"THINK" Before You Order: Multidisciplinary Initiative to Reduce Unnecessary Lab Testing. Issue 3 (May 2019)

• Record Type: Journal Article
• Authors: Shinwa, Masih; Bossert, Adam; Chen, Iris; Cushing, Anna; Dunn, Andrew S.; Poeran, Jashvant; Weinstein, Sally; Cho, Hyung J.
• Is Part Of: Journal for healthcare quality. Volume 41:Issue 3(2019)
• Publication Date: 2019-05
• Subjects: high value -- choosing wisely -- quality improvement -- utilization; Medical care -- Quality control -- Periodicals; Quality assurance -- Periodicals; 362.1
• DOI: 10.1097/JHQ.0000000000000157
• Languages: English
• ISSNs: 1062-2551

Abstract

Abstract : ABSTRACT: Inappropriate daily lab testing can have adverse effects on patients, including anemia, pain, and interruption of sleep. We implemented a student-led, multifaceted intervention featuring clinician education, publicity campaign, gamification, and system changes, including a novel nurse-driven protocol to reduce unnecessary daily lab testing in a teaching hospital. We applied a quasi-experimental interrupted time series design with a segmented regression analysis to estimate changes before and after our 14-month intervention with a comparison to a control surgical unit. There was an increasing trend in the baseline period, which was mitigated by the intervention (postintervention effect estimate −0.04 labs per patient day/month, p < .05), which was not seen in the control unit. Estimated cost savings was $94, 269 ($6, 734/month). A student-led, multidisciplinary campaign involving nurse-driven pathway, education, publicity, gamification, and system changes was effective in reducing daily lab testing.