Grant: Health System Impact Fellowships - PostDoc Central Canada 2 year

Blood samples taken in hospitals are sent to a laboratory, analyzed, and results used to diagnose and treat patients. However, many tests ordered are not needed. This leads to wasted healthcare spending and negative effects on patients, such as false positives (test results which incorrectly indicate that a person has a condition). Researchers have designed strategies to support hospital staff to reduce unnecessary testing. However, these strategies don't work all the time, which prevents widespread uptake. We need to know more about what influences hospital staff to order these tests, and what they think about these strategies, so that we can develop strategies that best suit their needs. The Eastern Ontario Regional Laboratory Association (EORLA), a group of 18 laboratories connected to 16 hospitals in Eastern Ontario, have been testing various different strategies to support hospital staff to reduce their orders of these tests. In study 1, we will assess the extent to which these strategies are working, by comparing the number of tests ordered before and after the strategies were put in place. We will also review the strategy documentation to pinpoint the specific techniques which may be supporting staff to change their behaviour. Finally, we will interview those who set up the strategies to explore the process and challenges, and hospital staff to explore how they think the strategies affected their test ordering. In study 2, we will interview hospital staff to help with the design of new strategies. Finally, we will develop a list of all the data EORLA have and investigate how it could be better linked so that EORLA can compare test-ordering practices across all their hospital sites.