Re-Purposing the Ordering of Routine Laboratory Tests in Hospitals in British Columbia

NCT06359587 | Recruiting

• 1 other identifier: H22-03005
• Study Type: interventional
• Target: 700,000
• Locations: 1 country
• Sites: 4

Brief Summary

The goal of this stepped-wedge cluster randomized trial is to assess the impact of a laboratory test overuse intervention bundle on laboratory test utilization in 6 health authorities (16 hospitals) in British Columbia. The main question it aims to answer is if the intervention bundle, inclusive of healthcare provider and patient engagement tools, can be effectively implemented for hospitalized medical inpatients in 16 hospitals across BC and reduce laboratory test over-use. Researchers will compare hospital clusters that receive the intervention at different (sequential) time points to see if there are significant changes in the measured outcomes after the intervention.

Conditions

Hospital Acquired Condition

Outcome Measures

Primary Outcomes (1)

• Change in number of target laboratory tests ordered per patient-day with LTO bundle compared to control period without LTO bundle

  The change in the number of the six target laboratory tests with the LTO bundle

  3 years

Secondary Outcomes (3)

• Change in number of total laboratory tests ordered per patient-day with the LTO bundle

  3 years

• Rate of hospital re-admissions and mortality

  3 years

• Change in costs associated with routine laboratory testing

  3 years

Study Arms (2)

Intervention Arm (Intervention Bundle Implementation)

EXPERIMENTAL

This arm involves the time periods of the hospital units where the LTO bundle, including healthcare provider and patient engagement tools, is actively implemented.

Behavioral: Laboratory test overuse (LTO) Bundle

Control Arm (No LTO Bundle Implementation)

NO INTERVENTION

This arm represents the time period of hospital units where the LTO bundle is not implemented.

Interventions

Laboratory test overuse (LTO) Bundle BEHAVIORAL

Key Components of the LTO Bundle: Educational materials, including an online module, clinical decision support tool, provision of lab utilization (Audit and Feedback) reports for healthcare providers. Patient engagement tools, such as videos and educational infographics. System level implementation tools adapted to the local context, including EMR-based tools and order set changes, etc.

Intervention Arm (Intervention Bundle Implementation)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients: The study will include all adult general medical patients that are admitted to the selected hospital during the study period under general internal medicine or family medicine (hospitalist) provider groups.
• Attending Physicians: All physicians who provide patient care in the general internal medicine or family medicine (hospitalist) provider groups in selected hospitals
• Learners and allied health staff (Medical Students/Resident physicians/Clinical Assistants/ Nurse Practitioners, etc.): All those who help take care of patients and can order labs during the study period in the under general internal medicine or family medicine (hospitalist) provider groups in selected hospitals The date range for both groups will extend from May 2024 until study completion in October 2026.

You may not qualify if:

• Patients: all patients in specialized medical units (e.g., coronary care, dialysis units, bone marrow transplants units etc.), in critical care, pediatric, obstetrical, surgical, and psychiatric units.
• Patients and Health Care Providers (HCPs) who are not in the internal medicine or family medicine groups

Sponsors & Collaborators

• Island Health: collaborator
• University of British Columbia: lead
• Providence Health & Services: collaborator
• Vancouver Coastal Health: collaborator
• Fraser Health: collaborator
• Interior Health: collaborator
• Northern Hospital, Australia: collaborator
• Canadian Institutes of Health Research (CIHR): collaborator

Study Sites (4)

University Hospital of Northern British Columbia

Prince George, British Columbia, V2M 1S2, Canada

RECRUITING

Mount St. Joseph's Hospital

Vancouver, British Columbia, V5T3N4, Canada

RECRUITING

Vancouver General Hospital

Vancouver, British Columbia, V5Z1N1, Canada

RECRUITING

St. Paul's Hospital

Vancouver, British Columbia, V6Z 1Y6, Canada

RECRUITING

Related Publications (1)

• Ambasta A, Holroyd-Leduc JM, Pokharel S, Mathura P, Shih AW, Stelfox HT, Ma I, Harrison M, Manns B, Faris P, Williamson T, Shukalek C, Santana M, Omodon O, McCaughey D, Kassam N, Naugler C. Re-Purposing the Ordering of Routine Laboratory Tests in Hospitalized Medical Patients (RePORT): protocol for a multicenter stepped-wedge cluster randomised trial to evaluate the impact of a multicomponent intervention bundle to reduce laboratory test over-utilization. Implement Sci. 2024 Jul 2;19(1):45. doi: 10.1186/s13012-024-01376-6.

  PMID: 38956637 DERIVED

MeSH Terms

Conditions

Iatrogenic Disease

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Anshula Ambasta

  University of British Columbia

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Anshula Ambasta

CONTACT

4036184586; anshula.ambasta@ubc.ca

Study Design

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

Model Details: Intervention Arm (Intervention Bundle Implementation): This arm involves the time periods where hospital units are actively receiving the intervention bundle, including healthcare provider (HCP) and patient engagement tools. Control Arm (No Intervention Bundle Implementation): This arm represents the time periods when the hospital units do not receive the intervention bundle. This time period is the control period. Each hospital will contribute to intervention and control period data.

Study Record Dates

• First Submitted: April 8, 2024
• First Posted: April 11, 2024
• Study Start: May 6, 2024
• Primary Completion (Estimated): November 16, 2026
• Study Completion (Estimated): November 16, 2026
• Last Updated: May 7, 2026

Record last verified: 2026-04

Locations

CA (4)