SHM Converge Scientific Abstract ePoster Gallery-Improving Lab Over-Utilization on the General Medicine and Cardiology Services

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This document describes a quality improvement project at the Medical University of South Carolina aimed at reducing overuse of daily laboratory testing, specifically CBCs and metabolic panels, on general medicine and cardiology services by 10%.<br /><br />The project used EHR data to establish a baseline and then implemented several resident-driven interventions over time. From April to June, baseline data were collected. From July to September, the team refined the data collection process and planned interventions. Between October and December, they presented the project at the hospitalist monthly meeting, emailed subspecialist attendings, posted reminder cards on workstations, displayed data posters in resident workrooms, and ran a competition between resident teams in which residents placed coins in a bowl for each lab they intentionally did not order. From January to March, they added more reminder cards and discussed the project at residency-wide meetings and academic half day.<br /><br />Results showed the project did not meet its 10% reduction goal by the end date of April 2023. Several interventions had limited or short-lived effects. The hospitalist presentation produced a brief improvement, while the email to subspecialists likely had minimal effect. Reminder cards were not very effective, posters were easy to overlook, and the competition was difficult to organize and track because some teams did not participate. A data limitation was that service team assignment was captured at admission rather than discharge.<br /><br />Despite not meeting the primary benchmark, the project had important educational and organizational benefits. It trained PGY-3 residents to lead a quality improvement effort, created a foundation for future hospitalist-led work, and helped highlight the need for culture change around routine lab ordering. The authors note that long-term reductions could improve cost and reduce unnecessary blood draws.

Asset Subtitle

Meg Scott

Meta Tag

Author List Chelsey Petz, Marc Heincelman, Mason Turner, Meg Scott, Meghan K. Thomas

Category Innovations

Concept Quality Improvement

Concept Blood Count

Concept Metabolic Panel

Concept Laboratory Utilization

Concept Internal Medicine Resident

Distinguished Non-Finalist

Presenter Organization Medical University of South Carolina

Presenting Author Meg Scott

Track Quality Improvement

Keywords

quality improvement

daily laboratory testing

CBC

metabolic panels

overuse reduction

general medicine

cardiology services

resident-driven interventions

electronic health record data

hospitalist meeting

Quality Improvement

Blood Count

Metabolic Panel

Laboratory Utilization

Internal Medicine Resident