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Residents Save $2M By Eliminating Needless Lab Tests

John Commins, for HealthLeaders Media, October 21, 2013

Criteria for testing and quality metrics set
Han says the residents weighed the safety of the patient against the need for a test. They didn't want patient care to suffer for lack of a diagnosis. "We were being careful about ordering it on everybody, to really be smarter about who we are ordering it for and almost predicting based on the patients past medical history and their current medical condition who are the patients we should be ordering for and who has the higher likelihood of an abnormal test."

"We met with our hospitalist group and came up with criteria. If the patient meets this criteria that would be the only scenario where would order these tests. We also monitor and have a quality and safety review board that follows all of the general outcomes of these patients including readmission rates and length of hospitalization and length of time in the ICU. Those quality metrics that we followed over time hadn't changed at all throughout this period where we were implementing the new policy of reduced lab orders. We were reassured that we actually had not diminished the quality of the care that we were providing. We didn't see higher rates of complications because a lab test was missed or failed to be ordered or failed to detect an abnormal test."

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4 comments on "Residents Save $2M By Eliminating Needless Lab Tests"


Real savings (10/27/2013 at 9:25 AM)
Honest accounting is right. The majority of the tests are chemistry tests.The real savings are the cost of reagents and controls. Thus $75,000 are the real savings. As my CFO would say the $2 million is" funny money".

Honest Accounting (10/23/2013 at 2:05 PM)
Good story and good effort, but please some truth in accounting! The project reduced CHARGES by $1.7 million, which probably did not mean much (if any) in real costs differences to the insurers, who probably paid per case or per day reimbursements that were not changed by reduced testing. It is good to reduce utilization that does not benefit patients, but care should be taken to report that correctly.

DonaldStumpp (10/23/2013 at 1:08 PM)
In other news.... the Lab Director was fired for not achieving revenue goals. Oh what a tangled web we weave. If the hospital revenues are on a DRG or case basis, then there truly is savings to the hospital, otherwise, this savings cost them. I'm not arguing it should not be done, but shows how incentives can be misplaced. If there is not value in the procedure or test or service, it needs to be eliminated.