NOV 14, 2019 1:30 PM PST

Strategies to Improve Laboratory Stewardship

C.E. Credits: P.A.C.E. CE Florida CE
Speaker
  • Medical Director & Co-Chair, Enterprise Laboratory Stewardship Committee, Enterprise Medical Operations, & Director of Microbiology, Virology, Mycology & Parasitology, Clevelaland Clinic
    Biography
      Gary W. Procop, MD, MS is Medical Director and Co-Chair of the Enterprise Laboratory Stewardship Committee for Enterprise Medical Operations. He is the Director of Molecular Microbiology, Virology, Mycology and Parasitology at the Cleveland Clinic. He is past Chair of the Departments of Clinical Pathology and Molecular Pathology, and past Section Head for Clinical and Molecular Microbiology. He completed a Bachelor of Science at Eastern Michigan University, followed by an M.D. and M.S. at Marshall University School of Medicine. Residency training in Anatomic and Clinical Pathology training was completed at Duke University Medical Center and a Clinical Microbiology Fellowship at the Mayo Clinic. He is a diplomat of the American Board of Pathology in Anatomic and Clinical Pathology, and Medical Microbiology. He is a Fellow of the American Academy of Microbiology, the College of American Pathologists, the American Society for Clinical Pathology, the Infectious Diseases Society of America, and the Royal Society of Tropical Medicine and Hygiene. He has given more than 670 scientific presentations, and has 218 published manuscripts, 50 chapters, and three books to his credit. He is the former Chair of the Committee on Continuing Certification (3C), member of the Accountability & Resolution Committee, and a Member of the Board of Directors of the American Board of Medical Specialties. He is a former Chair of the Microbiology Test Development Committee, a Past President, former Trustee and is currently an ex officio of the American Board of Pathology. He is Member of the Board of Directors and the Chair of the Antifungal Subcommittee of the Clinical Laboratory Standards Institute. He is a member of the Board of Directors of the American Society for Clinical Pathology, the Chair of the Commission on Science, Technology and Policy, and a Member of the Effective Test Utilization Subcommittee of this Commission. He is also a former Member of the Council on Scientific Affairs, former Chair of the Microbiology Resource Committee and is a current member of the Quality Practices Committee for the College of American Pathologists. He has served as a Member of the NGS Coalition and Conferences Committee for the American Society for Microbiology. Major recognitions include the ASM BD Award for Research in Clinical Microbiology, the CAP Distinguished Patient Care Award, the Cleveland Clinic John Beach Hazard Teaching Award, the ASCP Mastership Designation, and the Belinda Yen-Lieberman, PhD, and James M. Lieberman, MD, Endowed Chair in Clinical Microbiology. His primary interests are developing and promoting best practices in laboratory testing, the practical applications of molecular diagnostic methods for the diagnosis and treatment of infections; infectious disease pathology; mycology and parasitology. He is currently working on a Masters of Education in Health Professions through Johns Hopkins University.

    Abstract

    The Laboratory Stewardship Committee of the Cleveland Clinic is a multidisciplinary team of clinicians, pathologists, administrators, nurses and other caregivers.  The team has a commitment to work toward optimizing test utilization to promote best practices and the best possible patient care.  The goals include: working to decrease unnecessary phlebotomy, which in turn improves patient satisfaction and decreases the likelihood of iatrogenic anemia and the sequelae thereof; reduction of unnecessary daily and duplicate orders; the conscientious use of molecular testing; the promotion of best practices; the development of evidence-based guidelines for optimal testing; and, the reduction of health care costs through thoughtful and judicious use of healthcare resources.  

    Ten ongoing interventions have been integrated into the Cleveland Clinic practice since 2011.  These interventions deter duplicate or largely unnecessary tests (e.g., unneeded repetitive daily orders), notify providers of duplicate and expensive tests, and provide guidance for the use of complex molecular genetic testing.  These interventions in 2018 stopped 49,071 unnecessary tests for a cost-savings of $875,876.  These interventions, in aggregate since 2011, have resulted in the cessation of 209,143 unnecessary tests, which has saved $5,935,942.

    Learning Objectives:
    1. List at least 5 criteria that are important for building an effective Laboratory Stewardship committee.
    2. Support tools in conjunction with Computerized Physician/Provider Order Entry.
    3. Compare and contrast three of the methods discussed that were used to address expensive and/or molecular tests.


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