RePORT

Led by principal investigator Dr. Anshula Ambasta, MD, clinical assistant professor in the Cumming School of Medicine, the RePORT project successfully implemented strategies to reduce unnecessary lab tests across 14 major hospitals in Alberta from January 2023 to March 2024. The W21C team, led by Suru Pokharel, research project coordinator, partnered with a key sponsor and collaborator, the former Medicine Strategic Clinical Network (SCN), to drive this initiative forward. Key achievements included:  Building a Network of Champions: A multidisciplinary group of project champions was established across the hospitals, ensuring the project’s sustainability and laying the groundwork for future quality improvement initiatives at a provincial level.  Creating a Data Tracking System: An active Alberta Health Services Tableau dashboard was developed in collaboration with Laboratory Services to monitor lab test usage, providing the data needed for ongoing quality improvement efforts.  Improving Ordering Processes: The team worked with Connect Care analysts to advocate for system design changes, such as simplifying processes for using recent lab results and making appropriate test ordering easier.    

The RePORT project further focuses on patient-oriented research and included an arm to the project focused on the patient experience in in-hospital lab testing. To best serve patients and conduct true patient-oriented research, a patient advisory council (PAC) was formed at start of the project consisting of patient research partners, the PI, research associates and specialists, and members from the Alberta SPOR Support Unit. The PAC leads studies focused on improving the patient experience and empowering patients to be involved in their care. W21C research associates manage and support the PAC and its studies. 

To support implementation and sustainability, we established a network of 29 physicians and 6-unit staff. We conducted 11 audit and feedback sessions with 94 physicians, and 70 physicians reviewed our educational module. A 12.7% reduction in laboratory test ordering was achieved, and sustainability monitoring is ongoing.  The study utilized an evidence-based multi-modal intervention bundle, developed from Dr. Ambasta’s pilot work from 2018- 2021.  

The PAC has conducted one study on the patient experience of in-hospital lab testing and used the results from this study to develop patient engagement tools through the process of human centered design. The patient engagement tools were launched in Alberta hospitals and are now being evaluated through another PAC led study to see what can be improved for their launch in British Columbia. The goal is for the tools to eventually be launched throughout Canada. 

Team members (academic researchers and patient research partners) disseminated the results of our work through presentations at international (Preventing Overdiagnosis Conference, Denmark) and national conferences (Northwest Strategy for Patient Oriented Research Collaborative Forum in Edmonton, Putting Patients First Conference in Vancouver, Rocky Mountain Internal Medicine Conference in Banff, Choosing Wisely Canada National Meeting in Winnipeg).