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Mindfulness-based laboratory reduction: reducing utilization through trainee-led daily "time outs".
Am J Med. 2017 Feb 01;:
Authors: McDonald EG, Saleh RR, Lee TC
Abstract
BACKGROUND: Overuse of laboratory investigations is widely prevalent in hospitalized patients, leads to discomfort, and increases direct and indirect costs.
OBJECTIVE: We implemented a simple, inexpensive, mindfulness strategy on our inpatient medical clinical teaching unit to reduce unnecessary laboratory orders through education, a forcing function, and daily structured laboratory "time outs".
METHODS: On a 26-bed unit in an academic hospital centre, the per-period laboratory costs per patient were compared pre- and post-intervention using segmented regression analysis of an interrupted time-series.
RESULTS: The average cost per admitted patient decreased from $117 to $66 with an estimated savings of $50,657 over 985 admissions. After adjusting for fiscal period and the presence of our intervention, there was a significant reduction in the per-patient number of total tests, complete blood counts, and electrolyte panels performed (p<0.001 for all level and time trend changes).
CONCLUSION: This trainee designed and led intervention, centred around structured, mindfulness-based laboratory test ordering, was successful at decreasing the overuse of common daily bloodwork in hospitalized patients.
PMID: 28161348 [PubMed - as supplied by publisher]