RecruitingNot ApplicableNCT06359587

Re-Purposing the Ordering of Routine Laboratory Tests in Hospitals in British Columbia

Re-Purposing the Ordering of Routine Laboratory Testing in Hospitalized Medical Patients in British Columbia

Sponsor

University of British Columbia

Enrollment

700,000 participants

Start Date

May 6, 2024

Study Type

INTERVENTIONAL

Conditions

Hospital Acquired Condition

Summary

The goal of this stepped-wedge cluster randomized trial is to assess the impact of a laboratory test overuse intervention bundle on laboratory test utilization in 6 health authorities (16 hospitals) in British Columbia. The main question it aims to answer is if the intervention bundle, inclusive of healthcare provider and patient engagement tools, can be effectively implemented for hospitalized medical inpatients in 16 hospitals across BC and reduce laboratory test over-use. Researchers will compare hospital clusters that receive the intervention at different (sequential) time points to see if there are significant changes in the measured outcomes after the intervention.

Eligibility

Min Age: 18 Years

Inclusion Criteria4

Participants involved in this study include the following groups: patients and healthcare providers (including learners, physicians and allied health staff)
Patients: The study will include all adult general medical patients that are admitted to the selected hospital during the study period under general internal medicine or family medicine (hospitalist) provider groups.
Attending Physicians: All physicians who provide patient care in the general internal medicine or family medicine (hospitalist) provider groups in selected hospitals
Learners and allied health staff (Medical Students/Resident physicians/Clinical Assistants/ Nurse Practitioners, etc.): All those who help take care of patients and can order labs during the study period in the under general internal medicine or family medicine (hospitalist) provider groups in selected hospitals The date range for both groups will extend from May 2024 until study completion in October 2026.

Exclusion Criteria2

Patients: all patients in specialized medical units (e.g., coronary care, dialysis units, bone marrow transplants units etc.), in critical care, pediatric, obstetrical, surgical, and psychiatric units.
Patients and Health Care Providers (HCPs) who are not in the internal medicine or family medicine groups

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Interventions

BEHAVIORALLaboratory test overuse (LTO) Bundle

Key Components of the LTO Bundle: Educational materials, including an online module, clinical decision support tool, provision of lab utilization (Audit and Feedback) reports for healthcare providers. Patient engagement tools, such as videos and educational infographics. System level implementation tools adapted to the local context, including EMR-based tools and order set changes, etc.