The Laboratory Stewardship Committee of the Cleveland Clinic is a multidisciplinary team of clinicians, pathologists, administrators, nurses and other caregivers.  The team has a commitment to work toward optimizing test utilization to promote best practices and the best possible patient care.  The goals include: working to decrease unnecessary phlebotomy, which in turn improves patient satisfaction and decreases the likelihood of iatrogenic anemia and the sequelae thereof; reduction of unnecessary daily and duplicate orders; the conscientious use of molecular testing; the promotion of best practices; the development of evidence-based guidelines for optimal testing; and, the reduction of health care costs through thoughtful and judicious use of healthcare resources.  

Ten ongoing interventions have been integrated into the Cleveland Clinic practice since 2011.  These interventions deter duplicate or largely unnecessary tests (e.g., unneeded repetitive daily orders), notify providers of duplicate and expensive tests, and provide guidance for the use of complex molecular genetic testing.  These interventions in 2018 stopped 49,071 unnecessary tests for a cost-savings of $875,876.  These interventions, in aggregate since 2011, have resulted in the cessation of 209,143 unnecessary tests, which has saved $5,935,942.

Learning Objectives:
1. List at least 5 criteria that are important for building an effective Laboratory Stewardship committee.
2. Support tools in conjunction with Computerized Physician/Provider Order Entry.
3. Compare and contrast three of the methods discussed that were used to address expensive and/or molecular tests.