Essential role of laboratory physicians in transformation of laboratory practice and management to a value-based patient-centric model

Physician Leadership in the Employed Universe

Physicians are increasingly becoming employed by hospitals and health systems. While associated with less professional autonomy, such employment offers physicians the opportunity to become leaders within a vertically integrated healthcare environment. Multidisciplinary care teams, led by physician champions, can impact care for a large swath of patients and establish clinical excellence. Successful teams can improve outcomes, increase professional satisfaction, and potentially set physicians on a path to becoming leaders within their health system.

Laboratory Interventions to Eliminate Unnecessary Rapid COVID-19 Testing During a Reagent Shortage

Objectives

In the fall of 2020, US medical centers were running out of rapid coronavirus disease 2019 (COVID-19) tests. The aim of this study is to evaluate the impact of an intervention to eliminate rapid test misutilization and to quantify the effect of the countermeasures to control rapid test ordering using a test utilization dashboard.

Methods

Interventions were made to preserve a severely limited supply of rapid diagnostic tests based on real-time analysis of a COVID-19 test utilization dashboard. This study is a retrospective observational study evaluating pre- and postintervention rates of appropriate rapid test use, reporting times, and cost/savings of resources used.

Results

This study included 14,462 severe acute respiratory syndrome coronavirus 2 reverse transcriptase polymerase chain reaction tests ordered during the study period. After the intervention, there was a 27.3% decrease in nonconforming rapid tests. Rapid test reporting time from laboratory receipt decreased by 1.47 hours. The number of days of rapid test inventory on hand increased by 39 days.

Conclusions

Performing diagnostic test stewardship, informed by real-time review of a test utilization dashboard, was associated with significantly improved appropriate utilization of rapid diagnostic COVID-19 tests, improved reporting times, implied cost savings, and improved reagent inventory on hand, which facilitated the management of scarce resources during a pandemic.