Effectiveness of Developing and Implementing a Rational Laboratory Test Ordering System in a Community Hospital: A Case Study of Phra Ajarn Baan Thanakaro Hospital

Abstract

        Unnecessary laboratory test ordering poses a significant challenge to healthcare systems, particularly in resource-limited community hospitals, as it increases healthcare costs, contributes to staff workload, and affects the overall quality of patient care. This study aimed to develop and evaluate the effectiveness of a Rational Laboratory Use (RLU) system in reducing inappropriate test ordering, decreasing expenditures, and enhancing service efficiency. A developmental research design was employed at Phra Ajarn Baan Thanakaro Hospital, Sakon Nakhon Province, from January to June 2025. Data were collected before and after system implementation. The study samples included healthcare personnel and laboratory test order records. Research instruments consisted of a test-ordering logbook, a satisfaction questionnaire, and a monitoring system for laboratory service indicators. Data were analyzed using descriptive and inferential statistics. The findings revealed that following RLU implementation, the number of laboratory test orders decreased by 26.5% (p < 0.01), and associated costs were reduced by 28.7% (p < 0.001). The appropriateness of test ordering increased from 78.0% to 92.0% (p < 0.05). Turnaround time was shortened from 95 minutes to 68 minutes, and duplicate orders declined from 12.5% to 5.8% (p < 0.05). Healthcare personnel expressed high to very high satisfaction with the system (mean score 4.7–4.9). In conclusion, the RLU system was effective in minimizing unnecessary resource utilization, improving the appropriateness of laboratory test ordering, and sustainably enhancing service efficiency in community hospital settings.