Mindfulness-Based Laboratory Reduction: Reducing Utilization Through Trainee-Led Daily ‘Time Outs’ - 27/09/17
, Ramy R. Saleh, MD a, 1, Todd C. Lee, MD, MPH a, bAbstract |
Background |
Overuse of laboratory investigations is widely prevalent in hospitalized patients, leads to discomfort, and increases direct and indirect costs.
Objective |
We implemented a simple, inexpensive, mindfulness strategy on our inpatient medical clinical teaching unit to reduce unnecessary laboratory orders through education, a forcing function, and daily structured laboratory “time outs.”
Methods |
On a 26-bed unit in an academic hospital center, the per-period laboratory costs per patient were compared pre- and postintervention using segmented regression analysis of an interrupted time series.
Results |
The average cost per admitted patient decreased from $117 to $66, with an estimated savings of $50,657 over 985 admissions. After adjusting for fiscal period and the presence of our intervention, there was a significant reduction in the per-patient number of total tests, complete blood counts, and electrolyte panels performed (P <.001 for all level and time trend changes).
Conclusion |
This trainee-designed and -led intervention, centered around structured, mindfulness-based laboratory test ordering, was successful at decreasing the overuse of common daily blood work in hospitalized patients.
Le texte complet de cet article est disponible en PDF.Keywords : High-value health care, Laboratory tests, Overutilization, Quality improvement, Trainee-led
Plan
| Funding: This project was completed without any internal or external funding. |
|
| Conflict of Interest: The authors have no conflicts of interest to declare. |
|
| Authorship: All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the analysis. |
|
| Study concept and design: RRS, TCL; Acquisition of data: RRS, TCL, EGM; Analysis and interpretation of data: RRS, TCL, EGM; Drafting of the manuscript: TCL, EGM; Critical revision of the manuscript for important intellectual content: TCL, RRS, EGM; Statistical analysis: TCL, EGM; Study supervision: TCL, EGM. |
Vol 130 - N° 6
P. e241-e244 - juin 2017 Retour au numéro
Article précédent
- Independent of Cirrhosis, Hepatocellular Carcinoma Risk Is Increased with Diabetes and Metabolic Syndrome
- Allison J. Kasmari, Amy Welch, Guodong Liu, Doug Leslie, Thomas McGarrity, Thomas Riley
- Excess Ticagrelor Mortality in the Food and Drug Administration Adverse Event Reporting System: Time to Recount PLATO Trial Deaths
- Victor L. Serebruany, Seth D. Fortmann, Vasily Cherepanov, Oleg Litvinov, Moo Hyun Kim, Thomas A. Marciniak
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?