Repeated daily panels on stable inpatients are among the commonest low-value tests in medicine: urea, liver enzymes, coagulation profiles, ESR and repeat B12 or folate are the usual offenders. They add up to blood loss, hospital-acquired anaemia, cost and incidental findings that lead to more testing.
The habit is easy to change on a ward round. For each standing order, ask what result would alter management; if no answer comes, stop it.
- Avoid open-ended daily lab orders; set a stop date or review point.
- Repeat a coagulation profile only when there is bleeding, a procedure, liver failure or warfarin to monitor.
- Vitamin B12 and folate rarely need repeating during a single admission.
- Send urine cultures only when urinary symptoms or sepsis without another source are present, not on a positive dipstick alone.
Why it matters
Routine daily tests cause anaemia, cost and incidental findings without helping the patient.
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