Diagnostic Stewardship: the Central Role of Clinical Microbiology Laboratories

Diagnostic stewardship aims to improve diagnostic test utilization through evidence-based practices to improve care, quality, safety, and costs. Diagnostic stewardship is a collaborative effort that brings together multidisciplinary groups that have a common interest in promoting and ensuring best testing practices. For infectious disease testing, clinical microbiology laboratories are perhaps best positioned within their health care systems to lead these efforts, as they are not only diagnostic experts, but also directly oversee many of the tools and choices available to improve test performance and utilization. While some interventions may not fall under the direct purview of clinical microbiology laboratories, their expertise is nevertheless essential to inform these efforts, as well. Multiple stewardship strategies have been evaluated, providing laboratories with several opportunities to implement evidence-based practice changes to improve quality and outcomes. Further research is needed to continue advancing practice for well-established and emerging tests alike.