Re-Purposing the Ordering of 'Routine' Laboratory Tests in Hospitalized Medical Patients (RePORT Study)

Last updated: December 16, 2024
Sponsor: University of Calgary
Overall Status: Active - Not Recruiting

Phase

N/A

Condition

N/A

Treatment

Multimodal Intervention: Patient Engagement

Multimodal Intervention: Audit and Feedback

Multimodal Intervention: System Changes

Clinical Study ID

NCT06119464
REB17-1215
H22-03005
  • Ages > 18
  • All Genders
  • Accepts Healthy Volunteers

Study Summary

Laboratory test overuse occurs when tests are ordered repetitively, without due consideration of impact on clinical status. Repetitive inpatient lab testing often provides limited value for patient outcomes while increasing healthcare costs, patient discomfort, and unnecessary transfusions and prolonging hospitalizations. The research study aims to reduce laboratory test overuse in hospitals through implementation of a comprehensive, multi-disciplinary, and multi-faceted intervention bundle that includes audit and feedback reports, clinician education, clinical decision support tool, and patient infographics across 14 hospitals in Alberta.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • all participants (patients and healthcare providers) within enrolled adult hospitalsin Alberta of medical and hospitalist units during study period

Exclusion

Exclusion Criteria:

  • outside of the above-mentioned province

  • hospitals not enrolled

  • non-medical units (eg. ICU, surgical, pediatric, obstetrical units)

Study Design

Total Participants: 251817
Treatment Group(s): 5
Primary Treatment: Multimodal Intervention: Patient Engagement
Phase:
Study Start date:
January 02, 2023
Estimated Completion Date:
October 31, 2025

Study Description

Background: Laboratory and Pathology testing contributes to rising health care expenditure. A relatively large percentage (up to 42%) of laboratory testing can be considered wasteful. Redundant testing alone has been estimated to waste up to 5 billion dollars annually in the United States of America. Laboratory over-utilization leads to false positives that promotes further inappropriate testing and procedures, interruption of normal sleep pattern of inpatients, as well as iatrogenic anemia and pain. A Canadian study showed significant hemoglobin reductions as a result of phlebotomy. Studies support the safe reduction of repetitive laboratory testing without negative effects on adverse events, readmission rates, critical care utilization, or mortality.

The aim of this research study is the following:

  1. To implement a multimodal intervention bundle containing healthcare provider and patient engagement tools for hospitalized medical inpatients in 14 hospitals across the province of Alberta in Canada using a cluster randomized stepped-wedge design

  2. To evaluate the impact of the intervention bundle on laboratory test utilization of six target laboratory tests (complete blood count, electrolytes, creatinine, urea, partial thromboplastin time, and international normalized ratio), costs, and patient safety outcomes.

This intervention bundle will be implemented across all the adult hospital sites in Alberta starting January 2023 and evaluated until October 2024.

Connect with a study center

  • University of Calgary

    Calgary, Alberta T2N 1N4
    Canada

    Site Not Available

  • University of British Columbia

    Vancouver, British Columbia
    Canada

    Site Not Available

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