Keys to Success:
> Establish a Steering/Stewardship Committee
- Establish Lab Stewardship Core committee to drive strategic decisions
- Strong Chair to develop agenda and meeting cadence
- Steering committees may be developed for each rule category (Repeat Normal, Reference Lab, etc.)
- If multiple site facility, may need sub-committees at each site
> Ensure Cross-Functional Team Involvement
- Core Committee: Pathologist, Lab Director, Quality Director
- Steering Committee: Physicians or RN to represent ED, Surgery, Imaging, ICU, Oncology, etc.
- The more departments that can be represented the better
> Establish Clinical Guidelines within your Health System or Hospital
- Needs to be physician-driven, participation of pathology is critical
- Lab formulary
- Choosing Wisely
> Focus on Testing with the Most Impact
- Determine which Test Utilization Rule Categories are most impactful
- Do not try and tackle all Clinical Guidelines at once, start small, then layer additional
- Develop Steering Committees for each Test Utilization Rule Category or discipline if needed
> Follow Stewardship Committee Best-Practices
- Systematic Approach
- Monitoring / Trending
- Communication
- Professionalism
How to Drive Change once the Lab Stewardship Program is Established:
(1) Investigate how / why tests outside of lab formulary are being ordered
(2) Create and Run Regular Communication / Marketing Programs
(3) Continue to Evaluate and Monitor Test Utilization Rules and new Testing as Lab Stewardship program matures.