Seunggu J. Han, MD, is a neurosurgeon
Neurosurgery residents at the University of California San Francisco Medical Center have demonstrated that a reduction by nearly 50% in the use of five common lab tests has no effect on patient care. The reductions generated $1.7 million in savings for payers in fiscal 2011–12, and another $75,000 in decreased direct costs for the medical center, according to a study in Journal of Neurosurgery.
In the one year before the project, the residents identified 45,023 of tests for serum levels of total calcium, ionized calcium, chloride, magnesium, and phosphorus in the neurosurgical service. In fiscal year 2011–2012, this number was reduced 47% to 23,660. The residents' findings were part of an in-house initiative at UCSF that encourages clinicians to identify department-specific cost savings and quality improvements in care delivery.
Seunggu J. Han, MD, a lead researcher among the 18 residents in the project and a neurological surgeon with UCSF, says it makes sense that residents would lead cost savings and quality initiatives because they're often the front-line clinicians with the most contact with patients.
"As a group of residents, we picked up that the majority of tests we were ordering on the neurosurgery service really didn't impact the day-to-day care," Han says. "No clinical decisions were made based on those lab results, whether they were normal or not. The patient's care would not have changed at all whether we had done that test or not. That was the case particularly with those lab tests that we identified."