Quality Improvement Initiative to Decrease Lab Draws for Hospitalized Pediatric Patients
Molly E. Geaman, Katherine M. Brennan, and Joy A. Vanderway
Background and Objectives: Frequent blood lab testing within the hospitalized pediatric population can have undesirable consequences, including patient pain and anxiety, increased healthcare costs, and decreased caregiver satisfaction. Nurses on an inpatient unit at a large, urban, academic pediatric hospital recognized the need for quality improvement (QI) to decrease the frequency of lab draws when their patients were experiencing multiple lab draws each day.
Methods: A unit-based, collaborative QI project was implemented. Education and communication interventions were developed based on knowledge gained from meetings with frontline workers and stakeholders. Medical resident and nurse education was delivered in the form of flyers, in-person sessions, and PowerPoint presentation. Lab checklists were implemented to facilitate interprofessional daily communication about labs on rounds. Pre-implementation and post-implementation data were collected retrospectively from the electronic health record and compared using paired t tests and percent changes.
Results: The average number of lab draw encounters per total patient census per day decreased by 8.2% post-implementation. For patients who had lab draw encounters, their daily average number of lab draw encounters decreased by 7.5%. The average number of patients with lab-free days did not significantly change.
Conclusions: Medical resident and nurse education and interprofessional daily communication about labs on rounds were cost-effective methods to improve lab practices within an academic pediatric hospital. QI initiatives can decrease healthcare costs and waste, and decrease patient discomfort and harm.