Teaching the Laboratory's Role in Diagnostic Stewardship: Engaging Pathology Residents in a Quality Initiative to...

Area of Science:

• Laboratory Medicine
• Quality Improvement Science
• Pathology Resident Education

Background:

• Pathology residents actively participate in departmental quality initiatives to identify operational improvements.
• Projects aim to enhance diagnostic stewardship by ensuring timely access to biochemical information for clinicians.
• Initial investment in total laboratory automation did not meet autoverification rate goals, limiting expected improvements in turnaround times (TAT).

Purpose of the Study:

• To enhance the efficiency of new laboratory automation systems.
• To identify and address limitations in the current verification process and delta checks.
• To improve autoverification rates and reduce laboratory turnaround times.

Main Methods:

• Third-year pathology residents conducted a literature review of evidence-based practices.
• Clinical metrics, including TAT, were examined to assess current performance.
• Middleware rule modifications were updated based on findings, quality goals, and evidence-based practices, involving revision and elimination of chemistry analyte software rules.

Main Results:

• Autoverification rates increased from 78% to 89% within two months of implementing rule revisions.
• Average turnaround time (TAT) for STAT basic metabolic profile tests decreased from 51 to 46 minutes.
• Demonstrated significant improvements in laboratory efficiency and test result timeliness.

Conclusions:

• Involving pathology residents in quality improvement initiatives yields substantial benefits.
• Residents serve as valuable resources for evaluating laboratory workflows and clinical needs.
• This process educates residents on laboratory administration and the critical role of the laboratory in diagnostic stewardship.