Re-Purposing the Ordering of 'Routine' Laboratory Tests in Hospitalized Medical Patients (RePORT Study)

NCT06119464 | Active Not Recruiting

• 1 other identifier: REB17-1215
• Study Type: interventional
• Target: 251,817
• Locations: 1 country
• Sites: 1

Brief Summary

Laboratory test overuse occurs when tests are ordered repetitively, without due consideration of impact on clinical status. Repetitive inpatient lab testing often provides limited value for patient outcomes while increasing healthcare costs, patient discomfort, and unnecessary transfusions and prolonging hospitalizations. The research study aims to reduce laboratory test overuse in hospitals through implementation of a comprehensive, multi-disciplinary, and multi-faceted intervention bundle that includes audit and feedback reports, clinician education, clinical decision support tool, and patient infographics across 14 hospitals in Alberta.

Conditions

Utilization, Health Care

Keywords

Overutilization of lab test; Multimodal intervention; Lab test overuse; Laboratory; Hospital

Outcome Measures

Primary Outcomes (1)

• Number of routine laboratory tests ordered per patient-day in the intervention versus control periods

  Number of the six target laboratory tests (complete blood count, electrolytes, creatinine, urea, international normalized ratio and partial thromboplastin time) ordered per patient-day

  1 year 9 months

Secondary Outcomes (8)

• Costs associated with routine and all common laboratory test ordered

  1 year 9 months

• Proportion of hospital patient lab-free days

  1 year 9 months

• Proportion of critically abnormal test results

  1 year 9 months

• Length of stay

  1 year 9 months

• Transfer to Intensive Care Unit

  1 year 9 months

Study Arms (2)

Unexposed to intervention (control period)

NO INTERVENTION

This is the time period of the study where hospital clusters are not receiving the intervention

Exposed to intervention (intervention period)

EXPERIMENTAL

This is the time period of the study where hospital clusters are receiving the multimodal intervention.

Other: Multimodal Intervention: Education; Other: Multimodal Intervention: Audit and Feedback; Other: Multimodal Intervention: Patient Engagement; Other: Multimodal Intervention: System Changes

Interventions

Multimodal Intervention: Education OTHER

The multimodal intervention bundle consists of education, audit and feedback, patient engagement, and system changes.

Exposed to intervention (intervention period)

Multimodal Intervention: Audit and Feedback OTHER

The multimodal intervention bundle consists of education, audit and feedback, patient engagement, and system changes.

Exposed to intervention (intervention period)

Multimodal Intervention: Patient Engagement OTHER

The multimodal intervention bundle consists of education, audit and feedback, patient engagement, and system changes.

Exposed to intervention (intervention period)

Multimodal Intervention: System Changes OTHER

The multimodal intervention bundle consists of education, audit and feedback, patient engagement, and system changes.

Exposed to intervention (intervention period)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• all participants (patients and healthcare providers) within enrolled adult hospitals in Alberta of medical and hospitalist units during study period

You may not qualify if:

• outside of the above-mentioned province
• hospitals not enrolled
• non-medical units (eg. ICU, surgical, pediatric, obstetrical units)

Sponsors & Collaborators

• University of Calgary: lead
• Alberta Health services: collaborator
• University of British Columbia: collaborator
• Canadian Institutes of Health Research (CIHR): collaborator

Study Sites (1)

University of Calgary

Calgary, Alberta, T2N 1N4, Canada

Location

MeSH Terms

Conditions

Patient Acceptance of Health Care

Condition Hierarchy (Ancestors)

Treatment Adherence and Compliance; Health Behavior; Behavior

Study Officials

• Anshula Ambasta

  University of Calgary

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Clinical Assistant Professor

Model Details: Stepped-wedge cluster randomized trial, randomizing the sequence of entry into intervention at a cluster level.

Study Record Dates

• First Submitted: October 26, 2023
• First Posted: November 7, 2023
• Study Start: January 2, 2023
• Primary Completion: October 31, 2024
• Study Completion: October 1, 2025
• Last Updated: December 19, 2024

Record last verified: 2024-12

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)