ASCP 2024 Effective Test Utilization Best Practice Recommendations Now Available

ASCP’s Effective Test Utilization subcommittee has released a new set of recommendations of diagnostic tests to question, as part of its ongoing initiative to champion efforts to bring the right test to the right patient at the right time.

The 2024 Effective Test Utilization (ETU) Best Practice Recommendations comprise six recommendations suggested by members of ASCP’s Effective Test Utilization (ETU) subgroup, part of the ASCP Quality and Patient Safety Steering Committee. Many submissions were received for consideration, including some from the American Society for Microbiology (ASM). The recommendations were vetted by ASCP member experts and, where appropriate, colleagues from sister societies such as the American College of Obstetricians and Gynecologists (ACOG).

As in years past, the tests selected for this list were those that:

• are frequently performed;
• there is evidence that the test either offers no benefit or is harmful (either entirely or in specific clinical situations);
• the test is costly, and it does not provide higher quality patient care; and,
• Eliminating the test or changing to another test is within the control of the clinician.

By implementing these and other ETU best practices in the laboratory, ASCP is striving to see higher quality care, lower costs, and a more effective use of laboratory resources and personnel.

The recommendations comprise one component of a broader approach that the ETU subgroup is implementing to expand its reach and encourage more practitioners to implement effective test utilization and laboratory stewardship. “The main goal of effective test utilization is to continue the spirit of what the ABIM Foundation’s Choosing Wisely^© campaign was about,” says Elise Occhipinti, MD, FASCP, Chair of the ASCP Quality and Patient Safety Steering Committee. “To do that properly, we need to use multiple strategies that resonate with a broader audience.”

The approach includes retaining the recommendations that the ASCP ETU group has developed over the years and ensuring that they are still up to date. It will also need to retire recommendations that are no longer relevant.

“I don’t think there are too many of those, but as tests become obsolete, it is important to consider that,” says Dr. Occhipinti, who is also the chair of Clinical Pathology and Laboratory Medical Director of Ochsner Health.

Additionally, the group is continuing to reach out to ASCP members, as they are the source of many ideas for tests that need to be reviewed.

It will also continue to have a robust process for submitting experiences that ASCP members have implemented in their own institutions and provide a forum, such as the Choosing Wisely Champions program, to share those best practices.

“The submissions from our members are extremely valuable,” Dr. Occhipinti says. “It is the feedback of ASCP members which is really strong and that will make the program grow.”

She adds, “The ETU subgroup members don’t necessarily have clinical expertise in all areas. So, it is critical to partner with sister organizations, such as ACOG and the Infectious Disease Society of America, to ensure alignment and accuracy of our recommendations.”

Recruiting subject matter experts is the one area that remains a challenge. “I have gotten feedback that they have a lot on their plate and don’t want to add more responsibilities,” Dr. Occhipinti says.

Another goal is to develop an archive of all the utilization efforts that ASCP members have presented in the past. Utilization is still a fairly new field. Many healthcare institutions are at various stages of their utilization journey. Some have done very little in this area and others, like Ochsner Health, have done a lot to improve utilization in the laboratory, and healthcare systems overall.

“I would like for our utilization committee [at Ochsner] to have resources to find how various different individuals dealt with the same issue in different ways, and ASCP can facilitate these efforts,” Dr. Occhipinti says.

As test utilization is a relatively new field, there are many opportunities for growth as the ETU subgroup outlines its plans for the year ahead. Watch for more developments in future stories.

Meanwhile, readers are encouraged to share this new list of recommendations widely to raise awareness about effective test utilization best practices in the laboratory that impact the entire spectrum of patient care. ASCP continues to champion efforts to bring the right test to the right patient, at the right time. For more information and resources, please visit the ASCP Effective Test Utilization webpage.