Trustees approve ending in-house CK‑MB and phenytoin tests; lower hemoglobin "panic" threshold to 7 g/dL

The Share Medical Center Board of Trustees approved medical staff recommendations to discontinue in-house testing for CK‑MB (an older cardiac enzyme test) and phenytoin levels, and to change the laboratory's hemoglobin "panic" call threshold from less than 8 g/dL to less than 7 g/dL.

Dr. Burton, speaking for medical staff, said clinicians discussed the tests during the medical-staff meeting and concluded the two in-house assays were performed infrequently and could be sent to an outside laboratory at lower cost without affecting care. He said CK‑MB is largely superseded by troponin testing for chest‑pain evaluation.

The board heard cost comparisons: last year the hospital performed 28 CK‑MB tests in-house at a cost of $2,286.97; outsourcing those tests would have cost about $112. Dr. Burton said the hospital ran 15 phenytoin tests last year at an in-house cost of $687.75 versus about $165 if sent out. Trustees said shifting those low-volume tests offsite would reduce laboratory expense and workload.

On panic values, medical staff recommended lowering the hemoglobin threshold that triggers a 24/7 laboratory call to ordering clinicians from less than 8 g/dL to less than 7 g/dL. Dr. Burton said the change aligns with contemporary standards of care and will reduce the number of immediate calls the lab must make while maintaining clinical safety.

A motion to approve items 5b–5d (the two test discontinuations and the panic-value change) was made and seconded; the board approved the measures by roll call: Simon — yes; Mossberg — yes; Brown — yes; Hannaford — yes; Martin — yes; Bowman — yes; Burke — yes.