SHM Converge Scientific Abstract ePoster Gallery-Cutting the Draw : Data Transparency and Peer Feedback Reduce Unnecessary Daily Labs

Pdf Summary

This project aimed to reduce unnecessary routine daily blood draws at Emory Saint Joseph’s Hospital, where chart reviews showed that 30–40% of testing was likely unnecessary in stable patients. The team focused on hospital medicine inpatients and tracked routine blood draw orders per patient-day and per hospitalist work-hour using Epic Cogito data.<br /><br />The intervention began in February 2023 and included educational sessions based on ABIM Choosing Wisely guidelines, price transparency information to raise cost awareness, comparative dashboards showing group and individual performance, email and meeting feedback, and 1:1 interviews and surveys to give personalized feedback on ordering patterns.<br /><br />Results showed sustained improvement. Routine blood draws per patient-day decreased 4% overall over seven months, from 1.00 to 0.96, with a 9% quarterly reduction by May–July. After provider-specific data were shared in April 2023, rates dropped 15% in one month. Routine blood draws per hospitalist work-hour also fell 27%, from 1.63 to 1.19. Importantly, there was no change in stat testing frequency, suggesting that necessary urgent testing was not affected.<br /><br />The project demonstrates that transparent data sharing, peer comparison, and targeted feedback can meaningfully reduce low-value laboratory testing without requiring formal policy mandates. The authors note that future gains may come from EMR-based decision support, such as duplicate-order alerts and hard stops for standing lab orders longer than three days, and plan to expand the effort to other resident-driven specialties.

Asset Subtitle

Shobhna Singh

Meta Tag

Author List Geoffrey Smith, Michael Balk, Shobhna Singh

Category Innovations

Concept Routine Laboratory Tests

Concept Iatrogenic Anemia

Concept Provider Feedback

Concept Comparison

Concept EMR-Based Decision Support

Distinguished Non-Finalist

Presenter Organization Emory Saint Joseph's Hospital

Presenting Author Shobhna Singh

Track Value in Hospital Medicine

Keywords

routine blood draws

low-value testing

hospital medicine

ABIM Choosing Wisely

Epic Cogito

cost awareness

peer comparison

provider feedback

laboratory utilization

stat testing

Routine Laboratory Tests

Iatrogenic Anemia

Provider Feedback

Comparison

EMR-Based Decision Support