title: Impact of an educational intervention on the frequency of daily blood test orders for hospitalized patients.
abstract: OBJECTIVE
  During hospitalizations, blood is drawn for diagnostic laboratory tests to help guide patient care. Often, blood tests continue to be ordered even in the face of clinical and laboratory stability. Blood draws are painful and costly, and they may be associated with anemia. We hypothesized that provider education could reduce the frequency of daily blood tests ordered for hospitalized patients.
  
  
  METHODS
  During a 2-month intervention period, internal medicine providers were educated through flyers displayed in providers' offices and periodic email communications reminding them to order daily blood tests only if the results would change patient care. Two-month preintervention data from 982 patients and 2-month postintervention data from 988 patients were analyzed. The primary outcome measured was the number of daily blood tests ordered per patient per day.
  
  
  RESULTS
  Mean orders of CBC decreased from 1.46 to 1.37 tests per patient per day (P < .05) after the intervention. Basic metabolic panel orders were reduced from 0.91 to 0.83 tests per patient per day (P < .05). Cost analyses showed a reduction of $6.33 per patient day based on the decrease in the number of daily laboratory tests ordered.
  
  
  CONCLUSIONS
  Provider education and reminders can reduce the frequency of daily blood tests ordered by providers for hospitalized patients. This can decrease health care costs and may reduce the risk of complications such as anemia.
authors.affiliation: From the Departments of Medicine and Rthakka1@jhmi.edu.
authors.forename: Rajiv N
authors.initials: RN
authors.lastname: Thakkar
authors.affiliation: From the Departments of Medicine and.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kim
authors.affiliation: From the Departments of Medicine and.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Knight
authors.affiliation: Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Stefan
authors.initials: S
authors.lastname: Riedel
authors.affiliation: From the Departments of Medicine and.
authors.forename: Dhananjay
authors.initials: D
authors.lastname: Vaidya
authors.affiliation: From the Departments of Medicine and.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Wright
mesh_terms: D000328:Adult; D000368:Aged; D003365:Costs and Cost Analysis; D003955:Diagnostic Tests, Routine / Q000191:economics / Q000706:statistics & numerical data*; D004502:Education, Medical, Continuing; D005260:Female; D006403:Hematologic Tests / Q000191:economics / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D018962:Phlebotomy / Q000191:economics / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000191:economics; D019564:Unnecessary Procedures / Q000191:economics / Q000706:statistics & numerical data*; D014600:Utilization Review
keywords: Blood draw; Daily blood test; Excessive blood testing; Hospital-acquired anemia; Laboratory test; Phlebotomy