Background: Unnecessary inpatient laboratory testing is common and negatively impacts patients by causing discomfort and iatrogenic anemia. Such testing also burdens a busy phlebotomy team, particularly when patients decline labs due to recency of previous checks. Audit and feedback interventions are known to reduce low value practices in medical residents, but no published study has [...]

Background:   In line with the American Board of Internal Medicine’s (ABIM) Choosing Wisely® initiative, the Society of Hospital Medicine (SHM) recommends not performing repetitive complete blood count (CBC) and chemistry (CHEM7) testing in the face of clinical and lab stability.  In addition to decreasing the risk of hospital acquired anemia (HAA), reducing unnecessary routine blood work can ultimately result in significant [...]

Background: The Society of Hospital Medicine and the ABIM Foundation‘s Choosing Wisely Campaign have made tackling overutilization of routine labs part of their mission.  Based on the literature, 30-50% of routine labs ordered for hospitalized patients every morning may be unnecessary.  Aside from pain, discomfort and sleep disturbance, these daily labs predispose patients to iatrogenic [...]

Background: The practice of routinely ordering daily labs not based on clinical indication on patients in the hospital is a wasteful clinical practice. Routine daily labs can also lead to patient harm by causing pain and iatrogenic anemia, and can burden laboratory staff resulting in increased lab reporting times. Raising awareness about unnecessary lab orders [...]

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: As hospitals are increasingly reimbursed for value-based care, quality improvement projects addressing overutilization of routine “daily labs” have become commonplace. Although there are many published studies of daily labs reduction initiatives, there is little consensus on the actual costs of these routine labs to institutions, with most relying on Centers for Medicare & Medicaid [...]

Background: Up to 50% of the American healthcare spending is estimated to be wasteful. The largest type of wasteful spending is on overuse of tests and treatments. Among the diagnostic tests that are overused, excessive phlebotomy stands out due to its multifaceted implications, including hospital-acquired anemia, patient discomfort, provider burden, and avoidable downstream testing. The [...]

Background: US healthcare costs are exorbitant and excessive lab utilization contributes significantly1. Daily labs (DLs) are often over-ordered for inpatients.2 This leads to increased costs, iatrogenic anemia, patient discomfort and limits phlebotomy resources 3. The Choosing Wisely® campaign recommends against checking DL in patients who have clinical and lab stability5. Previous quality improvement initiatives have [...]

Background: Healthcare costs in the United States are exorbitant and excessive lab utilization contributes significantly1. Daily labs (DL), typically consisting of basic metabolic panels (BMPs) and complete blood counts (CBC) are often over-ordered for hospital inpatients2. This leads to increased costs, limits phlebotomy resources, iatrogenic anemia, patient discomfort and interruption of sleep3. The Choosing Wisely® [...]