SHM Converge Scientific Abstract ePoster Gallery-A Multi-Faceted Approach to Reducing Extended Respiratory Viral Testing in a Large Municipal Hospital System

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A quality improvement project at New York City Health + Hospitals, the largest U.S. public hospital system, aimed to reduce unnecessary extended respiratory viral panel (RVP) testing. Extended RVPs are often low-value for immunocompetent patients, adding cost, discomfort, anxiety, and possible false positives without improving management in most cases.<br /><br />The intervention used a multifaceted EMR-based strategy across inpatient, emergency, and ambulatory settings. This included updated test display titles, mandatory clinical decision support prompts, and a Best Practice Advisory alert for the three most frequently ordered extended RVP tests. In adult emergency and ambulatory settings, extended RVP ordering was restricted or removed because of low clinical utility. The system also encouraged more targeted Influenza/RSV/COVID-19 testing when appropriate, especially for patients who were not severely ill or immunocompromised.<br /><br />Results showed that systemwide extended RVP use decreased by 53.8%, preventing an estimated 14,021 tests per year. There were small increases in antibiotic prescribing in outpatient adult and pediatric emergency department settings, but these changes were not clinically meaningful.<br /><br />Overall, the study concluded that combining informed clinical decision support with targeted ordering restrictions can significantly and sustainably reduce low-value respiratory viral testing at scale, without causing important increases in antibiotic use.

Asset Subtitle

Surafel Tsega

Meta Tag

Author List Joseph Talledo, Milana Zaurova, Mohit Hans, Mona Krouss, Peter Alarcon Manchego, Surafel Tsega

Category Research

Concept Extended Respiratory Viral Panel

Concept Low-Value Testing

Concept Immunocompetent Patient

Concept Targeted Restriction

Concept Clinical Utility

Distinguished Non-Finalist

Presenter Organization New York City Health + Hospitals

Presenting Author Surafel Tsega

Track Value in Hospital Medicine

Keywords

quality improvement

extended respiratory viral panel

RVP testing

New York City Health + Hospitals

clinical decision support

electronic medical record

low-value care

respiratory viral testing

antibiotic prescribing

test utilization reduction

Extended Respiratory Viral Panel

Low-Value Testing

Immunocompetent Patient

Targeted Restriction

Clinical Utility