{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:59:13Z","timestamp":1789732753001,"version":"4.0.1"},"reference-count":13,"publisher":"BMJ","issue":"3","funder":[{"name":"None"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2021,10,28]]},"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:p>Peripheral blood smear (PBS) review by a pathologist is a necessary and invaluable diagnostic tool. However, innovative highly sophisticated haematology analysers that flag peripheral blood abnormalities have decreased the need for a PBS review. Ordering practices including PBS reviews lumped as part of an \u2018order set\u2019 or with complete blood count (CBC) constituted most PBS requests at our institution. A retrospective review of all PBS review orders from 1 April 2016 to 31 January 2017 was performed to investigate the ordering practices at our institution. A total of 2864 PBS were ordered during the above study period. In many cases, the PBS report did not add any significant clinical information beyond that acquired by the CBC and differential count. These findings inspired policy changes within our institution for pathologist PBS reviews. Within the electronic order system, all PBS orders for inpatients were linked to a pop-up window with criteria for peripheral smear review and instructions on the approval policy. Outpatient orders required clinicians to request pathology approval. This implementation reduced total number of PBS orders by 42.5% with no adverse effect on patient management. Empowering pathologists and clinicians with guidelines on PBS review orders is a beneficial educational exercise of resource utilisation. Discussion with physicians regarding clinical indications reduces non-contributory PBS reviews, provides guidance to appropriate testing, and aptly allocates pathologist and laboratory staff time and resources.<\/jats:p>","DOI":"10.1136\/jclinpath-2021-207905","type":"journal-article","created":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T13:25:36Z","timestamp":1636982736000},"page":"154-158","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Educational cost-effective intervention to reduce pathologist\u2019s peripheral blood smears reviews with non-contributory findings: an academic institution experience"],"prefix":"10.1136","volume":"75","author":[{"given":"Trang K","family":"Lollie","sequence":"first","affiliation":[{"name":"Pathology and Laboratory Medicine, UCLA Medical Center, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Parks","sequence":"additional","affiliation":[{"name":"Pathology and Laboratory Medicine, UCLA Medical Center, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lissette","family":"Bakic","sequence":"additional","affiliation":[{"name":"Pathology and Laboratory Medicine, UCLA Medical Center, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Ziman","sequence":"additional","affiliation":[{"name":"Pathology and Laboratory Medicine, UCLA Medical Center, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1490-2374","authenticated-orcid":false,"given":"Sheeja","family":"Pullarkat","sequence":"additional","affiliation":[{"name":"Pathology and Laboratory Medicine, UCLA Medical Center, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,11,15]]},"reference":[{"key":"2025120523594713000_75.3.154.1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-015-0356-4"},{"key":"2025120523594713000_75.3.154.2","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1093\/ajcp\/aqy146","article-title":"Optimization of laboratory ordering practices for complete blood count with differential","volume":"151","author":"Shen","year":"2019","journal-title":"Am J Clin Pathol"},{"key":"2025120523594713000_75.3.154.3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3343\/alm.2013.33.1.1","article-title":"Purpose and criteria for blood smear scan, blood smear examination, and blood smear review","volume":"33","author":"Gulati","year":"2013","journal-title":"Ann Lab Med"},{"key":"2025120523594713000_75.3.154.4","doi-asserted-by":"publisher","DOI":"10.1309\/TVJW-ENEK-G1U3-WE0A"},{"key":"2025120523594713000_75.3.154.5","doi-asserted-by":"crossref","DOI":"10.1186\/s13000-020-01033-8","article-title":"Clinician-ordered peripheral blood smears have low reimbursement and variable clinical value: a three-institution study, with suggestions for operational efficiency","volume":"15","author":"Beckman","year":"2020","journal-title":"Diagn Pathol"},{"key":"2025120523594713000_75.3.154.6","doi-asserted-by":"crossref","first-page":"408","DOI":"10.5858\/arpa.2011-0535-OA","article-title":"Validation and optimization of criteria for manual smear review following automated blood cell analysis in a large university hospital","volume":"137","author":"Pratumvinit","year":"2013","journal-title":"Arch Pathol Lab Med"},{"key":"2025120523594713000_75.3.154.7","doi-asserted-by":"crossref","unstructured":"Chang B , Golardi N , Chen L . 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Measuring the clinical impact of pathologist reviews of blood and body fluid smears a laboratory outcome study 2007;131.","DOI":"10.5858\/2007-131-468-MTCIOP"},{"key":"2025120523594713000_75.3.154.11","first-page":"71","article-title":"Peripheral blood film - a review","volume":"12","author":"Adewoyin","year":"2014","journal-title":"Ann Ib Postgrad Med"},{"key":"2025120523594713000_75.3.154.12","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-015-0137-7"},{"key":"2025120523594713000_75.3.154.13","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPPGSA9D0HYNAH"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jclinpath-2021-207905","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T07:59:57Z","timestamp":1765007997000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jclinpath-2021-207905"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,15]]},"references-count":13,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,2,17]]},"published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1136\/jclinpath-2021-207905"],"URL":"https:\/\/doi.org\/10.1136\/jclinpath-2021-207905","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,15]]}}}