Background: The majority of patients on medicine wards are phlebotomized daily. This is particularly problematic in academic centers where trainees are primarily responsible for patient care. Unnecessary phlebotomy is not only costly, but can lead to iatrogenic anemia, puncture site infection, and increase patient discomfort. The objective of this study was to determine whether an educational intervention given to Internal Medicine (IM) residents and attending physicians could reduce daily lab tests ordered on general medicine wards.
Methods: IM residents at Truman Medical Center in Kansas City were given an educational intervention in the form of an oral presentation and emails on the dangers of phlebotomy and the advantages of add-on labs. Attending physicians on service were notified of the project aim. Data pertaining to total labs and add-on labs ordered was analyzed for two months before and after the intervention.
Results: Following the intervention, the mean number of inpatient labs ordered per patient per day by IM residents decreased from 3.95 to 3.78 (p = 0.009) and the proportion of add on labs ordered by IM residents increased from 27% to 29% (p = .001).
Conclusions: A brief educational intervention was effective in reducing the total number of labs and increasing the percentage of add-on labs ordered by IM residents. We introduce here the possibility of reducing unnecessary phlebotomy by increasing the use of add-on labs through physician education. Our findings also support that a short educational intervention can influence the behaviors of resident physicians.