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Abstract

Background: Laboratory testing is a fundamental diagnostic and prognostic tool to ensure the quality of healthcare, treatment and responses. Our study initial goal was to evaluate the cost of the currently performed laboratory tests for patients who are undergoing chemotherapy treatments in our organization's Oncology Treatment Center. Secondarily to reduce the cost of unnecessary lab tests by 50% in one year period.

Methods: This was a cross-sectional observational study. The intervention strategy involved implementing the British Columbia Cancer Agency (BCCA) guidelines in the patient’s EHR, to be followed by oncologists when ordering lab tests for chemotherapy patients. Data were collected for 200 cases with 10 different chemotherapy protocols post-intervention, and a paired t-test was used to compare the cost differences pre and post-intervention.

Results: Data analysis demonstrated a significant cost reduction in unnecessarily performed lab tests (77%, p<0.01), when following the BCCA guidelines.

Conclusions: Lean-thinking in clinical practice realized by integrating a standardized laboratory test guided by BCCA guidelines into the EHR in our organization has significantly reduced the financial costs within one year. Thereby enhanced efficient resource utilization and increased awareness for further efforts to expand such practice to be applied to the other treatment protocols.

Keywords: Unnecessary lab tests; BCCA guidelines; Lean thinking; Efficient utilization