Improving Healthcare Value: Effectiveness Of A Program To Reduce Laboratory Testing For Non-Critically-Ill Patients With Covid-19

Avoiding routine, repetitive inpatient laboratory testing is a Choosing Wisely (R) recommendation, with benefits that may be even more pronounced in the setting of the COVID-19 pandemic, considering the need to limit unnecessary exposure, use of personal protective equipment, and laboratory resources. However, the COVID-19 pandemic presented a unique challenge: how to efficiently develop and standardize care for a disease process that had yet to be fully characterized. This article describes the development of a local committee to critically review evidence-based practices, reach consensus, and guide practice patterns, with the aim of delivering high-value care. Following the local introduction of recommendations and electronic health record order sets, non-critically-ill COVID-19 patients at our hospital had more inpatient days where they did not receive laboratory tests, achieving sustained special cause variation on statistical process control charts. The principles of Choosing Wisely (R) can be applied even within novel and rapidly evolving situations. (C) 2021 Society of Hospital Medicine