title: Reducing unnecessary inpatient laboratory testing in a teaching hospital.
abstract: 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.
authors.affiliation: Department of Family and Community Medicine, School of Medicine, University of California San Francisco, CA, USA.
authors.forename: Todd A
authors.initials: TA
authors.lastname: May
authors.forename: Mary
authors.initials: M
authors.lastname: Clancy
authors.forename: Jeff
authors.initials: J
authors.lastname: Critchfield
authors.forename: Fern
authors.initials: F
authors.lastname: Ebeling
authors.forename: Anita
authors.initials: A
authors.lastname: Enriquez
authors.forename: Carmel
authors.initials: C
authors.lastname: Gallagher
authors.forename: Jim
authors.initials: J
authors.lastname: Genevro
authors.forename: Jay
authors.initials: J
authors.lastname: Kloo
authors.forename: Paul
authors.initials: P
authors.lastname: Lewis
authors.forename: Rita
authors.initials: R
authors.lastname: Smith
authors.forename: Valerie L
authors.initials: VL
authors.lastname: Ng
mesh_terms: 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*