Appropriate design of biochemistry request cards can promote the use of protocols and reduce unnecessary investigations.

Attempts to control laboratory workload in the past always proved to be short-lived. We designed a request card based on clinical conditions for a gynaecology out-patient clinic to help clinical staff to adhere to agreed investigation protocols. Each request card had a tick-box associated with a clinical condition. The tests performed for each condition were advertised on a poster in the clinic. The workload was assessed for a 2-year period before and after the introduction of these cards. The numbers of all endocrine tests, except progesterone and sex hormone binding globulin, fell by 19% (P<0.0001) whereas the clinical cases seen remained steady at 227 per month. This report demonstrates that agreed protocols can be implemented but that a persistent aide-mémoire is necessary.