Background: Practical and financial pressures have placed a renewed focus on improving the human experience of healthcare from both the patient and provider perspective. Despite this, aligning patients and interdisciplinary providers around meaningful experience improvement in the inpatient setting remains elusive. We sought to develop an innovative interdisciplinary design process for experience improvement on a [...]

Background : As part of the Choosing Wisely campaign, the Society of Hospital Medicine recommends against performing “repetitive complete blood count [CBC] and chemistry testing in the face of clinical and lab stability.” This recommendation stems from a body of research that shows that frequent or excessive phlebotomy can have negative consequences, including iatrogenic anemia, increased [...]

Background: Unnecessary diagnostic testing contributes to the escalating cost of health care in the US and can cause harm to patients. Daily blood work has become a routine part of care for hospitalized adults though only a fraction of tests change diagnosis or management decisions. At academic medical centers, residents are responsible for ordering most [...]

Background: Formal curricula for teaching medical students high value care are lacking, and there is little evidence identifying strategies that can effectively impact students’ knowledge and skills. Research is needed to develop models for student-led HVC implementation in healthcare settings. Purpose: To create a student-led longitudinal curricular experience that leads to improvements in utilization outcomes. [...]

Background: Decades-old clinical data and practice guidelines support the use of lipase over amylase in the workup and management of acute pancreatitis. Yet, laboratory testing for amylase continues to cost the Center for Medicare and Medicaid Services more than $19 million in largely avoidable charges each year. Previously hypothesized drivers of overutilization of amylase testing [...]

Background: Inappropriate laboratory utilization in hospitalized patients is a significant contributing factor to health care expenditures, iatrogenic anemia, downstream testing, and poor patient satisfaction. For these reasons, the Society of Hospital Medicine has recommended through the Choosing Wisely Campaign to avoid repetitive complete blood counts (CBC) and chemistry testing in the face of clinical stability. [...]

Background: In response to skyrocketing healthcare costs, providing high value care is an increasing priority for health care systems. Physicians are responsible for translating high value care (HVC) to the bedside, however there is a paucity of instruments designed to measure observable markers of HVC at the beside. This confounds efforts to develop and measure [...]

Background: As part of the ABIM Foundation’s Choosing Wisely campaign the Society of Hospital Medicine recommended providers avoid performing repetitive CBC and chemistry testing in the face of clinical and lab stability. In 2014 as part of an EMR upgrade our institution removed the “daily labs” order. A 1-year post change audit showed no change [...]