[AVBC 2025] Clinician education to reduce over-ordering of respiratory panel tests in a new public hospital
Care Process & Redesign
Training ＆ Education
Appropriate & Value-based Care Conference
National Healthcare Group
5 December 2025
To reduce the over-ordering of respiratory panel tests and improve diagnostic stewardship in a new public hospital in. Diagnostic stewardship is crucial, yet challenging.
Year Submitted: 2025
Published Date: 05 December 2025
Tags: Care Process ＆ Redesign, Quality Improvement, Education Research, Cost Saving, Education Analytics, Training ＆ Education
About this Content
Aims
To reduce the over-ordering of respiratory panel tests and improve diagnostic stewardship in a new public hospital in Singapore.
Background
Upon Woodlands Health's opening in May 2024, the volume of tests ordered far exceeded the anticipated load. Initial audits found tests were often sent for non-respiratory complaints or nosocomial infections.
Methods
Upon Woodlands Health's opening in May 2024, the volume of tests ordered far exceeded the anticipated load. Initial audits found tests were often sent for non-respiratory complaints or nosocomial infections.
Results
The number of respiratory multiplex PCR tests dropped significantly (-85%; 195 to 29 tests per 1000 discharges). However, there was no improvement in appropriateness in Respiratory Multiplex PCR tests.
Conclusion
Diagnostic stewardship is crucial, yet challenging. It is important to gather high-quality data to measure appropriateness and clinical impact. A better understanding of factors underlying clinicians' ordering behavior is needed.
Lessons Learnt
Clinicians may have chosen alternatives without appreciating clinical indications, leading to a 'replacement effect'. A reduction in tests leads to reduced costs, but clinical data on patient outcomes was not measured.
Keywords
Respiratory, Multiplex PCR, Education, Cost, Tests
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Woodlands Health |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Medical |
Applicable Specialty or Discipline | Infectious Diseases |
Project Lead(s) | Jayashri Shobna Venketasubramanian |
Project Member(s) | Lasantha Ratnayake |
Connect with this contributor!
Jayashri Shobna Venketasubramanian - js_venketasubramanian@wh.com.sg