Laboratory stewardship perceptions and testing patterns at a pediatric tertiary care center

Tejas S Desai; Ken Tang; Viveak Kaul; Ivan M Blasutig; Melanie Buba

doi:10.1093/labmed/lmae003

Laboratory stewardship perceptions and testing patterns at a pediatric tertiary care center

Lab Med. 2024 Feb 28:lmae003. doi: 10.1093/labmed/lmae003. Online ahead of print.

Authors

Tejas S Desai^{1

2}, Ken Tang³, Viveak Kaul⁴, Ivan M Blasutig^{1

5

6}, Melanie Buba^{1

2

4}

Affiliations

¹ Children's Hospital of Eastern Ontario, Ottawa, Canada.
² Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
³ Independent Statistical Consultant, Richmond, Canada.
⁴ Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
⁵ Eastern Ontario Regional Laboratory Association, Ottawa, Canada.
⁶ Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada.

PMID: 38417046
DOI: 10.1093/labmed/lmae003

Abstract

Background: Despite stewardship efforts, laboratory testing overuse persists across medicine.

Objectives: To understand laboratory stewardship perceptions and testing patterns at a tertiary care pediatric hospital so that we could identify potential improvement opportunities.

Methods: An electronic survey exploring laboratory stewardship was sent to all pediatric medicine resident and staff physicians. Laboratory testing data were also assessed for patterns of testing and overuse.

Results: The survey response rate was 54% (43/80). The results indicated good familiarity with stewardship but poor familiarity with testing specifics (eg, cost). A mobile reference application was the most preferred quality improvement intervention, and online modules were the least desired. Overuse was apparent, with as many as 53% of laboratory tests being repeated within 7 days and only half of repeated tests subsequently yielding abnormal results.

Conclusions: Altogether, the data we collated demonstrated poor understanding of laboratory stewardship and substantial repeat testing with few abnormal results. These study findings suggest that laboratory stewardship is lacking at our center, and that multiple improvement opportunities exist.

Keywords: hospital medicine; laboratory medicine; laboratory stewardship; medical education; pediatrics; quality improvement.