Reducing unnecessary inpatient laboratory testing in a teaching hospital

Am J Clin Pathol. 2006 Aug;126(2):200-6. doi: 10.1309/WP59-YM73-L6CE-GX2F.


After an inpatient phlebotomy-laboratory test request audit for 2 general inpatient wards identified 5 tests commonly ordered on a recurring basis, a multidisciplinary committee developed a proposal to minimize unnecessary phlebotomies and laboratory tests by reconfiguring the electronic order function to limit phlebotomy-laboratory test requests to occur singly or to recur within one 24-hour window. The proposal was implemented in June 2003. Comparison of fiscal year volume data from before (2002-2003) and after (2003-2004) implementation revealed 72,639 (12.0%) fewer inpatient tests, of which 41,765 (57.5%) were related directly to decreases in the 5 tests frequently ordered on a recurring basis. Because the electronic order function changes did not completely eliminate unnecessary testing, we concluded that the decrease in inpatient testing represented a minimum amount of unnecessary inpatient laboratory tests. We also observed 17,207 (21.4%) fewer inpatient phlebotomies, a decrease sustained in fiscal year 20042005. Labor savings allowed us to redirect phlebotomists to our understaffed outpatient phlebotomy service.

Publication types

  • Comparative Study

MeSH terms

  • Hospitals, Teaching*
  • Humans
  • Inpatients*
  • Medical Laboratory Science / economics
  • Medical Laboratory Science / methods*
  • Phlebotomy / economics
  • Phlebotomy / statistics & numerical data*
  • Practice Patterns, Physicians'*
  • Unnecessary Procedures / economics
  • Unnecessary Procedures / statistics & numerical data*