Mindfulness-Based Laboratory Reduction: Reducing Utilization Through Trainee-Led Daily 'Time Outs'.
Overuse of laboratory investigations is widely prevalent in hospitalized patients, leads to discomfort, and increases direct and indirect costs.



We implemented a simple, inexpensive, mindfulness strategy on our inpatient medical clinical teaching unit to reduce unnecessary laboratory orders through education, a forcing function, and daily structured laboratory "time outs."



On a 26-bed unit in an academic hospital center, the per-period laboratory costs per patient were compared pre- and postintervention using segmented regression analysis of an interrupted time series.



The average cost per admitted patient decreased from $117 to $66, with an estimated savings of $50,657 over 985 admissions. After adjusting for fiscal period and the presence of our intervention, there was a significant reduction in the per-patient number of total tests, complete blood counts, and electrolyte panels performed (P <.001 for all level and time trend changes).



This trainee-designed and -led intervention, centered around structured, mindfulness-based laboratory test ordering, was successful at decreasing the overuse of common daily blood work in hospitalized patients.
Department of Medicine, McGill University, Montreal, Quebec, Canada; Clinical Practice Assessment Unit, McGill University Health Centre, Montreal, Quebec, Canada. Electronic address: emily.mcdonald@mcgill.ca.
Emily G
EG
McDonald
Department of Medicine, McGill University, Montreal, Quebec, Canada.
Ramy R
RR
Saleh
Department of Medicine, McGill University, Montreal, Quebec, Canada; Clinical Practice Assessment Unit, McGill University Health Centre, Montreal, Quebec, Canada.
Todd C
TC
Lee
D002170:Canada; D019411:Clinical Laboratory Techniques / Q000191:economics*; D017046:Cost Savings; D006760:Hospitalization / Q000191:economics*; D006784:Hospitals, Teaching / Q000191:economics; D006801:Humans; D007755:Laboratories, Hospital / Q000191:economics*; D064866:Mindfulness; D019564:Unnecessary Procedures / Q000191:economics*
High-value health care; Laboratory tests; Overutilization; Quality improvement; Trainee-led