In Support of Quality and Safe Patient Care: Defining the Value of Laboratory Medicine

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Figure 1.
Responses regarding initiatives taken that best describe the laboratory’s value.

Table 1.

Responses to change

Questions	Strongly Disagree		Disagree		Neither Agree norDisagree		Agree		Strongly Agree		Total % in Agreement
The shift, FROM fee for service, eg, “clinical laboratory fee schedule” reimbursed TO bundled, capitated, or value-based reimbursement is commanding significant attention from our parent organization.	18	4%	27	7%	131	33%	142	35%	84	21%	56.2%
Significant change in our laboratory will occur as a direct result of this reimbursement change.	18	4%	29	7%	135	34%	146	36%	74	18%	54.7%
Our laboratory feels significant pressure to demonstrate our value to our institution’s senior leadership.	18	4%	40	10%	76	19%	142	35%	126	31%	66.7%
Our laboratory feels significant pressure to cut costs.	15	4%	25	6%	85	21%	130	32%	147	37%	68.9%

Note: Agree + strongly agree = total percent in agreement.

Table 2.

Categories of current and completed quality improvement initiatives that demonstrate the value of laboratory medicine

Category	Frequency of Responses
Appropriateness of laboratory testing (utilization focus)	33%
Infection prevention and therapy including antibiotic stewardship	23%
Operational/process improvement	17%
Emergent care: Diagnosis/treatment and operations	15%
Quality assurance systems	9%
Patient management and support	3%

Note: Based on 133 codable responses.

Table 3.

Examples of qualitative and quantitative measures that impact patient outcomes in determining the laboratory’s involvement and performance

Category	Frequency of Responses
Operational and process measures	31%
Laboratory use and outcome measures	20%
Emergent care measures	16%
Infection prevention and therapy, including antibiotic stewardship measures	15%
Quality system measures	11%
Miscellaneous and patient/health care staff satisfaction survey measures	7%

Note: Question #10 (Appendix A) category and detail results–Highest to lowest frequency: 184 codable responses.

Table 4.

Wish list concepts that could support the value of the laboratory

Category
Appropriateness of test orders that is diagnosis- and treatment-driven
Appropriateness of test orders as they relate to wellness and prevention
Provide accurate, timely, and cost-effective test information
Communication of laboratory results for coordination of care
Laboratory result follow-up with interpretation and application
Support patient involvement in their own care and well-being
Patient safety and laboratory medicine

Note: Based on 183 respondents providing multiple ideas.