Transforming Laboratory Utilization Review into Laboratory Stewardship: Guidelines by the PLUGS National Committee for Laboratory Stewardship

Appropriate utilization of clinical laboratory services is important for patient care and requires institutional stewardship. Clinical laboratory stewardship programs are dedicated to improving the ordering, retrieval, and interpretation of appropriate laboratory tests. In addition, these programs focus on developing, maintaining, and improving systems to provide proper financial coverage for medically necessary testing. Overall, clinical laboratory stewardship programs help clinicians improve the quality of patient care while reducing costs to patients, hospitals, and health systems. This document, which was created by a new multiinstitutional committee interested in promoting and formalizing laboratory stewardship, summarizes core elements of successful hospital-based clinical laboratory stewardship programs. The core elements will also be helpful for independent commercial clinical laboratories.

Laboratory cost analysis: a practical approach

This article presents a practical method for performing a cost analysis for the smaller laboratory for which computerized methods may be unavailable or unappealing. An overview of cost accounting as it fits into planning functions is presented, and three common methods for performing such analyses and appropriate applications are described. The concept of breakeven analysis and its uses are presented. Finally, a worksheet approach to cost analysis is presented, including examples that demonstrate proper use. The worksheets, although not universally applicable without modifications, use a stepwise process to achieve a simplistic but useful cost analysis. Readers are encouraged to adapt these worksheets to their own operations.

Joint ventures in the next decade: four approaches

Hospitals and physicians will either learn how to integrate their strategies and businesses, or they will end up presiding over the "boutiques" of healthcare.