By Nicholas Spies, MD
Healthcare systems are increasingly focused on improving patient outcomes by optimizing lab test utilization and curbing unnecessary testing. Clinical decision support (CDS) tools have emerged as powerful solutions for helping labs achieve these goals. However, effectively developing, implementing, and managing these tools requires quite a bit of organized effort and informatics “know-how.”
At Monday afternoon’s scientific session, titled “Adventures in clinical decision support: Tackling orders for daily lab tests,” attendees will gain practical insights into overcoming common CDS challenges. Using a universal stewardship opportunity — daily test orders for inpatients — the session aims to ground the concepts in real-world applications. Attendees will leave with actionable strategies to sustainably enhance their own initiatives to improve laboratory stewardship.
First, Ronald Jackups, MD, PhD, will describe successes at Barnes-Jewish Hospital in St. Louis, Missouri. Jackups will highlight how the hospital’s strategy of “starting with the least interruptive approach that will provide incremental improvement” serves to align stakeholders and enlist their support. If minimally invasive approaches fail to achieve their desired effects, Jackups’ team then moves to more intensive strategies. This “in for a penny, in for a pound,” approach has resulted in some significant stewardship wins at Barnes-Jewish, and it’s a method that can be emulated broadly.
Next, Grace Mahowald, MD, PhD, will discuss the CDS approach at Massachusetts General Hospital in Boston, where her team aims to tackle overuse of the manual differential in the complete blood count. After performing a data-driven analysis of these test orders, Mahowald and colleagues identified that a common use case stemmed from patients with acute bleeding, where the counts and concentrations, rather than the differential, was the part of testing that provided true clinical utility.
By implementing a convenient order-switching intervention, they effectively addressed their primary goal, while providing a solution that was, as Mahowald says, “easily adoptable to other hospitals within the system.”
Both presentations will emphasize the importance of leading teams through change. “The most challenging part of any clinical decision support project is stakeholder engagement: aligning all relevant stakeholders toward a single path forward,” Jackups notes.
Join this enlightening session to discover how your laboratory can apply CDS to evolve your own laboratory stewardship efforts.
