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: Excessive laboratory use has been associated with increased hospital costs, increased incidence of anemia, and unnecessary additional testing and procedures. Previous studies have focused on resident interventions within teaching hospitals amongst other residents, but few studies have had residents intervene on non-teaching faculty. A quality improvement initiative was implemented at our institution to reduce [...]

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: 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® [...]

Background: An estimated 20-30% of inpatient standing labs are medically unnecessary1, contributing to iatrogenic anemia2, sleep disruption3, and increased healthcare costs. The Society of Hospital Medicine identified routine repetitive complete blood count (CBC) and chemistry (BMP) as a common wasteful inpatient practice4. At our institution, repetitive inpatient CBC, BMP, magnesium, and phosphorus account for 500,000 [...]