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A Student-Led, Multifaceted Intervention to Decrease Unnecessary Folate Ordering in the Inpatient Setting.

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    A student-led intervention significantly reduced inpatient serum folate testing by 87%. This initiative optimized laboratory test ordering, decreasing unnecessary diagnostic procedures for folate deficiency.

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    Area of Science:

    • Clinical Laboratory Science
    • Healthcare Management

    Background:

    • Unnecessary laboratory testing contributes to increased healthcare costs and potential patient harm.
    • Serum folate testing is often overutilized in inpatient settings, despite a low prevalence of deficiency in the U.S. population.

    Purpose of the Study:

    • To implement and evaluate a multi-phase intervention aimed at reducing serum folate laboratory testing in hospitalized patients.
    • To assess the impact of the intervention on ordering patterns for serum folate and vitamin B12.

    Main Methods:

    • A three-phase intervention was introduced: education, personalized feedback, and electronic medical record order uncoupling.
    • Data on monthly serum folate and vitamin B12 test orders were collected before and during the intervention.
    • Segmented regression analysis was used to evaluate changes in ordering trends.

    Main Results:

    • Average monthly serum folate orders decreased by 87% from baseline (98.4 to 12.7 orders/month).
    • Joint ordering of folate and vitamin B12 significantly decreased during the intervention (slope = -4.22, p = .0089).
    • Single ordering of vitamin B12 significantly increased (slope = +5.6, p < .001), suggesting a shift in testing patterns.

    Conclusions:

    • The student-designed intervention effectively reduced unnecessary serum folate testing in the inpatient setting.
    • The intervention successfully modified laboratory test ordering behaviors, aligning with the low prevalence of folate deficiency.
    • This approach offers a model for optimizing diagnostic test utilization in hospitals.