Authors
Min Yu, Sophia Bellegarde, Jacqueline Chen, Kristin Kupczewski, Ryan Fogaren
Published in
American journal of clinical pathology. Volume 166. Issue 1. Jul 06, 2026.
Abstract
Send-out laboratory testing has increased substantially with the expansion of specialized assays, introducing operational complexity and risk of inefficiencies in test ordering and review. While laboratory stewardship programs emphasize appropriate test utilization, practical approaches to standardizing send-out test review at the individual request level remain limited.
We implemented a structured, informatics-enabled workflow for send-out test review at an academic medical center. The workflow standardized request submission, reviewer notification, decision documentation, and communication without modifying existing clinical review criteria. This quality improvement initiative was evaluated over 8 months (August 2025 to March 2026).
A total of 3055 requests were reviewed. Median monthly volume was 381 (range, 306-446). Documentation completeness was 98%. Median review turnaround time was 1 day (IQR, 0-1), with 83.9% completed within 1 day. Overall, 81.2% were approved, 11.8% were declined or canceled, and 6.9% were replaced. Review outcomes varied across clinical services, and a limited number of tests accounted for a disproportionate share of declined and modified requests.
Implementation of a structured workflow for send-out test review enabled standardized documentation, rapid turnaround, and improved visibility into utilization patterns. This approach provides a scalable framework for enhancing laboratory oversight and supporting targeted test utilization interventions.
PMID:
42522271
Bibliographic data and abstract were imported from PubMed on 29 Jul 2026.
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