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Bedside Assessment of the Necessity of Daily Lab Testing for Patients Nearing Discharge

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&NA; As part of the Choosing Wisely® campaign, the Society of Hospital Medicine recommends against performing “repetitive complete blood count chemistry testing in the face of clinical and lab stability.”… Click to show full abstract

&NA; As part of the Choosing Wisely® campaign, the Society of Hospital Medicine recommends against performing “repetitive complete blood count chemistry testing in the face of clinical and lab stability.” With this recommendation as a framework, we targeted 2 hospitalist‐run inpatient medicine units that employed bedside, scripted, interdisciplinary rounds. Our multifaceted intervention included prompting the hospitalist to identify clinically stable patients for next‐day discharge and to discontinue labs when appropriate. It was coupled with the education of the clinicians and a regular data review for the hospitalists and unit staff. Among 2877 discharges included in a 1‐year period, there was a significantly decreasing trend after the intervention in the percentage of patients getting labs in the 24, 48, and 72 hours before discharge (‐1.87%, ‐1.47%, and ‐0.74% decrease per month, respectively; P < .05). Our structured, multifaceted approach effectively reduced daily lab testing in the 24 to 48 hours prior to discharge. Journal of Hospital Medicine 2018;13:38‐40. Published online first October 18, 2017.

Keywords: lab testing; medicine; daily lab; assessment necessity; hospital medicine; bedside assessment

Journal Title: Journal Of Hospital Medicine
Year Published: 2018

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