clinical_laboratory_stewardship_101217

1. 1
Clinical Laboratory Stewardship
Oct. 2017
Guidelines by the National Committee for Laboratory Stewardship

2. NCLS Publication

3. Background
3 most significant causes of
patient harm
• Ordering the wrong test
• Failing to retrieve a test
result
• Misinterpreting a test result
13 Billion test performed
70% decisions based
10-30% unnecessary

4. Trends in Healthcare
Laboratory
Stewardship
Pharmacy Utilization
management
Antimicrobial
Stewardship
Blood
Utilization
Radiology Utilization
management

5. National Committee for Laboratory Stewardship
Commissioned in 2016
10 members from 7 academic institutions
Medical Directors, Clinical Chemists, Medical Technologists
Recommendation that integrated healthcare systems, independent
hospitals implement laboratory stewardship programs
Summarize the core elements of a successful hospital-based
laboratory Stewardship program
Compliments existing guidelines from Clinical Laboratory Standards
Institute and Choosing Wisely

6. Laboratory Stewardship – 4 Basic Elements

7. Laboratory Stewardship – 4 Basic Elements
Leadership commitment
Accountability to a high
level medical executive
Committee/subcommittees
Laboratory expertise and
other key support
Networking
Governance

8. Laboratory Stewardship – 4 Basic Elements
Interventions

9. Laboratory Stewardship – 4 Basic Elements
a) Appropriateness of
laboratory test orders.
b) Retrieval of test results.
c) Appropriateness of
test interpretation.
d) Impact of each
stewardship intervention
Data Extraction and Monitoring

10. Laboratory Stewardship – 4 Basic Elements
“An effective laboratory
stewardship program will
need to establish how the
leadership committee will
solicit and vet
opportunities”
“the committee may want to
consider opportunities
identified through the
Choosing Wisely programs
and other published
research, or from internal
data related to patient
safety incidents”.
Data review and strategies/tactics for improvement

11. National Committee for Laboratory Stewardship
Conclusion
Evidence-based, patient-centered efforts to improve
test utilization are justified, beyond being cost-effective,
because they increase patient safety and
Satisfaction
NCLS has defined the core elements of a successful hospital-based
laboratory Stewardship program
NCLS future direction
• devise a tiered recognition program and provide certificates of
recognition, depending on the degree of participation

12. Clinical Laboratory Stewardship
Guidelines by the
National Committee for Laboratory Stewardship