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Related Experiment Video

Updated: Mar 8, 2026

Improving IV Insulin Administration in a Community Hospital
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Reducing unnecessary testing: an intervention to improve resident ordering practices.

Jose Melendez-Rosado1, Kristine M Thompson2, Jed C Cowdell3

  • 1Division of Gastroenterology, Cleveland Clinic Florida, Florida, USA.

Postgraduate Medical Journal
|January 21, 2017
PubMed
Summary
This summary is machine-generated.

Cost awareness education did not reduce common laboratory test ordering by internal medicine residents. While readmission rates decreased, overall test utilization and mortality remained unchanged, suggesting further research on educational interventions is needed.

Keywords:
cost awarenessdaily laboratory testingresident education

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Area of Science:

  • Internal Medicine
  • Healthcare Management
  • Medical Education

Background:

  • Unnecessary laboratory tests contribute to healthcare costs.
  • Understanding the impact of cost awareness on physician ordering behavior is crucial for resource optimization.
  • Internal medicine residents' ordering patterns for common tests like complete blood cell count (CBC) and renal profile (RP) warrant investigation.

Purpose of the Study:

  • To assess the effect of education and cost awareness on laboratory test ordering by internal medicine residents.
  • To determine if interventions influence the utilization of CBC and RP.
  • To evaluate the impact of cost awareness on hospitalization, 30-day readmission rates, and mortality.

Main Methods:

  • A pre-intervention study (February-April 2014) involving 567 patients served as the control.
  • Interventions included education and visual cost reminders for laboratory tests.
  • Post-intervention assessment (12 months in 2015) included 629 patients, analyzing test counts and clinical outcomes.

Main Results:

  • Complete blood cell count (CBC) orders significantly increased post-intervention (1.7 to 2.3 per hospitalization, p<0.001).
  • CBC with differential orders significantly decreased (1.7 to 1.2, p<0.001).
  • Renal profile (RP) orders showed no significant change (3.7, p=0.23), and mortality rates remained stable. However, readmission rates significantly decreased (p=0.008).

Conclusions:

  • Educational interventions incorporating cost reminders did not significantly reduce the overall ordering of common laboratory tests.
  • The study highlights the need for further research into effective educational strategies to curb redundant test ordering in hospital settings.
  • While not reducing overall test volume, interventions showed a positive impact on readmission rates.