Reducing Unnecessary Routine Laboratory Testing in Hospitalized Adults Across British Columbia Hospitals Using an Intervention Bundle

What this Trial Is About

The trial investigates the impact of a laboratory test overuse intervention bundle on reducing unnecessary lab tests among adult hospitalized medical patients in 16 hospitals across British Columbia. This stepped-wedge cluster randomized study aims to assess whether educational and patient engagement tools can effectively decrease overuse of routine lab tests such as complete blood count, electrolytes, creatinine, and coagulation tests. The study addresses concerns like patient discomfort, sleep disruption, and hospital-acquired anemia caused by excess testing. The intervention group will receive a bundle including online educational modules, clinical decision support tools, audit and feedback reports for healthcare providers, and patient engagement materials like videos and infographics. Local hospital teams will adapt and implement these tools over sequential 12-week steps, with an initial 4-week period for piloting and adapting tools followed by 8 weeks of active intervention. The control periods involve usual care without the intervention tools. Participants include hospitalized adult general medical patients under internal or family medicine care, their attending physicians, learners, and allied health staff involved in ordering tests. Researchers will collect data for at least 24 weeks after implementation to evaluate changes in laboratory test utilization, readmission rates, mortality, and related costs. The study uses monitoring of test ordering patterns, readiness assessments, and workflow observations to measure impact and sustainability without dedicated personnel support.

Re-Purposing the Ordering of Routine Laboratory Tests in Hospitals in British Columbia