• Evan J Wiens, Izabella Supel, Justine Gallardo, and Colette M Seifer.
• Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
• Intern Med J. 2021 Mar 1; 51 (3): 398-403.

BackgroundUp to 30% of medical spending in developed countries is unnecessary. Unnecessary testing is not only wasteful economically, but can be injurious to patients. Studies have shown that interventions such as education, auditing, and restrictive ordering can reduce unnecessary testing. However, these interventions are time- and resource-intensive. We conducted a study to determine if the passive intervention of placing signs on clinicians' computers was effective in reducing unnecessary testing.AimsTo determine the effectiveness of signage on physicians' computers to limit unnecessary testing.MethodsWe identified two acute medicine wards on which all orders are placed via computer. On one ward (Ward A), we placed signs outlining recommendations regarding responsible test-ordering. Ward B acted as a control. Data was collected during a 6-month study period to determine whether test-ordering practices differed.ResultsA total of 1645 patients accounting for 17 786 patient-days were included in the study. Fewer tests were ordered on Ward A than Ward B (7.38 vs 8.20 tests/patient-day; P < 0.01). Additionally, significantly fewer patients on Ward B received ≥1 complete blood count/day (36.1% vs 42.5%, P = 0.04). This effect was most pronounced among patients admitted for 7-30 days.ConclusionThe passive intervention of placing signs on clinicians' computers significantly reduced unnecessary testing.© 2020 Royal Australasian College of Physicians.

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