664991005000},"page":"730-738","source":"Crossref","is-referenced-by-count":2,"title":["Changes in Coagulation Testing During a National Shortage of Blue-Top Tubes"],"prefix":"10.1093","volume":"158","author":[{"given":"Hannah G","family":"Schuett","sequence":"first","affiliation":[{"name":"Departments of Pathology and Laboratory Medicine , Los Angeles, CA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6285-7585","authenticated-orcid":false,"given":"Oksana","family":"Volod","sequence":"additional","affiliation":[{"name":"Departments of Pathology and Laboratory Medicine , Los Angeles, CA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anders H","family":"Berg","sequence":"additional","affiliation":[{"name":"Departments of Pathology and Laboratory Medicine , Los Angeles, CA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyu","family":"Rhee","sequence":"additional","affiliation":[{"name":"Departments of Pathology and Laboratory Medicine , Los Angeles, CA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sam S","family":"Torbati","sequence":"additional","affiliation":[{"name":"Emergency Medicine Los Angeles, CA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard V","family":"Riggs","sequence":"additional","affiliation":[{"name":"Medical Affairs, Cedars-Sinai Medical Center , Los Angeles, CA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David P","family":"Frishberg","sequence":"additional","affiliation":[{"name":"Departments of Pathology and Laboratory Medicine , Los Angeles, CA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,10,5]]},"reference":[{"author":"Class 2 device recall VACUETTE blood collection tube 9NC coagulation sodium citrate 3.2.","key":"2022120107124220900_CIT0001"},{"author":"Sodium citrate blood specimen collection tube conservation strategies\u2014letter to health care and laboratory personnel.","key":"2022120107124220900_CIT0002"},{"author":"Blue top tube recommendations.","key":"2022120107124220900_CIT0003"},{"key":"2022120107124220900_CIT0004","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s12959-021-00284-9","article-title":"Prevalence and risk factors of thrombotic events on patients with COVID-19: a systematic review and meta-analysis","volume":"19","author":"Xiong","year":"2021","journal-title":"Thromb J."},{"key":"2022120107124220900_CIT0005","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.mayocp.2020.10.031","article-title":"Coronavirus disease 2019-associated coagulopathy","volume":"96","author":"Lippi","year":"2021","journal-title":"Mayo Clin Proc."},{"key":"2022120107124220900_CIT0006","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.1111\/jth.14929","article-title":"Scientific and Standardization Committee communication: clinical |guidance on the diagnosis, prevention, and treatment of venous thromboembolism in hospitalized patients with COVID-19","volume":"18","author":"Spyropoulos","year":"2020","journal-title":"J Thromb Haemost."},{"author":"Facts and reports","key":"2022120107124220900_CIT0007"},{"key":"2022120107124220900_CIT0008","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1093\/ajcp\/aqac035","article-title":"Laboratory supply shortages","volume":"158","author":"Hilborne","year":"2022","journal-title":"Am J Clin Pathol."}],"container-title":["American Journal of Clinical 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