SHM Converge Scientific Abstract ePoster Gallery-Laboratory Stewardship Project

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This project addressed unnecessary recurring laboratory testing on inpatient medicine teams at Mount Sinai Morningside-West. The authors note that excessive lab testing causes pain, higher costs, longer hospital stays, anemia, transfusions, and venipuncture complications, and that electronic medical records make repeated lab orders easy to place without reassessment.<br /><br />The team’s goal was to reduce recurring lab orders. They tracked the percentage of inpatients with recurring lab orders and monitored whether morning-draw labs increased. Their interventions included educating staff about the harms of unnecessary testing, adding a recurring-lab flag in the EMR, auditing charts and giving feedback, involving nurses, surveying barriers, creating an intranet resource with QR code outreach, and later adding incentives and competition among teaching teams.<br /><br />Results showed substantial improvement. At Site A, recurrent lab orders on the teaching service dropped from 57% before implementation to 42.49% in phase 2 and 17.08% in phase 3. At Site B, they fell from 55% to 23.76% during phase 3. In the first six full months, common lab orders per patient decreased by 14% at Site A compared with the prior year, meeting the primary goal. Survey responses suggested the main barrier was the extra work required to review labs daily, along with fear of missing important information. The most common recommendation from housestaff was to discuss lab orders as a team during rounds.<br /><br />Overall, the study concluded that lab stewardship is achievable. Education, EMR flags, feedback, and especially positive incentives reduced unnecessary recurring lab orders without increasing later-day lab ordering.

Asset Subtitle

Faye E. Reiff-Pasarew

Meta Tag

Author List Adrian Chernyk, Benjamin Dempsey, Faye E. Reiff-Pasarew, Foram Parikh, Julie M. Pearson, Krystle Hernandez, Nikta S. Athari Anaraki, Philip L. Chen, Shantheri Shenoy, Sharel Sadud, Vasundhara Singh

Category Research

Concept Blood Work

Concept Laboratory Stewardship

Concept Recurring Lab Order

Concept Patient Safety

Concept Cost Reduction

Distinguished Non-Finalist

Presenter Organization Mount Sinai Morningside Hospital, Icahn School of Medicine at Mount Sinai

Presenting Author Faye E. Reiff-Pasarew

Track Quality Improvement

Keywords

recurring laboratory testing

inpatient medicine

lab stewardship

electronic medical records

unnecessary lab orders

quality improvement

hospital length of stay

anemia and transfusions

education and feedback

EMR flag

Blood Work

Laboratory Stewardship

Recurring Lab Order

Patient Safety

Cost Reduction