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Achieve lab excellence with the right test for the right patient at the right time

The overutilization and underutilization of laboratory tests is a growing concern that contributes to rising healthcare costs.1 Several factors drive this issue, including clinical routines, lack of cost transparency, and the ease of ordering repeat tests in EHR systems.2

Quest is committed to helping health systems develop effective strategies to optimize laboratory resource use—providing clinicians with the right information while reducing costs for patients and health care organizations like health systems, FQHCs and large provider groups.

Advisory services take lab stewardship to the next level

Quest Diagnostics oeers expert support to drive organizational change management, governance, and medical advancements.

Identify opportunities and build tailored solutions to enhance performance

As part of your lab stewardship committee, our expert advisors address governance program initiation, opportunity assessments, data analysis (both simple and complex), and laboratory data improvements. Additionally, we create custom dashboards to showcase the data most critical to your system's needs.

How Quest advisory services can help

Our team of clinicians, data scientists, and statisticians work with you to build a customized lab stewardship program

Assist with identifying send-out testing optimization opportunities

Identify gaps in accessing, analyzing and using test utilization data, and provide recommendations for improvements

Analyze budget, test menu, test volumes, service level TAT, hospital specialties/certifications, staffing, equipment, and other resources

Develop recommendations for specific tests to be performed at the on-site lab or sent to a reference lab

Understand lab initiatives associated with third-party reference testing (send-outs)

Create a formal report utilizing laboratory data to provide specific recommendations that improve the laboratory service

Define actionable goals, utilizing specific recommendations to improve laboratory service

Implement test utilization opportunities

Quest will work with you to build a laboratory stewardship committee to identify and achieve your goals

  • Executive sponsor: system-level influencer to provide oversight and enable the project team
  • Medical sponsors: local and system-level influencers who report to and obtain support from senior leadership and promote solution adoption
  • Clinicians and subject matter experts: knowledge leaders who provide expertise, report to, and obtain support from the practice area
  • Lab director: a leader who provides information about lab workflow, and program support as initiatives are launched
  • Informatics role: extract data, provide information about lab data workflow, and build interventions in EMR
  • Quest Diagnostics support: facilitate committee, identify opportunities and assist with implementation
  • Your data will be examined to identify opportunities to decrease laboratory costs and help improve patient care
  • Quest will provide analytic tools to support your laboratory stewardship efforts
  • Your laboratory stewardship committee will be empowered to assess and validate interventions based on the opportunities identified, both known and recently discovered
  • Effective approaches include the development of a pilot program to evaluate the effectiveness of potential interventions
  • The pilot will be evaluated and further interventions will be considered
  • Quest will collaborate with the laboratory stewardship committee to optimize the impact of interventions

Our team will also provide ongoing identification of opportunities, assessment of intervention effectiveness, measuring and monitoring the impact. For example:

  • Discontinued procalcitonin
  • Limited MRSA PCR
  • Limited inpatient BNP
  • Replaced CK-MB with hs-troponin
  • Rename UA to reduce microscopic exams
  • Revised auto validation rules to reduce manual differences
  • Added ESR AOE questions
  • Built specific order codes for paraneoplastic testing

Leverage the power of Quest lab analytics and stewardship

Optimize lab testing
Reduce overuse and underuse by identifying duplicate tests, limited utility tests, and more

Reduce cost
Identify missed opportunities in chronic disease management before the cost of care escalates and the patient is at risk

Close gaps in care
Unleash the power of your diagnostic data to reduce variations in care by turning actionable insight into clinical practice that supports appropriate, equitable, and efficient care

Disclaimer

Quest Diagnostics Incorporated’s lab stewardship service provides data analytics insights informed by relevant third-party guidelines (including any applicable client protocols) and based solely on laboratory data provided by the hospital client to optimize the efficiency of testing and improve patient care at the hospital client. All information in the service is provided as guidance for the hospital client and does not constitute a recommendation regarding the treatment of any individual patient.

The lab stewardship service does not and is not intended to replace a treating provider’s medical judgement, based upon evaluation of the patient. Any user of the service is solely responsible for any decision made or action taken in reliance on the information provided by the service and for compliance with all applicable local, state, and federal law.

Definitions

Quest's identification of potentially problematic ordering patterns is intended as a guide to assist providers and is not intended to replace a treating provider’s medical judgement, based upon evaluation of the patient.

Overutilization: The term "overutilization" refers to testing ordered for a patient whose symptoms and/or condition may not support the need for the testing under generally accepted third-party clinical guidelines.

Underutilization: The term "underutilization" refers situations where third-party clinical guidelines suggest that not all clinically appropriate testing was ordered.

Inappropriate testing: The term "inappropriate" refers to testing that is inconsistent with applicable third-party guidelines.

Appropriate: The term "appropriate" refers to testing that is consistent with applicable third-party guidelines.

Unnecessary: The term "unnecessary" refers to testing ordered for a patient whose symptoms and/or condition may not support the need for the testing under generally accepted third-party clinical guidelines.

Misutilization/mis-ordering: The term "misutilization" or "mis-ordering" refers to testing ordered for a patient whose symptoms and/or condition may not support the need for the testing or is otherwise inconsistent with generally accepted third-party clinical guidelines.

References

  1. Shaik T, Mahmood R, Kanagala SG, et al. Lab testing overload: a comprehensive analysis of overutilization in hospital-based settings. Proc (Bayl Univ Med Cent). 2024;37(2):312-316. Published 2024 Feb 8. doi:10.1080/08998280.2023.2288788
  2. Sedrak MS, Patel MS, Ziemba JB, et al. Residents’ self-report on why they order perceived unnecessary inpatient laboratory tests. J Hosp Med. 2016;11(12):869–872. doi: 10.1002/jhm.2645

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