ED

YNHH President Richard D'Aquila (left) congratulated members of the Emergency Department team responsible for reducing duplicate lab testing by 40 percent. Front row (l-r) Tom Zaldumbide, RN; Richell Delegiro, RN; Daryl Wentworth, RN; Amit Patel, application analyst, Information Technology Services; Dr. Venkatesh; and Gail D'Onofrio, MD, chief, Emergency Medicine. Back row (l-r) Chris Chmura, RN; Hajdasz, Scott Sussman, MD, associate director, Hospitalist Group; Meir Dashevsky, MD; Vic Parwani, MD; Mark Sevilla, RN, director, Emergency Services; and Andy Ulrich, MD.



To improve the value of patient care, a Clinical Redesign team in the Adult Emergency Department focused on reducing duplicate lab testing.

The team questioned the frequency with which point-of-care tests and core lab tests were run on the same patient during a single ED visit. While team members agreed that duplicate testing is warranted on some occasions, they found it was possible to reduce duplicate lab tests significantly without compromising care quality.

"One key to the project's success was identifying a problem that everyone could agree on," said Arjun Venkatesh, MD. "Physicians wanted to reduce unnecessary testing to improve the value of emergency care, and nurses and patient care associates wanted to avoid unnecessary blood draws and reduce waste."

David Hajdasz, clinical redesign manager, YNHH Internal Consulting Group, said that when presented with impactful, data-based evidence showing how point-of-care results were equivalent to core lab results, the team acted quickly to change behaviors. "The 90-day cycle time of the Clinical Redesign project kept the team focused and generated swift implementation of high-impact interventions," Hajdasz said.

He explained that the team reduced the number of duplicate labs ordered by 40 percent through a series of specific interventions which included educating staff on the similarities between point-of-care and lab results, informing individual providers about how often they ordered duplicate lab tests, modifying an Epic order set and empowering the staff to choose single type of test.