• Vishwanath Anil, Komal Harisinghani, Priyasi Monga, Nageshwar Reddy Kothur, Surya Prakash Reddy Bussa, Srikanth Maddika, Carole Ehleben, and Ashok Kumar Kanugula.
• From the Department of Internal Medicine, Wellstar Spalding Medical Center, Griffin, Georgia.
• South. Med. J. 2024 Dec 1; 117 (12): 730735730-735.

ObjectivesThe healthcare industry is grappling with escalating expenses, partially attributed to the inefficient use of medical resources, particularly by ordering unnecessary laboratory tests. Such practices not only increase costs but also result in extended hospital stays, patient discomfort, and potential clinical complications such as iatrogenic anemia. Blood tests, although essential for guiding medical decisions, are associated with significant clinical and financial costs. This quality improvement project aimed to decrease unnecessary laboratory testing at Wellstar Spalding Medical Center, a community hospital with a newly established residency program.MethodsOur study team played a pivotal role in formulating an algorithm that outlined the indications for a complete blood count and basic or comprehensive metabolic profile. We then conducted standardized didactic sessions for resident physicians and faculty, educating them on the use of "add-on" laboratory values, providing electronic medical records training, and highlighting the compounding costs of these simple laboratory tests. We analyzed data during a 3-month period, both before and in the intervention phase, adjusting for the number of physician-patient interaction days to account for potential variations in patient census in the hospital.ResultsThe number of complete blood count orders and basic/comprehensive metabolic profile orders underwent an absolute decrease in the postintervention period. When adjusted for the number of physician-patient interaction days, this decrease remained consistent, although not statistically significant.ConclusionsOur project has yielded clinically and administratively meaningful results. We have seen a measurable decrease in costs and the prevention of unnecessary laboratory testing. If it also can be shown that we have prevented iatrogenic anemia, our project could be seen as enhancing the patient experience and reducing hospital length of stay. We also have raised awareness about high-value care and instilled clinical awareness among residents regarding ordering daily blood tests contributing to an improvement in patient care.

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