Complete blood counts (CBCs) are ordered routinely on many low-risk labor admissions despite guidelines and expert opinion. Our project, a collaboration between the residency programs in obstetrics and family medicine, reduces unnecessary testing, limits waste, and promotes high value care by eliminating routine CBCs on low-risk patients admitted in labor. This project was a finalist in our institution’s housestaff High Value Contest. Prior to project implementation 94% of labor patients had a CBC ordered. We provided multidisciplinary education for housestaff, faculty, and nursing staff. Educational interventions included: didactic sessions, badge cards, and signage. Upon project implementation, CBCs ordered decreased by 30% almost immediately with no increase in post-partum hemorrhage or transfusions. Waste eliminated is over $500,00 annually with no risk to patient safety. Future directions include institutionalizing change with EMR improvements and spreading widely.
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