Background: Thoughtful laboratory testing is a key component of high-value and cost-effective patient care. Studies estimate that nearly half of laboratory tests may be unnecessary in certain patient populations. The drivers of observed variation in laboratory testing are not clearly established; our study aims to examine whether testing varies by hospitalist years of experience. Methods: [...]

Background: Laboratory testing is an integral part of modern medicine with an estimated 4-5 billion tests performed in the United States each year, and accounts for 3-5% of healthcare spending. At our resident-run clinic in an underserved community, the cost of laboratory tests in 2013 was over $400,000, exceeding the government subsidy. In this study, [...]

Background: The ordering of unnecessary daily labs affects the safety of patients through hospital-acquired anemia, patient discomfort, and unnecessary downstream testing. This results in both additional financial and labor costs burdening the health system. As such, establishing effective interventions is warranted with necessary analysis of site-specific lab-ordering culture. We seek to perform this analysis to [...]

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: The Choosing Wisely Campaign encourages physicians to avoid over-utilizing routine labs in hospitalized patients with clinical and laboratory stability.  A number of studies have shown adverse effects on hospitalized patients from lab overutilization.  In previous research, we observed that internal medicine physicians at our center often order a daily complete blood count (CBC) and [...]

Background: The Choosing Wisely campaign was launched in 2012 with a goal of “advancing a national dialogue on avoiding wasteful or unnecessary medical tests, treatments, and procedures.[1] ”  The Society of Hospital Medicine published 5 recommendations for Adult Hospital Medicine in 2013[2] , including one that advised against performing repetitive complete blood count (CBC) and [...]

Background: Serum magnesium is a commonly checked laboratory assay during hospital admissions. However, there is little evidence demonstrating benefit from ordering and repleting magnesium for most inpatients – including critically-ill patients. Methods: Laboratory and magnesium repletion ordering data from 2015-2016 was obtained directly from laboratory and pharmacy databases for inpatient encounters with at least one [...]

Background: Cost associated with diagnostic testing contributes greatly to the rising cost of health care in the United States (Bindraban et al, 2018). There is evidence to suggest that up to 20% of lab testing is unnecessary (Bindraban et al, 2018).Main Line Health (MLH) is a health system in suburban Philadelphia made up of four [...]