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Related Experiment Videos

How to successfully influence laboratory test utilization.

F V Plapp1, C E Essmyer, A B Byrd

  • 1Saint Luke's Regional Laboratories, Saint Luke's Hospital, USA.

Clinical Leadership & Management Review : the Journal of CLMA
|February 24, 2001
PubMed
Summary
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This study reduced average laboratory tests per inpatient discharge by 33% through administrative and physician education strategies. Hospital ranking improved from the 75th to the 15th percentile for test ordering.

Area of Science:

  • Healthcare Management
  • Clinical Pathology
  • Health Services Research

Background:

  • Hospital exceeded 75th percentile for laboratory tests per inpatient discharge in 1994.
  • High volume, cost, complexity, and questionable medical benefit identified as areas for improvement.

Purpose of the Study:

  • To decrease the average number of laboratory tests ordered per inpatient discharge.
  • To improve the hospital's rank among peer teaching hospitals regarding test utilization.

Main Methods:

  • Implemented a combination of administrative changes and physician education initiatives.
  • Targeted high-volume, expensive, difficult, or questionable medical benefit laboratory tests.
  • Monitored monthly revenue and usage reports to assess impact.

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Main Results:

  • Average inpatient tests per discharge decreased from 44 (Q1 1994) to 29 (Q3 1999).
  • Hospital's rank improved from the 75th to the 15th percentile compared to peer group.
  • Sustained reduction achieved over a 5.5-year period.

Conclusions:

  • Combined administrative and educational strategies effectively reduced laboratory test utilization.
  • Significant improvement in hospital's rank demonstrates successful cost-effective test ordering.
  • Initiatives provide a model for optimizing laboratory test ordering in teaching hospitals.