A new resource from the Society for Healthcare Epidemiology of America (SHEA) estimates that a typical 200-bed community hospital could save approximately $2.5 million to $2.8 million annually by implementing five diagnostic stewardship interventions.
Published in Antimicrobial Stewardship and Healthcare Epidemiology, the paper provides hospital and clinical laboratory leaders with a framework for developing institution-specific business cases for improving test utilization.
The researchers examined five common targets:
- Clostridioides difficile testing;
- Urine cultures;
- Procalcitonin testing;
- Respiratory pathogen panels; and
- Blood cultures.
The largest estimated opportunity involved blood culture stewardship, which could produce approximately $1.86 million in annual savings. Optimizing respiratory pathogen panel use could save $383,650 to $668,000, depending on how extensively broad panels were replaced with more focused viral testing.
The researchers estimated that discontinuing unnecessary procalcitonin testing could save nearly $79,000 annually. Improvements involving C. difficile testing and urine cultures also produced projected savings.
Connecting laboratory testing with hospital performance
The financial benefits potentially extend beyond the clinical laboratory budget. Unnecessary testing can contribute to inappropriate antimicrobial treatment, longer hospital stays, and the identification of infections that may not be clinically meaningful.
Those findings can negatively affect publicly reported healthcare-associated infection rates and hospital quality scores. SHEA estimated that improved performance under the Centers for Medicare and Medicaid Services’ Hospital-Acquired Condition Reduction Program could generate an additional $200,000 to $600,000 in savings, depending on a hospital’s baseline performance.
Hospitals with poor performance under that program can lose 1% of their Medicare payments. Diagnostic stewardship also may influence CMS star ratings and Leapfrog safety grades.
“Healthcare leaders know that every investment must improve both patient care and operational performance,” said Sarah E. Turbett, MD, senior author of the paper, in a SHEA announcement. “This framework helps hospitals evaluate and implement diagnostic stewardship in ways that improve clinical outcomes, strengthen quality metrics, and demonstrate measurable value.”
For clinical laboratories, the framework may provide a practical way to show hospital executives that investments in laboratory stewardship can deliver savings throughout the organization. It also demonstrates how laboratory utilization decisions can affect reimbursement, quality rankings, antimicrobial use, and hospital reputation.
