Impact of an Educational Intervention on the Frequency of Daily Blood Test Orders for Hospitalized Patients

Abstract

Provider education and reminders can reduce the frequency of daily blood tests ordered by providers for hospitalized patients. This can decrease health care costs and may reduce the risk of complications such as anemia.

Toward High-Value Care: A Quality Improvement Initiative to Reduce Unnecessary Repeat Complete Blood Counts and Basic Metabolic Panels on a Pediatric Hospitalist Service

“…Many of these focused on order entry process, either through alterations in the ordering process [16][17][18][19][20][21] or providing charge data in electronic ordering systems. 23,24 Although feedback to teams regarding charges 25 and educational initiatives 30 have decreased costs, we believe our report is the first to use improvement science to combine multiple interventions that have successfully improved and sustained physician ordering behavior without a technology support emphasis.…”

Decreasing daily blood work in hospitals: What works and what doesn't

“…Many interventions are multifaceted incorporating both a component of person‐oriented intervention as well as change in system design or process. Table lists the studies reviewed that have used education and reminders, audit and feedback, computer physician entry order systems, and forcing restraints …”

“…Other studies have shown short‐term benefits. Thakkar et al performed an educational session, with educational flyers and weekly email reminders, whereas Ko et al performed an educational session, followed by visual reminders throughout the surgical intensive care unit (SICU) and a daily checklist. Both saw a significant decrease overall in blood tests ordered and associated cost savings without a change in mortality during the intervention period.…”

“…As general rule in quality improvement initiatives, the minimum intervention required to achieve the desired change should be used to help insure that unintended consequences are kept to a minimum [Colour figure can be viewed at wileyonlinelibrary.com] they order. One such tool is the Hierarchy of Effectiveness, a widely Table 1 lists the studies reviewed that have used education and reminders, [15][16][17][18] audit and feedback, [19][20][21] computer physician entry order systems, [22][23][24] and forcing restraints. [25][26][27][28][29][30] So, while education is always a component of changing ordering behaviors, there is a limited role for education as a sole intervention given the lack of long-term effects.…”

Reducing Blood Glucose Testing Is Safe in Patients Receiving Parenteral Nutrition

“…Unfortunately, the effect of reducing the frequency of laboratory testing on clinical outcomes, such as rate of complications or hospital length of stay, is difficult to determine due to the number of confounding factors. Most studies in this area assumed clinical equivalence rather than tracking outcomes …”