September 2014—Occasionally on certain patients, when we draw for a CBC in the early morning, we get a low Hgb of 6 or 7 g/dL. We draw the same patient for a CBC in the afternoon and we get a higher Hgb by at least 1–1.5 g/dL. Can you explain the reason for this difference? We would like to standardize reference ranges throughout our system of regional facilities, using our main laboratory to establish the ranges. How does the CAP view using the transference process as described in CLSI document C28-A3C, Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory; Approved Guideline? Is this an approved method for establishing reference ranges? Is it an acceptable process once the laboratory director approves it?
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