Choosing Wisely Canada recommendations for clinical biochemistry: test ordering for sustainable and high-quality patient care

Abstract

Laboratory Medicine is growing at a rapid rate in both the breadth of unique tests and the total number of tests performed per year. Inappropriate overutilization of laboratory tests can lead to patient harm, excessive environmental waste and increased carbon emissions. A focus on reducing inefficiencies in healthcare is needed to ensure a robust and sustainable healthcare system. To promote laboratory sustainability, the Canadian Society of Clinical Chemists (CSCC) has developed ten recommendations related to medical tests within clinical biochemistry. These recommendations are designed as ‘low-hanging fruit’ that should be adopted by both hospital and community laboratories. By implementing automated strategies and/or educational approaches to reduce misuse of laboratory resources, clinical laboratories can move toward a more sustainable model that improves patient care. This list of recommendations, created for Choosing Wisely Canada, covers tests for diabetes, celiac disease, monoclonal gammopathies, iron disorders, liver disorders, kidney disorders, substance use disorders, and allergen testing.