SHM Converge Scientific Abstract ePoster Gallery-Driving Higher Value Lab Ordering: Impacts of Personalized Monthly Email Reports on Hospitalist Practices

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This quality improvement project evaluated whether personalized monthly email feedback could reduce unnecessary routine lab ordering among hospitalists at Baylor St. Luke’s Medical Center. The intervention was designed to address persistent overuse of daily laboratory tests, which increases cost and may cause patient harm without improving care.<br /><br />Beginning in April 2025, 57 providers received automated monthly emails summarizing their total lab orders, lab ordering patterns, and lab-to-encounter ratios compared with peers. The comparison adjusted for differences between admission and management encounters. Historical data from the prior 12 months established baseline performance, and a U-chart was used to assess change over time. Balancing measures included length of stay and 7-day readmission rates.<br /><br />Results showed a special cause variation with an overall downward trend in average weekly labs ordered per encounter after implementation. The pattern of CBC ordering also changed: use of CBC hemograms increased while the more expensive CBC with differential decreased. Importantly, there were no significant adverse changes in balancing measures, suggesting reduced lab use did not worsen patient outcomes such as length of stay or readmission rates.<br /><br />The project concluded that peer-comparison email feedback is an effective, low-cost, and scalable strategy for reducing unnecessary laboratory utilization. The authors suggest that ongoing feedback may help sustain behavior change over time. Future plans include surveying providers at 6 months and 1 year, developing a more user-friendly dashboard, and expanding the intervention to additional sites.

Asset Subtitle

Neeraj Agrawal

Meta Tag

Author List Aidan Boyne, Jimin Kim, Jordan Pemberton, Meredith Apicella, Neeraj Agrawal

Category Innovations

Concept Laboratory Test

Concept Laboratory Ordering

Concept Laboratory Utilization

Concept Patient Harm

Concept Quality Improvement

Distinguished Non-Finalist

Presenter Organization Baylor College of Medicine

Presenting Author Neeraj Agrawal

Track Value in Hospital Medicine

Keywords

quality improvement

routine lab ordering

hospitalists

personalized email feedback

laboratory utilization

peer comparison

CBC ordering

patient outcomes

length of stay

readmission rates

Laboratory Test

Laboratory Ordering

Laboratory Utilization

Patient Harm

Quality Improvement