Background: Excessive daily routine laboratory testing for hospitalized patients is a contributor to poor hospital sleep, iatrogenic anemia, and excessive costs. Recommendations from the Choosing Wisely™ campaign specifically state to avoid sleep interruptions for routine care (American Academy of Nursing) and to avoid routine labs for stable patients (Society of Hospital Medicine). The purpose of [...]

Background: Telemetry utilization for a long time has been dependent on individual physician experiences, preference as there were no good randomized controlled trails or guidelines from any scientific organization. American Heart Association has released the guidelines for appropriate use of telemetry in Oct 2004. Even more than a decade of these guidelines been available there [...]

Background: The Society of Hospital Medicine (SHM) identifies repetitive CBC & chemistry testing as low-value, and they selected this as a Choosing Wisely Recommendation. Overuse of phlebotomy is associated with hospital-acquired anemia, decreased patient satisfaction and increased hospital costs. Process improvement techniques have been utilized to reduce inpatient phlebotomy, but prospectively identifying a cohort of [...]

Background: In the US, thyroid stimulating hormone (TSH) is the 4th most commonly ordered laboratory test with thyroxine measurement being the 10th commonest. In 2016, Medicare alone spent $482 million on 21.5 million performed TSH tests and $12.28 million on 7.1 million performed thyroxine measurement tests. The objectives of this study were to analyze (a) [...]