Establishing Referral Laboratory Testing Governance and Addressing "Miscellaneous" Test Orders across an Academic...

Area of Science:

• Laboratory Medicine
• Health Systems Management
• Clinical Operations

Background:

• Referral laboratories are crucial for clinical support but present challenges in hospital regulations, logistics, and cost.
• The use of

Purpose of the Study:

• To establish an approved referral laboratory test list and a digital request form.
• To assess the impact of discrete ordering on referral test management and turnaround times.

Main Methods:

• Implemented a laboratory stewardship committee process for approving new referral tests.
• Retrospectively reviewed miscellaneous referral orders and identified tests for discrete electronic health record (EHR) ordering.
• Assessed the uptake and turnaround time impact of newly created discrete referral tests.

Main Results:

• Approved 16 of 27 new referral tests requested over 20 months.
• Recommended 37 of the top 100 miscellaneous tests for discrete ordering.
• Achieved 64% uptake for the first 5 discrete tests, improving turnaround times by an average of 1.1 days.

Conclusions:

• Successfully implemented oversight for referral laboratory testing within the health system.
• Effectively transitioned providers from miscellaneous orders to discrete referral test orders.
• Demonstrated significant improvements in result turnaround times through process optimization.