Changing resident test ordering behavior: a multilevel intervention to decrease laboratory utilization at an academic...

Area of Science:

• Healthcare Management
• Clinical Laboratory Science
• Medical Economics

Background:

• Increasing hospital laboratory test volumes contribute to errors and significant costs.
• Previous efforts to reduce laboratory utilization often lacked a multilevel, collaborative approach.

Purpose of the Study:

• To implement and evaluate multilevel interventions with residents to reduce unnecessary laboratory tests and associated costs.
• To assess the sustainability of cost savings and reduced laboratory utilization.

Main Methods:

• Collaborative intervention design with residents targeting ordering behavior through system changes, education, marketing, detailing, incentives, and feedback.
• Focus on high-cost, high-volume tests like complete blood counts (CBC), electrolytes, enzymes, and liver function tests.

Main Results:

• Achieved an 8% cumulative reduction in laboratory ordering over three years.
• Generated cost savings of $2,019,000.
• Demonstrated sustained reduction in laboratory utilization and cost savings.

Conclusions:

• A multilevel, collaborative approach involving residents is effective in reducing laboratory utilization and costs.
• Simultaneous targeting of multiple intervention levels ensures sustained improvements in healthcare resource management.