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Drawing "Rainbows": A bad and expensive practice

Not cost effective, researchers say

by Dennis Ernst • June 16, 2021



When you draw stat lab work on new ER patients or newly admitted patients, do you draw more tubes than what was ordered just in case more tests are added on later? One hospital found this practice was costing them hundreds of thousands of dollars every year.

Drawing tubes with wide variety of colored stoppers, also known as “drawing a rainbow”, is standard practice at many facilities. The assumption is that physicians will order additional tests that could require a second venipuncture, and they will get those results faster if the person drawing blood for the original order draws extra tubes in anticipation. Spectrum Health Hospitals in Grand Rapids, Michigan found this assumption to be eating their lunch.

According to an article in MLO magazine, the facility found only four percent of the extra tubes were ever used for testing, each tube taking nearly two minutes to process. They also discovered the staff was spending more time drawing and processing extra tubes than they were saving by not having to perform a second venipuncture. After calculating the additional costs to draw and manage tubes without orders, the cost of the extra tubes, and their disposal, the facility estimated a cost savings of $200,200 per year by discontinuing the practice.

Armed with these compelling statistics, the process improvement team at Spectrum Health was able to convince the ED and laboratory that drawing a rainbow of tubes on every patient was a low-value practice. After implementing a process change that permitted extra tubes be drawn only when requested by physicians, the projected savings of over $200,000 per year were realized.

Does your facility waste thousands on drawing unnecessary tubes in the ED and elsewhere? Conducting your own process-improvement study just may reveal the proverbial pot of gold really does exist at the end of the rainbow.

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