Researchers issue blueprint for phasing out unnecessary blood tests in hospitals

A gloved hand puts a test tube of blood into a tube tray to prepare for testing

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Repeated blood draws during a hospital stay can have a negative impact on a patient's health and contribute to rising health care costs. In a review article published this week in JAMA Internal Medicine, physicians at Johns Hopkins joined an international team that crafted an improvement blueprint to reduce repetitive lab testing for hospitalized patients.

The paper is co-authored by residents and faculty from the High Value Practice Academic Alliance, a consortium of nearly 90 academic medical centers collaborating to improve health care quality and safety by reducing unnecessary components of practice that do not add value to patient care. Earlier this year, members of the alliance authored a paper recommending hospitals stop ordering certain tests for diagnosing heart attacks.

"Excessive blood draws can deplete a patient's hemoglobin count, which often leads to repeat testing," says Kevin Eaton, a third-year internal medicine resident at Johns Hopkins Hospital.

An estimated 20 percent of hospitalized patients can develop hospital-acquired anemia—caused by repeated blood draws—and diagnosing the anemia can cause a spiral of additional unnecessary tests, interventions, and costs for the patient.

Published studies show that decreasing blood draws for testing did not result in missed diagnoses or increase the number of readmissions to the hospital, and the cost savings of eliminating unnecessary tests ranges between $600,000 and $2 million per year, the researchers say.

The improvement blueprint recommendations include:

  • Outline and standardize best practices through data and educational initiatives
  • Establish target numbers by which to reduce lab test ordering
  • Reprogram the electronic test-ordering systems to restrict the number of "pre-ordered" tests
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