High expectations vs. unknown factors
While reducing the tests by 47% is an impressive achievement, Han and his fellow residents had pledged to reduce that amount by 50%. "We were just shy of that 50% reduction and the lesson we learned was that it is hard to make changes like this. When you set a goal that takes a lot of effort and foresight and when you are trying to implement these goals there are a lot of unknown elements that you don't always know about going forward," Han says.
"As a group of residents, one of the unknown factors we encountered was there were a lot of lab orders that we don't have control over. On our service the anesthesiologists help us take care of the patients and have the ordering privileges to order any kind of labs on their patients that they deemed appropriate around the operative and perioperative care settings. All the labs they ordered in some ways counted against us but they certainly felt it was an important part of the care so we never argued. That was probably what was included still in that group of 53% of tests that were still being ordered."
Even though they generated nearly $2 million in savings, including the $75,000 in direct costs for the medical center, the residents were not awarded the $400 prize from UCSF. Nonetheless, Han says they are all "very proud of our results."
"We were actually surprised that it wound up calculating out to be a fairly large sum of money," he says. "The medical center did thank us for our efforts at the quality retreat for the medical center they gave us the award for the best quality improvement initiative initiated by physicians."