Re-purposing the ordering of ‘routine’ laboratory tests in hospitalized medical patients (RePORT)

Blood tests can help diagnose diseases and monitor health status. However, overuse of blood testing, particularly in hospitals, leads to patient discomfort, loss of sleep, contributes to blood loss leading to blood transfusions, and wastes health care dollars. We previously developed and tested a multi-part healthcare provider (HCP) engagement strategy to safely reduce overuse of six target laboratory tests that make up 40 percent of costs on laboratory testing in hospitalized medical patients. In collaboration with a Patient and Family Advisory Council (PFAC), we have co-designed a patient engagement strategy that includes an infographic, video and website. Our team, made up of clinicians, researchers, patient partners and policy makers, proposes to launch the HCP and patient engagement strategies across 16 hospitals in British Columbia and 14 hospitals in Alberta in a cluster randomized stepped-wedge design. We will evaluate the impact of this strategy on number of laboratory tests done, patient experience, patient safety, costs and HCP experience, using administrative data systems and patient and HCP interviews. We will work with the PFAC to design implementation evaluation, particularly of the patient engagement strategy.