SHM Converge Scientific Abstract ePoster Gallery-Reducing Unnecessary Daily Laboratory Tests

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This quality improvement project evaluated whether education could reduce unnecessary inpatient laboratory testing at University Hospital. Although lab tests represent only about 5% of hospital spending, they strongly influence clinical decisions and can contribute to overtesting, increased costs, and hospital-acquired anemia. The authors noted that providers often order daily labs by habit, aided by easy ordering in the electronic medical record and the lack of standardized limits.<br /><br />The intervention consisted of educational sessions for the hospital medicine team and nursing supervisors, including didactic presentations and interactive question-and-answer periods. Lab ordering data from November 2021 to April 2023 were collected and analyzed using Statistical Process Control charts. The study tracked the number of CBC, BMP/CMP, and renal function panel tests ordered per patient.<br /><br />After the educational interventions, the department saw a 37.4% reduction in total labs ordered per patient. Test-specific reductions were 41.2% for CBCs, 35.9% for BMP/CMPs, and 27.1% for renal function panels. This decrease translated into an estimated cost savings of about $6,310 per month compared with the previous year.<br /><br />The authors conclude that education can meaningfully reduce unnecessary laboratory testing, but maintaining these gains through education alone may be difficult. They therefore plan to add provider feedback packets and implement a hard stop in the Epic EMR to limit continuous daily lab orders to a 48-hour timeframe, making the change more sustainable.

Asset Subtitle

Aesha F. Aboueisha

Meta Tag

Author List Aesha F. Aboueisha, Ankur Segon, Cadfael Soulard, Juan Garza

Category Innovations

Concept Laboratory Test

Concept Educational Intervention

Concept Ordering Behavior

Concept Inpatient Laboratory Testing

Concept Quality Improvement

Distinguished Non-Finalist

Presenter Organization University of Texas Health Science Center San Antonio

Presenting Author Aesha F. Aboueisha

Track Quality Improvement

Keywords

quality improvement

inpatient laboratory testing

education intervention

unnecessary lab orders

hospital medicine

electronic medical record

CBC

BMP/CMP

cost savings

Statistical Process Control

Laboratory Test

Educational Intervention

Ordering Behavior

Inpatient Laboratory Testing

Quality Improvement