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.
El texto completo de este artículo está disponible en PDF.Keywords : High-value health care, Laboratory tests, Overutilization, Quality improvement, Trainee-led
Esquema
| Funding: This project was completed without any internal or external funding. |
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| Conflict of Interest: The authors have no conflicts of interest to declare. |
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| 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. |
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| 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 Regresar al número
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Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
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