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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
Original Article

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

The authors declare no conflicts of interest.

© 2019 National Association for Healthcare Quality
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