Reducing unnecessary inpatient laboratory testing in a teaching hospital.
After an inpatient phlebotomy-laboratory test request audit for 2 general inpatient wards identified 5 tests commonly ordered on a recurring basis, a multidisciplinary committee developed a proposal to minimize unnecessary phlebotomies and laboratory tests by reconfiguring the electronic order function to limit phlebotomy-laboratory test requests to occur singly or to recur within one 24-hour window. The proposal was implemented in June 2003. Comparison of fiscal year volume data from before (2002-2003) and after (2003-2004) implementation revealed 72,639 (12.0%) fewer inpatient tests, of which 41,765 (57.5%) were related directly to decreases in the 5 tests frequently ordered on a recurring basis. Because the electronic order function changes did not completely eliminate unnecessary testing, we concluded that the decrease in inpatient testing represented a minimum amount of unnecessary inpatient laboratory tests. We also observed 17,207 (21.4%) fewer inpatient phlebotomies, a decrease sustained in fiscal year 20042005. Labor savings allowed us to redirect phlebotomists to our understaffed outpatient phlebotomy service.
May
Todd A
TA
Department of Family and Community Medicine, School of Medicine, University of California San Francisco, CA, USA.
Clancy
Mary
M
Critchfield
Jeff
J
Ebeling
Fern
F
Enriquez
Anita
A
Gallagher
Carmel
C
Genevro
Jim
J
Kloo
Jay
J
Lewis
Paul
P
Smith
Rita
R
Ng
Valerie L
VL
D006784:Hospitals, Teaching; D006801:Humans; D007297:Inpatients; D013677:Medical Laboratory Science / Q000191:economics / Q000379:methods*; D018962:Phlebotomy / Q000191:economics / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians'; D019564:Unnecessary Procedures / Q000191:economics / Q000706:statistics & numerical data*