Criteria for testing and quality metrics set
Han says the residents weighed the safety of the patient against the need for a test. They didn't want patient care to suffer for lack of a diagnosis. "We were being careful about ordering it on everybody, to really be smarter about who we are ordering it for and almost predicting based on the patients past medical history and their current medical condition who are the patients we should be ordering for and who has the higher likelihood of an abnormal test."
"We met with our hospitalist group and came up with criteria. If the patient meets this criteria that would be the only scenario where would order these tests. We also monitor and have a quality and safety review board that follows all of the general outcomes of these patients including readmission rates and length of hospitalization and length of time in the ICU. Those quality metrics that we followed over time hadn't changed at all throughout this period where we were implementing the new policy of reduced lab orders. We were reassured that we actually had not diminished the quality of the care that we were providing. We didn't see higher rates of complications because a lab test was missed or failed to be ordered or failed to detect an abnormal test."