A program at Cleveland Clinic reduced the number of unnecessary lab tests by blocking physicians from ordering the same test for hospitalized patients more than once a day. According to a recent study published in the American Journal of Clinical Pathology, the initiative prevented nearly 12,000 unnecessary tests over a two-year period. The program aimed to improve patient satisfaction by preventing unnecessary needle sticks, as well as to reduce anemia caused by excess blood draws. As an added benefit, the reduction in tests resulted in a cost saving of more than $183,000.
The initiative focused on implementation of a clinical decision support tool that was incorporated in the system’s computerized physician order entry (CPOE) program. The tool prevented physicians from ordering a test if it had already been ordered that day, and then provided the results of the earlier test. This was done only for tests deemed never to be needed more than once per day by a multidisciplinary test utilization committee. While many hospitals use a CPOE system that alerts the doctor that a test has already been ordered, physicians often ignore it because they don’t have the results handy, or the time to track them down, researchers said.
“The difference in our program is that we provided a ‘hard stop,’ meaning the system won’t allow doctors to order the duplicate tests, and even more importantly, the program provides the result of the test that had been previously ordered,” says Gary W. Procop, MD, MS, FASCP, an author of the study, pathologist, and medical director of enterprise test utilization and consultation services at Cleveland Clinic. “Doctors appreciated that. One told me that he was thrilled that computers were finally helping him do a better job.” Read the study abstract.