SHM Converge Scientific Abstract ePoster Gallery-Reducing Lab Utilization Through Evidence Based Emails

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This quality improvement project at Baylor St. Luke’s Medical Center tested whether brief, evidence-based email reminders could reduce low-value laboratory ordering by hospitalists. The SMART aim was to decrease lab tests ordered by the Baylor Hospitalist Group by 3% over 14 weeks through frequent educational emails.<br /><br />From November 2022 to February 2023, residents sent weekly to biweekly emails explaining why certain tests were often not clinically useful. The targeted tests included TSH, folic acid, phosphorus, vitamin D, CBC, and BMP. Weekly data were collected and tracked using control charts. The main outcome was the number of common labs ordered per encounter; process measures included TSH and phosphorus orders per encounter; balancing measures were length of stay and 30-day readmission rate.<br /><br />The intervention led to measurable reductions. During the 14-week period, aggregate labs decreased by 5%, phosphorus labs by 20%, and TSH labs by 17%, producing significant cost savings. U charts showed significant special-cause shifts for aggregate labs and phosphorus, but not for TSH. Importantly, there were no significant shifts in GMLOS or 30-day readmission rates, suggesting that reducing lab use did not worsen patient outcomes.<br /><br />The authors conclude that simple educational email interventions can reduce lab utilization and save costs, but may not be sustainable on their own. They recommend combining education with broader, multipronged strategies and potentially EMR-based changes to achieve longer-lasting reductions in low-value testing.

Asset Subtitle

Vinh Tran

Meta Tag

Author List Christo Mathew, Disha Kumar, Gustavo Mastroleo, Hasan Ali, Neeraj Agrawal, Rashmi Thimmapuram, Riya Madan, Vinh Tran

Category Research

Concept Quality Improvement Intervention

Concept Low-Value Testing

Concept Evidence-Based Email Reminder

Concept Test Utilization

Concept Overuse

Distinguished Non-Finalist

Presenter Organization Baylor College of Medicine

Presenting Author Vinh Tran

Track Quality Improvement

Keywords

quality improvement

hospitalist

laboratory ordering

low-value testing

email reminders

evidence-based education

TSH

phosphorus

control charts

cost savings

Quality Improvement Intervention

Low-Value Testing

Evidence-Based Email Reminder

Test Utilization

Overuse