College of American Pathologists

  QP123 - Frequency Monitoring of Outpatient Laboratory Testing


Posted January 16, 2012

Clinical laboratories are commonly asked by institutional administrators to monitor and improve laboratory test utilization. One important aspect of laboratory utilization includes ensuring that tests are performed at appropriate intervals. This is because testing patients at inappropriate intervals can have both economic and clinical consequences. This study will examine ordering practices for commonly requested outpatient tests to determine how often these tests are ordered excessively. Participating laboratories will have the opportunity to compare their test ordering practices with other institutions and recognized guidelines at a time when they are under pressure to maximize resource utilization.


Measure how often patients are tested at frequencies that are consistent with recognized guidelines.

Data Collection

Participants will prospectively monitor consecutive hemoglobin A1c (HgA1c) test results to identify patients who have had three HgA1c levels resulted in the past 24 months. Continue monitoring for six weeks or until 40 patients have been identified. For each identified patient, again query the laboratory information system to determine if the patient has test results for LDL or urine protein: creatinine ratio (UPRT) in the past 24 months. The patient’s age, dates of current and previous tests, and current and previously reported test results will be recorded. The study excludes current inpatients, children under the age of 18, and patients who have received kidney transplants.

Performance Indicators

  • Primary:
    • Percent of hemoglobin A1c tests performed at appropriate frequency
    • Percent of LDL tests performed at appropriate frequency
    • Percent of urine protein tests performed at appropriate frequency
  • Secondary:
    • Average intervals between test results for each test examined

Ship Date

June 18, 2012

Order Deadline

July 12, 2012*

*Orders must be received by the order deadline.


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