Use of computerized provider order entry (CPOE) is on the rise in U.S. hospitals. Order sets are often used in CPOE systems to facilitate efficient order entry; many order sets contain orders for laboratory blood tests. Use of these sets may result in increased utilization of laboratory blood testing, which can cause iatrogenic anemia and add to soaring healthcare costs.
This study was approved by the Institutional Review Board. A link to an online survey was emailed to 135 residents, hospitalist team members, and nonhospitalist physicians in the Department of Medicine at an academic medical center that has been using Meditech for CPOE since 2003. Most admission orders are entered using order sets, all of which contain orders for morning laboratory tests. The survey consisted of six Likerttype questions assessing opinions about the inclusion of morning laboratory orders in admission order sets, and a space for comments.
Response rate for the survey was 46%. Responses were received from 22 residents, 18 hospitalist physicians, 6 hospitalist midlevel providers, and 15 nonhospitalist physicians. 61% of responders agreed or strongly agreed that having morning laboratory test orders in admission order sets can lead to unnecessary lab testing. 26% said they delete these lab orders about half the time, usually, or always. 52% disagreed or strongly disagreed that removing morning lab test orders from admission order sets would compromise patient care. However, 61% thought it was useful or very useful to have morning laboratory test orders in admission order sets, and 64% agreed or strongly agreed that they improve their efficiency. Only 31% agreed or strongly agreed that morning laboratory tests should be removed from admission order sets.
Although having morning laboratory test orders in admission order sets may lead to unnecessary laboratory testing, it can also improve efficiency in patient care. Strategies should be considered to manipulate order sets and CPOE systems in ways that will promote wise use of resources without hindering efficiency.
To cite this abstract:Knight A, Thakkar R, Riedel S. Morning Laboratory Orders in Admission Order Sets: A Lovehate Relationship. Abstract published at Hospital Medicine 2012, April 1-4, San Diego, Calif. Abstract 97588. Journal of Hospital Medicine. 2012; 7 (suppl 2). https://www.shmabstracts.com/abstract/morning-laboratory-orders-in-admission-order-sets-a-lovehate-relationship/. Accessed April 7, 2020.