Related Experiment Video
Updated: Aug 18, 2026
Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
Published on: October 31, 2010
An administrative intervention to improve the utilization of laboratory tests within a university hospital
Ronit Calderon-Margalit1, Shlomo Mor-Yosef, Michael Mayer
1Hadassah University Hospital, Hebrew University School of Medicine, Jerusalem, Israel. ronitca@hadassah.org.il
Background:
Improving the appropriateness of testing behavior and reducing the number of laboratory tests have been recognized as essential parts of quality improvement.
Objective:
To assess the effectiveness of an administrative and a short-term educational intervention aimed at reducing clinical biochemistry laboratory utilization.
Design:
An analysis comparing utilization of laboratory tests performed on in-patients before and after the intervention.
Setting:
Computerized database of all laboratory tests performed in Hadassah Ein Kerem Medical Center, Jerusalem, Israel during 1999-2003.
Intervention:
The administrative intervention included restricting available emergency laboratory tests and frequency of repeated orders. The educational measures included: discussion of the misuse of laboratory tests and its consequences with the hospital medical staff, and presentation of the new restrictive policy. A feedback of the intervention's results was sent to the wards and reviewed with senior medical staff.
Main Outcome Measures:
Change in utilization (measured as rates per 100 hospital days) of clinical biochemistry tests by hospital division and by selected laboratory tests.
Results:
An overall reduction of 19% in laboratory tests (95% CI: 18.8-19.2%) was observed in the year after the intervention. Utilization decreased significantly in all the hospital's medical divisions, within a range of 14.9-43.8%. During the intervention period, utilization of hematology tests was reduced by 7.6% (P = 0.009). Statistically significant reductions were noted in the ordering of all 12 selected clinical biochemistry tests. Although the orders of total cholesterol decreased by 72.2%, the utilization of 'high-volume' tests, such as glucose and electrolytes, showed only a modest decrease (7.9% and 6.9%, respectively).
Conclusions:
The present study included all hospital medical staff and covered all the available clinical biochemistry tests. This rather simple and low-cost intervention resulted in significant reductions in clinical biochemistry test orders as well as in the ordering of hematological blood tests.
