Utilization, Health Care Clinical Trial
Official title:
Re-Purposing the Ordering of 'Routine' Laboratory Tests in Hospitalized Medical Patients (RePORT Study)
Laboratory test overuse occurs when tests are ordered repetitively, without due consideration of impact on clinical status. Repetitive inpatient lab testing often provides limited value for patient outcomes while increasing healthcare costs, patient discomfort, and unnecessary transfusions and prolonging hospitalizations. The research study aims to reduce laboratory test overuse in hospitals through implementation of a comprehensive, multi-disciplinary, and multi-faceted intervention bundle that includes audit and feedback reports, clinician education, clinical decision support tool, and patient infographics across 14 hospitals in Alberta.
Status | Recruiting |
Enrollment | 251817 |
Est. completion date | October 2024 |
Est. primary completion date | October 2024 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - all participants (patients and healthcare providers) within enrolled adult hospitals in Alberta of medical and hospitalist units during study period Exclusion Criteria: - outside of the above-mentioned province - hospitals not enrolled - non-medical units (eg. ICU, surgical, pediatric, obstetrical units) |
Country | Name | City | State |
---|---|---|---|
Canada | University of Calgary | Calgary | Alberta |
Lead Sponsor | Collaborator |
---|---|
University of Calgary | Alberta Health services, Canadian Institutes of Health Research (CIHR), University of British Columbia |
Canada,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Number of routine laboratory tests ordered per patient-day in the intervention versus control periods | Number of the six target laboratory tests (complete blood count, electrolytes, creatinine, urea, international normalized ratio and partial thromboplastin time) ordered per patient-day | 1 year 9 months | |
Secondary | Costs associated with routine and all common laboratory test ordered | Costs of test and associated costs with and without intervention | 1 year 9 months | |
Secondary | Proportion of hospital patient lab-free days | Number of hospital patient-days not associated with laboratory blood draws | 1 year 9 months | |
Secondary | Proportion of critically abnormal test results | As defined by lab standards, we will track the proportion of critically abnormal test results | 1 year 9 months | |
Secondary | Length of stay | Patient length of stay on the unit | 1 year 9 months | |
Secondary | Transfer to Intensive Care Unit | Transfer rate to Intensive Care Unit | 1 year 9 months | |
Secondary | In-patient and 30-day patient mortality over study period | Mortality rate in hospital and at 30-days post discharge | 30 days post discharge | |
Secondary | 30-day post discharge readmission rate | Hospital re-admission within 30 days post discharge | 30 days post discharge | |
Secondary | Number of all common laboratory tests | Number of all common laboratory tests (tests that contribute to >80% of hospital laboratory test utilization during study period) per patient-day. | 1 year 9 months |
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