Re-Purposing the Ordering of 'Routine' Laboratory Tests in Hospitalized Medical Patients (RePORT Study)

Utilization, Health Care Clinical Trial

Official title: Re-Purposing the Ordering of 'Routine' Laboratory Tests in Hospitalized Medical Patients (RePORT Study)

Status Recruiting

Clinical Trial Summary

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.

Clinical Trial Description

Background: Laboratory and Pathology testing contributes to rising health care expenditure. A relatively large percentage (up to 42%) of laboratory testing can be considered wasteful. Redundant testing alone has been estimated to waste up to 5 billion USD annually in the USA. Laboratory over-utilization leads to false positives that promotes further inappropriate testing and procedures, interruption of normal sleep pattern of inpatients, as well as iatrogenic anemia and pain. A Canadian study showed significant hemoglobin reductions as a result of phlebotomy. Studies support the safe reduction of repetitive laboratory testing without negative effects on adverse events, readmission rates, critical care utilization, or mortality. The aim of this research study is the following: 1. To implement a multimodal intervention bundle containing healthcare provider and patient engagement tools for hospitalized medical inpatients in 14 hospitals across the province of Alberta in Canada using a cluster randomized stepped-wedge design 2. To evaluate the impact of the LTO intervention bundle on laboratory test utilization of six target laboratory tests (complete blood count, electrolytes, creatinine, urea, partial thromboplastin time, and international normalized ratio), costs, and patient safety outcomes. This intervention bundle will be implemented across all the adult hospital sites in Alberta starting January 2023 and evaluated until September 2024. The investigators anticipate recruitment to continue until March 2024. Baseline data will be collected from March 2018. ;

Related Conditions & MeSH terms

• Utilization, Health Care

• NCT number: NCT06119464
• Study type: Interventional
• Source: University of Calgary
• Contact: Anshula Ambasta
• Phone: 1-403-6184586
• Email: aambasta@ucalgary.ca
• Status: Recruiting
• Phase: N/A
• Start date: January 2, 2023
• Completion date: September 8, 2024