Inpatient Test Utilization and Test Volume Benchmarking: A Q-Probes Study.

Area of Science:

• Clinical Pathology
• Laboratory Medicine
• Healthcare Quality Improvement

Background:

• Test ordering practices exhibit wide variability within and between healthcare organizations.
• Current methods for benchmarking test utilization data lack standardization, hindering comparative analysis.

Purpose of the Study:

• To develop and implement a standardized methodology for comparing inpatient laboratory test utilization data.
• To identify common inpatient test groups and efficiently detect outlier test volumes.

Main Methods:

• Utilized inpatient test volumes for 50 analytes and total inpatient days from participating laboratories.
• Standardized test volumes per 1000 inpatient days and calculated comparative ranges.
• Employed standardized median absolute deviation to assess test volume variability and identify outliers.

Main Results:

• The methodology successfully identified common inpatient tests and flagged volume outliers.
• High test volume outliers included creatine kinase myocardial band, free prostate-specific antigen, myoglobin, serotonin release assay, and hepatitis B serologies.
• No low-volume outliers were observed; 39% of participants had no outliers, while 15% had multiple high-volume outliers.

Conclusions:

• The developed approach enables measurement of inpatient test volume data across organizations.
• It effectively identifies test volumes outside standardized comparative ranges, signaling potential areas for intervention in test utilization practices.