title: Impact of Laboratory Test Use Strategies in a Turkish Hospital.
abstract: OBJECTIVE
  Eliminating unnecessary laboratory tests is a good way to reduce costs while maintain patient safety. The aim of this study was to define and process strategies to rationalize laboratory use in Ankara Numune Training and Research Hospital (ANH) and calculate potential savings in costs.
  
  
  METHODS
  A collaborative plan was defined by hospital managers; joint meetings with ANHTA and laboratory professors were set; the joint committee invited relevant staff for input, and a laboratory efficiency committee was created. Literature was reviewed systematically to identify strategies used to improve laboratory efficiency. Strategies that would be applicable in local settings were identified for implementation, processed, and the impact on clinical use and costs assessed for 12 months.
  
  
  RESULTS
  Laboratory use in ANH differed enormously among clinics. Major use was identified in internal medicine. The mean number of tests per patient was 15.8. Unnecessary testing for chloride, folic acid, free prostate specific antigen, hepatitis and HIV testing were observed. Test panel use was pinpointed as the main cause of overuse of the laboratory and the Hospital Information System test ordering page was reorganized. A significant decrease (between 12.6-85.0%) was observed for the tests that were taken to an alternative page on the computer screen. The one year study saving was equivalent to 371,183 US dollars.
  
  
  CONCLUSIONS
  Hospital-based committees including laboratory professionals and clinicians can define hospital based problems and led to a standardized approach to test use that can help clinicians reduce laboratory costs through appropriate use of laboratory tests.
authors.affiliation: Yildirim Bayezid University, Department of Biochemistry, Ankara, Turkey.
authors.forename: Fatma Meriç
authors.initials: FM
authors.lastname: Yılmaz
authors.affiliation: Ankara Numune Training and Research Hospital, Health Technology Assessment Unit, Ankara, Turkey.
authors.forename: Rabia
authors.initials: R
authors.lastname: Kahveci
authors.affiliation: Ankara Numune Training and Research Hospital, Department of Microbiology, Ankara, Turkey.
authors.forename: Altan
authors.initials: A
authors.lastname: Aksoy
authors.affiliation: Ankara Numune Training and Research Hospital, Health Technology Assessment Unit, Ankara, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Özer Kucuk
authors.affiliation: Ankara Numune Training and Research Hospital, Department of General Surgery, Ankara, Turkey.
authors.forename: Tezcan
authors.initials: T
authors.lastname: Akın
authors.affiliation: Advanced Pediatrics Centre PostGraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Joseph Lazar
authors.initials: JL
authors.lastname: Mathew
authors.affiliation: Brunel University, Health Economics Research Group, Uxbridge, United Kingdom.
authors.forename: Catherine
authors.initials: C
authors.lastname: Meads
authors.affiliation: Ankara Numune Training and Research Hospital, Department of Oncology, Ankara, Turkey.
authors.forename: Nurullah
authors.initials: N
authors.lastname: Zengin
mesh_terms: D019411:Clinical Laboratory Techniques / Q000191:economics* / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D017598:Efficiency, Organizational; D006801:Humans; D007755:Laboratories, Hospital / Q000458:organization & administration*; D014421:Turkey