Managing laboratory test ordering: a challenge in the new laboratory medicine model.

Abstract

The role of Laboratory Medicine in patient care has evolved in the last decades. The same has occurred to the laboratory model, which has evolved from a traditional model where the laboratory is merely involved in clinical decision-making to a leading model where the laboratory is not only involved but also determines decision-making. The advent of new technologies and automation of processes have enabled laboratory professionals to focus on the first and last phase of the analytical process namely, test ordering and decision-making based on laboratory results. These phases are more error-prone than the analytical phase, and where action must be taken to improve the quality of patient care. We share our experience in the design and establishment of laboratory test demand management interventions that facilitated diagnosis of occult disease, improved adherence to clinical guidelines, and optimized patient safety. A description is provided of key points in the management of laboratory test over/underutilization. The objective of this review is to promote the involvement of laboratory professionals in the design and implementation of demand management interventions and in the development of the new Leader Laboratory model.