A patient arrives for a fasting glucose or a lipid profile, and mentions the toast they had on the way in. Now the clinic has two bad options: take the sample and flag it, or send them home and rebook. Either way someone loses a morning, and in most cases the patient did nothing wrong. Nobody told them clearly what fasting meant, or the time they booked made it close to impossible.
of patients arrived properly fasted for their blood test in one laboratory study. More than half said they had received no information at all about how to prepare.
Source: Kačkov et al., Biochemia Medica, 2013Where fasting goes wrong
Very little of it is about willpower. Most failures are set up long before the patient walks in, at the moment they book.
- A 3pm slot for a test that needs a 10 to 12 hour fast
- Instructions sent after booking, buried in a confirmation email nobody reads twice
- Vague wording like "please fast", which leaves people guessing about coffee, chewing gum, or their usual tablets
- Two tests booked together where only one needs fasting, and the instructions only cover the other
Only offer times that make fasting realistic
A 12 hour fast is easy when it runs overnight and the appointment is first thing. It is miserable when the appointment is mid afternoon. So give each fasting test a latest start time, such as 10:30, and stop offering anything later. Hiding unsuitable times works far better than warning about them. Patients skim warnings, but they cannot pick a time that is not there.
(opens full size in a new tab)Explain fasting in plain words, before they book
"Fast before your test" means different things to different people. Spell it out, and show it on the booking page before the patient confirms, not only afterwards.
- Give the exact number of hours: "Don't eat for 10 hours before your appointment."
- Say what is allowed: plain water, yes. Tea, coffee, juice, and chewing gum, no.
- Say what to do about regular medication, in your clinicians' own words
- Repeat the same wording in the confirmation, and in a reminder the evening before
When tests are booked together, take the strictest rule
A full blood count needs no fast. A lipid profile often does. Booked together in one appointment, the whole visit needs the fast, the morning slot, and both tests' preparation steps, with any repeated lines shown once. Build this rule into how bookings work, rather than trusting reception to remember it on a busy Monday.
(opens full size in a new tab)A quick checklist
- Every fasting test has its fasting hours and a latest start time recorded
- Online booking only offers times before that cut-off
- Patients see why the times are limited
- Instructions say exactly what is and is not allowed
- The same instructions appear in the confirmation and the evening-before reminder
- Combined bookings automatically take the strictest rule
The screens above come from the demo of Drawn, a booking system for blood testing clinics that we are building. The clinic in it is made up, so you can book a fasting test yourself and see these rules at work.
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