Does admission order form design really matter? A reduction in urea blood test ordering

Area of Science:

• Clinical Medicine
• Healthcare Management
• Medical Diagnostics

Background:

• Laboratory blood testing is a high-volume medical procedure with increasing rates.
• Inappropriate test ordering leads to significant financial implications for healthcare systems.
• Physician test ordering behavior is influenced by the design of order and request forms.

Purpose of the Study:

• To redesign the laboratory request section of the standard medicine admission order form.
• The goal was to reduce inappropriate blood urea nitrogen (BUN) testing upon hospital admission.

Main Methods:

• The standard medicine admission order form was redesigned.
• The redesigned form was implemented for general internal medicine physicians and residents.
• The study was conducted in two large teaching hospitals within one health zone in Alberta, Canada.

Main Results:

• A significant step reduction in the ordering of blood urea nitrogen (BUN) tests was observed.
• The redesign effectively altered physician ordering patterns and behavior.
• The intervention demonstrated a positive impact on resource stewardship.

Conclusions:

• Redesigning admission order forms can effectively reduce unnecessary laboratory test ordering.
• Changes in form design can positively influence physician behavior regarding test ordering.
• This approach offers a beneficial strategy for improving efficiency and reducing costs in laboratory testing.