Submitted by Cathy Welsh, MS, RD
ever wondered which is faster: STAT, ASAP, rush, or now? The answer is that it
depends on how your facility has defined the processes around these different
The priority of an order can affect the functionality of the order in your
electronic medical record (EMR). For example, an order for a STAT blood draw
can print the requisition (request for service) to the nursing unit for the
nurse to collect the sample, whereas the blood draw ordered just as “routine”
will print to the laboratory department for a phlebotomist to collect during
priorities are defined differently for the pharmacy and for patient care orders
vs a lab order. For example, medication orders placed as STAT may not print requisitions
to the pharmacy at all, but may print on the unit for items that the nurse
pulls from the nearby Pyxis MedStation®.
message when considering your EMR priorities is that when everything is STAT,
nothing is STAT. People should choose the lowest level of urgency appropriate
to the request, so that when the situation is emergent, the resources are
available to meet that need in the minimum amount of time.
The problem was that physicians
entered the majority of orders as STAT, believing that to do anything else
would result in lengthy waiting times. This led to a heavy demand of laboratory
services, and a lack of responsiveness to “true” stat orders. To resolve the
problem, the facility had to define what each priority meant and to determine
realistic turnaround times.
These are the three main categories of priorities:
time of 45 minutes or less. These orders have the highest priority, reserved
for life-threatening situations, such as a serious allergic reaction. About 20%
of all orders actually are STAT.
time of 45 minutes to 2 hours. These “as soon as possible” orders are meant for
situations that are not life threatening, but where obtaining the result
quickly will have a significant clinical impact or prevent the backup of
workflow. For example, all orders placed in the emergency department are
considered “ASAP” at a minimum.
to 8 hours. Routine orders cover laboratory orders or procedures that are
obtained at the next most convenient time, taking the patient’s needs into
consideration. For example, you can postpone a routine lab until the routine
labs are drawn in the morning (4 am)
to minimize the amount drawn and the need to stick the patient an additional
time. About 30% to 50% of orders are
The result was that the number of
orders entered as STAT reduced significantly. Overall, results came back more
quickly and the length of stay was lowered.
Defining priorities is important. You
can flex reports, requisition printing, firing alerts, and other
functionalities to vary by priority. Get involved and become a part of any
conversations that are happening at your facility. Remember, when everything is
STAT, nothing happens very quickly.