Abstract

Objective: In hospitals, physicians-in-training are major contributors to the burden of tests ordered, increasing cost and resource utilization. We implemented an intervention to discourage overutilization of the complete blood count (CBC) and the basic metabolic panel (BMP).

Methods: An intervention was designed, comprising education on high-value care and burden of over-testing, encouragement of competition, and use of positive reinforcement. The intervention was monitored by a test index determined by dividing the total number of a specific laboratory test ordered for a patient by the total number of hospital days.

Results: Following a 6-month intervention, the mean CBC index decreased from 1.56 ± 0.02 to 1.45 ± 0.03 (p < 0.001), and the BMP index, from 1.35 ± 0.02 to 1.14 ± 0.03 (p < 0.001). There was significant interaction between the intervention and the slope of the BMP index trend (p = 0.03), but not the CBC index trend. The intervention had no impact on hospital length of stay and mortality.

Conclusion: This quality improvement intervention is an effective approach to reducing overutilization of laboratory tests.

Details

Title
A quality improvement project to reduce overutilization of blood tests in a teaching hospital
Author
Almeqdadi, Mohammad 1   VIAFID ORCID Logo  ; Hari Krishnan Nair 1   VIAFID ORCID Logo  ; Hill, Jeoffrey 2 ; Sanchez-Cruz, Julian 1 ; Nader, Claudia 3 ; Jaber, Bertrand L 4 

1  Department of Medicine, St. Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, MA, USA 
2  Division of Addiction Medicine, Boston University Medical Center, Boston, MA, USA 
3  Division of Infectious Diseases, Department of Medicine, St. Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, MA, USA 
4  Division of Nephrology, Department of Medicine, St. Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, MA, USA 
End page
194
Publication year
2019
Publication date
May 2019
Publisher
Greater Baltimore Medical Center
e-ISSN
20009666
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1080/20009666.2019.1601979
ProQuest document ID
2332148275
Copyright
© 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center. This work is licensed under the Creative Commons  Attribution – Non-Commercial License http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.