A Quality Improvement Initiative: Reducing Unnecessary Phlebotomy, Enhancing Patient Experience, and Minimizing...

Area of Science:

• Healthcare Quality Improvement
• Laboratory Medicine
• Environmental Sustainability in Healthcare

Background:

• Rising laboratory testing volumes increase healthcare costs, decrease patient satisfaction, and harm the environment.
• Unnecessary laboratory tests pose medical risks and negatively impact patient well-being.
• A quality improvement (QI) project was initiated to optimize laboratory utilization among healthcare professionals.

Purpose of the Study:

• To implement a multimodal intervention to enhance appropriate laboratory utilization.
• To reduce unnecessary laboratory test orders among residents and hospitalists.

Main Methods:

• A multimodal intervention was employed, including assessing baseline knowledge gaps.
• Targeted education and daily structured discussions on lab necessity were implemented.
• An electronic dashboard provided real-time data on lab ordering volume and per-attending orders.

Main Results:

• A net decrease of 4657 lab orders occurred over three months.
• Significant reductions were observed in comprehensive metabolic panel (CMP), serum Mg, serum Phos, and complete blood count (CBC) orders.
• Patient satisfaction increased, with "rest and recover" responses rising from 51.8% to 63.2%, alongside an estimated $10,645 in cost savings and a 1304.61 kg CO2 reduction.

Conclusions:

• A multifaceted QI approach effectively reduced unnecessary laboratory testing.
• The intervention improved patient experience, generated cost savings, and mitigated environmental impact.
• The QI framework is transferable for broader implementation.