All User Bulletin: Test Order Optimization

All-user-bulletins highlight stumbling blocks that all physicians need to be aware of when using the Connect Care clinical information system.

Rationalize Test Ordering Please!

Alberta's laboratories are under intense pressure as the COVID-19 pandemic unfolds. Human and physical resources (e.g. reagents) are prioritized for assays that most help most patients. As patient volumes and complexity increase, we will hit a test capacity "wall" that will mandate implementation of laboratory test restrictions. This has always been part of pandemic planning.

The likelihood of implementing essential test restrictions, and the timing, is affected by decisions that all physicians make right now.

For every laboratory test, and every patient, ask:

• Is this test, or this test frequency, essential to patient care at this time?
• Will anticipated test results significantly affect care choices at this time?
• Can sequential (ordering tests, rather than 'shotgunning') testing reduce the overall test burden?
• Can tests be deferred to a future date (e.g. tests done for surveillance or chronic disease management)?

Above all, check the "Orders" tab at every patient encounter, and at every rounding, looking for tests that can be removed or rationalized.