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Reducing pathology testing in emergency departments: A scoping review
Luise Kazda1, Kristen Pickles2, Philomena Colagiuri2
1Wiser Healthcare Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Healthy Environments and Lives (HEAL) Global Research Centre, Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT, Australia.
Reducing unnecessary pathology testing in emergency departments (EDs) through various interventions significantly cuts costs without harming patient care or staff efficiency. Further research should explore environmental impacts.
Area of Science:
- Medical Diagnostics
- Health Services Research
- Quality Improvement
Background:
- Unnecessary pathology testing in emergency departments (EDs) incurs substantial financial and environmental costs.
- Current practices often fail to improve clinical care outcomes despite high test volumes.
Purpose of the Study:
- To summarize interventions aimed at reducing pathology testing in EDs.
- To evaluate the effectiveness of these interventions on test frequency, costs, and patient/staff impacts.
Main Methods:
- Comprehensive literature search up to February 2025, including citation searches.
- Inclusion of intervention and etiological observational studies on ED pathology tests; exclusion of secondary studies and abstracts.
- Analysis of 34 eligible studies, predominantly quality improvement initiatives.
Main Results:
- 33 of 34 studies reported significant reductions in targeted pathology tests (median 29%).
- All 25 studies on financial impacts showed cost reductions, with potential savings up to AUS$1 million.
- No adverse patient or staff impacts were identified; environmental impacts were not reported.
Conclusions:
- Interventions effectively reduce test frequency with positive or neutral effects on patient care and staff efficiency.
- Significant cost savings are achievable through reduced pathology testing.
- Future research should incorporate environmental impact assessments and explore clinical co-benefits.
