• Emily G McDonald, Ramy R Saleh, and Todd C Lee.
• Department of Medicine, McGill University, Montreal, Quebec, Canada; Clinical Practice Assessment Unit, McGill University Health Centre, Montreal, Quebec, Canada. Electronic address: emily.mcdonald@mcgill.ca.
• Am. J. Med. 2017 Jun 1; 130 (6): e241-e244.

BackgroundOveruse of laboratory investigations is widely prevalent in hospitalized patients, leads to discomfort, and increases direct and indirect costs.ObjectiveWe 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."MethodsOn 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.ResultsThe 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).ConclusionThis 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.Copyright © 2017 Elsevier Inc. All rights reserved.

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