Official websites use. Share sensitive information only on official, secure websites. Email: luca. Reducing unnecessary laboratory blood testing in the hospital setting represents a challenge to improve the adequacy of healthcare and a tricky task for teaching hospitals. Our hospital network actively participates in the Choosing Wisely Campaign and is engaged in avoiding unnecessary low value interventions and investigations.
Multicenter, proof of concept, prospective, observational, before and after study, in a network of public hospitals in Switzerland. All patients admitted between 1 January and 31 December were analyzed.
The primary outcome was a significant reduction in the number of laboratory tests per patient and per day during the hospital stay. Secondary outcomes were reduction in the blood sample volume taken per patient and per day in laboratory costs. Over the 36 months of the study, 33 admissions were analyzed. The peer pressure related to the unmasked benchmarking process did probably play a determinant role. Reducing unnecessary laboratory testing in hospitalised patients is a difficult task and represents a challenge to improve the adequacy of healthcare.
Avoiding inappropriate laboratory blood testing in hospitalised patients represents a significant concern for the improvement of the quality and adequacy of provided healthcare. Coming back to the opportunity of limiting unnecessary laboratory prescriptions, growing evidence suggests that decreasing the amount of laboratory tests is not associated with an increase in readmission, missed diagnoses or mortality.
Several interventions have been targeted at the inadequacy of blood testing in hospitals. The most successful were those that implemented multifaceted approaches involving a combination of 3 strategies: education, audit, and feedback on provider ordering practices, and restrictive ordering options in the electronic prescription tools. In one of these recommendations the Swiss Society of General Internal Medicine invited physicians to avoid ordering blood tests at regular intervals or to perform routine extensive lab panels without specific clinical questions.
