Quality improvement intervention cuts tests ordered

(HealthDay)—Implementation of a multifaceted quality improvement intervention is associated with a decrease in the number of ordered laboratory tests, according to a study published online March 21 in the Journal of Hospital Medicine.

Adam H. Corson, M.D., from the Swedish Medical Center in Seattle, and colleagues undertook a quality improvement intervention, composed of academic detailing, audit and feedback, and transparent reporting of the frequency with which common labs were ordered, to decrease unnecessary common laboratory tests in a large community hospitalist group. The authors compared ordered lab tests in a cohort of patients during the 10-month pre-intervention baseline period (7,824 patients) with those in a cohort during the seven-month intervention period (5,759 patients).

The researchers found that during the intervention period, the number of common labs ordered per patient-day decreased by 0.22 (10.7 percent) compared with baseline, after adjustment for age, sex, and principle discharge diagnosis (P < 0.01). In the intervention period versus baseline, there were nonsignificant reductions in hospital mortality (2.2 versus 1.8 percent; P = 0.1) and volume of blood transfused in patients who received a transfusion (127.2-milliliter decrease; P = 0.06). There was an estimated $16.19 decrease in hospital direct costs per admission with the intervention.

"Implementation of a multifaceted quality improvement intervention within a community-based hospitalist group was associated with a significant, but modest, decrease in the number of ordered lab tests and hospital costs," the authors write.