Increasing Efficiency of Specialized Lab Ordering in OB/GYN
Introduction/Problem
Results/Progress to Date
 The OB/GYN department is a multidisciplinary department with multiple specialty
divisions.
 Divisions all have specific, commonly ordered labs that are not easily found in
OMR lab interface without searching.
 Specific lab tests are ordered at specific times in pregnancy, easily arranged into
order sets.
 Prenatal genetic screening based on risk factors, includes a wide spectrum of
diseases, and can result in expensive duplication of testing if ordered incorrectly.
 Order sets can reduce duplication and help with clinical decisions regarding
appropriate screening.
 Physicians, nurses and support staff spend a large amount of time placing routine
orders.
Aim/Goal
 Restructure lab ordering process across OB/GYN by creating specialized lab order
sets.
 Increase ease and efficiency of lab ordering for specific diagnoses and conditions.
 Reduce or eliminate unnecessary lab testing.
The Team
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Aisling Lydeard, NP, Nursing Director Ambulatory OB/GYN & MFM
Celeste Royce, MD Co-Chair, GYN Leadership Committee
Kim Parker, Director of LIS
Marc Tierney, LIS Applications System Analyst II
Howard Munoz-Bennet, CCC programmer
Jeanne McNeil, IS Manager
The Interventions
 Gathered data on current lab panels in OMR that are used by OB/GYN.
 Identified top diagnoses for lab panels and routine testing performed within all
divisions.
 Created distinct lab panels to include all current labs ordered by providers.
 Eliminated labs that are not part of standard of care from panels to prevent
unnecessary testing.
 Structured lab panels to create disease specific clusters for ease of ordering.
 Ensure all panel sets are compliant with ACOG standards of care.
 Worked with lab to confirm match and programming to each individual lab and
panel.
Example: Ashkenazi Jewish Panel: Previously, genetic screening required
searching and ordering for all 9 individual tests in OMR separately.
Present state: one click on this panel to view and order all appropriate labs.
Lessons Learned
 Drawing from multidisciplinary work force (medical assistants, nurses and
physicians) allowed us to identify work flow issues related to lab ordering.
 Inclusion of all members of the care team in project development helped
identify issues early in process and prevent delays.
 Timeline for programming and the amount of work behind the scenes needs
to be including in project planning and goal setting.
 Education of care team is key for standardization of routine lab testing.
Next Steps
 Monitor for efficiency of lab ordering by all providers within department.
 Evaluate if implementation decreases lab ordering outside of clinical guidelines
for routine obstetrical issues/ disease processes.
 Evaluate success of program by comparing testing patterns prior to and after
introduction of new templates.
For more information, contact:
Celeste Royce, MD [email protected]
Increasing Efficiency of Specialized Lab Ordering in OB/GYN
Results/Progress to Date
For more information, contact:
Celeste Royce, MD [email protected]