[AVBC 2025] Switching from Renal Panel to serum Creatinine for contrasted scans in Alexandra Hospital
Care Process & Redesign
Appropriate & Value-based Care Conference
National University Health System
10 November 2025
The aim of the project is to reduce costs and unnecessary testing for renal function assessment prior to contrasted scans as. Ordering sCr instead of RP for pre-contrast assessment reduces unnecessary testing and healthcare costs without compromising the.
Year Submitted: 2025
Published Date: 10 November 2025
Tags: Care Process ＆ Redesign, Quality Improvement, Workflow Redesign, Productivity, Cost Saving
About this Content
Aims
The aim of the project is to reduce costs and unnecessary testing for renal function assessment prior to contrasted scans as part of an AH Appropriate Care project.
Background
In Alexandra Hospital (AH), renal function assessment is required for at-risk patients within 3 months prior to contrasted CT and MRI scans. The Renal Panel (RP) is often ordered when serum Creatinine (sCr) alone is sufficient. The test fee for RP is $55.10, while sCr alone is $13.25. Ordering sCr instead of RP reduces unnecessary testing without compromising patient care.
Methods
The methodology involved reviewing hospital workflows to understand why clinicians frequently ordered RP instead of sCr. An established process was identified where staff routinely emailed clinicians to request RP when no recent Creatinine result was available. As an intervention, the workflow was amended in collaboration with the Radiology department in November 2024, specifically replacing RP with sCr. This change was communicated to all clinicians via an email blast. Aggregated, de-identified data focusing on outpatient contrasted scans was obtained, and orders for sCr and RP within 3 months prior were analyzed. A baseline was established by averaging sCr orders over the 10 months preceding the intervention.
Results
At baseline, RP was more commonly ordered compared to sCr (25.2% vs 2.3%). After the intervention, the proportion of RP orders decreased from 25.2% to 19.8%, while that of sCr increased from 2.3% to 11.1%. Cumulatively, 391 sCr orders were increased, which would have been RP orders otherwise. This represented a cumulative estimated savings to patients of $16,363 (gross before subsidy) thus far, and an average monthly estimated savings of $2,045.
Conclusion
Ordering sCr instead of RP for pre-contrast assessment reduces unnecessary testing and healthcare costs without compromising the quality of care delivered.
Lessons Learnt
The overuse of the renal panel for pre-contrast renal function check is probably a common problem across local hospitals. Implementing similar behavior-based interventions can significantly reduce healthcare costs without impacting clinical care.
Keywords
renal, function, assessment, costs, testing, sCr, RP, hospital, workflow
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National University Health System |
Organization(s) Involved | Alexandra Hospital |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Medical |
Applicable Specialty or Discipline | Nephrology, Radiology |
Project Lead(s) | Lim Fang Jin |
Project Member(s) | Agrawal Sachin Nandkishore |
Connect with this contributor!
Lim Fang Jin - fang_jin_lim@nuhs.edu.sg