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Multidisciplinary Initiative to Reduce Unnecessary Lab Testing

Shinwa, Masih; Bossert, Adam; Chen, Iris; Cushing, Anna; Dunn, Andrew S.; Poeran, Jashvant; Weinstein, Sally; Cho, Hyung J.

The Journal for Healthcare Quality (JHQ): May/June 2019 - Volume 41 - Issue 3 - p 165–171
doi: 10.1097/JHQ.0000000000000157
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ABSTRACT Inappropriate daily lab testing can have adverse effects on patients, including anemia, pain, and interruption of sleep. We implemented a student-led, multifaceted intervention featuring clinician education, publicity campaign, gamification, and system changes, including a novel nurse-driven protocol to reduce unnecessary daily lab testing in a teaching hospital. We applied a quasi-experimental interrupted time series design with a segmented regression analysis to estimate changes before and after our 14-month intervention with a comparison to a control surgical unit. There was an increasing trend in the baseline period, which was mitigated by the intervention (postintervention effect estimate −0.04 labs per patient day/month, p < .05), which was not seen in the control unit. Estimated cost savings was $94,269 ($6,734/month). A student-led, multidisciplinary campaign involving nurse-driven pathway, education, publicity, gamification, and system changes was effective in reducing daily lab testing.

For more information on this article, contact Hyung J. Cho at hyung.cho@mountsinai.org.

The authors declare no conflicts of interest.

© 2019 National Association for Healthcare Quality
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