HAMILTON, ON - An estimated 20–50% of all laboratory testing is inappropriately ordered, meaning that it is either an incorrect test, a redundant test or a correct test ordered at the wrong time. This results in large amounts of wasted public money, misdirected clinical effort, increased workload and the potential for patient harm.
It is for this reason the Canadian Society for Medical Laboratory Science (CSMLS) worked collaboratively with the University of Alberta to create a laboratory specific tool to help clinicians, medical laboratory professionals and patients improve how labs and lab tests are utilized in Canada.
The Lab Wisely (labwisely.ca) website was designed to educate medical laboratory professionals about lab utilization and empower them to make wise choices when collecting samples and running lab tests. Protecting valuable laboratory resources has never been more important, especially at this time of increased demand due to COVID-19 testing across Canada.
“We believe medical laboratory technologists and assistants are poised to be the change-makers in appropriate lab utilization,” says CSMLS CEO Christine Nielsen. “Lab Wisely gives lab professionals recommendations on how to save time and money when it comes to lab tests, all for the benefit of patient care.”
The website includes a searchable database of all Choosing Wisely Canada’s recommendations, but can be searched using laboratory terminology to make it easier to find the items most directly related to the lab. It also houses seven specific recommendations for improving laboratory resource utilization. A panel of experts created the seven recommendations, which were then approved by Choosing Wisely Canada.
“The recommendations presented in Lab Wisely are specific to laboratory science because they were created by subject matter experts in laboratory science,” says Amanda VanSpronsen, Project Lead from the University of Alberta.“These experts helped identify laboratory practices that highlight the need and justification for laboratory professionals to actively participate in health care resource utilization.”
Along with the recommendations, the website includes communication tools and products to help advocate for improved lab utilization. Medical laboratory professionals, other health professionals and patients can use the information to start meaningful conversations about appropriate lab testing.
Seven Things Clinicians and Patients Should Question
- Don’t collect more blood than what is needed. Use short draw tubes, consider add-on testing, and reduce or combine duplicate orders.
- Don’t proceed with testing or reporting when sample quality or identification is suspect.
- Don’t collect extra blood tubes in anticipation of test orders.
- Don’t support repeat test ordering (re-testing) at a frequency that is not backed by evidence.
- Don’t routinely repeat critical results for most common analytes before reporting.
- Don’t support ordering system mechanisms that contribute to over-testing. Encourage the development of an evidence-based utilization management program that may include interventions such as unbundling order sets, reflex testing algorithms, and decision-support technology.
- Don’t allow standing orders for repeat testing without a stop or review date.