Targeted reduction in neurosurgical laboratory utilization: Resident-led effort at a single academic institution. Clinical article

Seunggu (Jude) Han, Rajiv Saigal, John D. Rolston, Jason S. Cheng, Catherine Y. Lau, Rita I. Mistry, Michael W. Mcdermott, Mitchel S. Berger

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Object. Given economic limitations and burgeoning health care costs, there is a need to minimize unnecessary diagnostic laboratory tests. Methods. The authors studied whether a financial incentive program for trainees could lead to fewer unnecessary laboratory tests in neurosurgical patients in a large, 600-bed academic hospital setting. The authors identified 5 laboratory tests that ranked in the top 13 of the most frequently ordered during the 2010-2011 fiscal year, yet were least likely to be abnormal or influence patient management. Results. In a single year of study, there was a 47% reduction in testing of serum total calcium, ionized calcium, chloride, magnesium, and phosphorus. This reduction led to a savings of $1.7 million in billable charges to health care payers and $75,000 of direct costs to the medical center. In addition, there were no significant negative changes in the quality of care delivered, as recorded in a number of metrics, showing that this cost savings did not negatively impact patient care. Conclusions. Engaging physician trainees in quality improvement can be successfully achieved by financial incentives. Through the resident-led quality improvement incentive program, neurosurgical trainees successfully reduced unnecessary laboratory tests, resulting in significant cost savings to both the medical center and the health care system. Similar programs that engage trainees could improve the value of care being provided at other academic medical centers.

Original languageEnglish (US)
Pages (from-to)173-177
Number of pages5
JournalJournal of neurosurgery
Volume120
Issue number1
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Motivation
Cost Savings
Quality Improvement
Delivery of Health Care
Calcium Chloride
Quality of Health Care
Routine Diagnostic Tests
Health Care Costs
Phosphorus
Magnesium
Patient Care
Economics
Calcium
Physicians
Costs and Cost Analysis
Serum

Keywords

  • Cost reduction
  • Quality improvement
  • Resident education
  • Value-based care

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Targeted reduction in neurosurgical laboratory utilization : Resident-led effort at a single academic institution. Clinical article. / Han, Seunggu (Jude); Saigal, Rajiv; Rolston, John D.; Cheng, Jason S.; Lau, Catherine Y.; Mistry, Rita I.; Mcdermott, Michael W.; Berger, Mitchel S.

In: Journal of neurosurgery, Vol. 120, No. 1, 01.01.2014, p. 173-177.

Research output: Contribution to journalArticle

Han, Seunggu (Jude) ; Saigal, Rajiv ; Rolston, John D. ; Cheng, Jason S. ; Lau, Catherine Y. ; Mistry, Rita I. ; Mcdermott, Michael W. ; Berger, Mitchel S. / Targeted reduction in neurosurgical laboratory utilization : Resident-led effort at a single academic institution. Clinical article. In: Journal of neurosurgery. 2014 ; Vol. 120, No. 1. pp. 173-177.
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