Clinical Research Directory
Browse clinical research sites, groups, and studies.
Optimization of Low-Value Medical Testing Practices in Hospitalized Patients in Argentina
Sponsor: Hospital Italiano de Buenos Aires
Summary
Overuse of laboratory testing in hospitalized patients is a common form of low-value care and may contribute to patient discomfort, unnecessary downstream testing, inefficient use of healthcare resources, and increased costs. Although diagnostic stewardship interventions have reduced unnecessary laboratory testing in several high-income settings, evidence from Latin America remains limited, particularly regarding implementation processes and sustainability. OPTIMIZAR is a multicenter, effectiveness-implementation hybrid type 2 study evaluating a multicomponent diagnostic stewardship intervention in internal medicine wards and intensive care units across public and private tertiary hospitals in Argentina. The intervention targets laboratory ordering practices through workflow redesign, operational support, clinician education, and audit and feedback, with local leadership teams supporting implementation at each site. Effectiveness will be evaluated using an interrupted time series design with aggregated unit-level data collected before and after implementation. The primary outcome is monthly laboratory testing intensity, measured as Argentine Standardized Biochemical Units per occupied bed-day. Secondary outcomes include in-hospital mortality and hospital length of stay. Implementation outcomes will be assessed descriptively using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework.
Official title: Optimization of Low-Value Medical Testing Practices in Hospitalized Patients in Argentina (OPTIMIZAR)
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
600
Start Date
2025-06-01
Completion Date
2025-07-31
Last Updated
2026-06-05
Healthy Volunteers
No
Conditions
Interventions
OPTIMIZAR Multicomponent Diagnostic Stewardship Bundle
A multifaceted diagnostic stewardship intervention targeting laboratory ordering practices. Components include: (1) decision-making workflow redesign with designated responsibility for daily laboratory ordering; (2) operational support strategies such as sample reutilization ("add-on" testing) and remote electronic order modification; (3) structured educational sessions on diagnostic stewardship principles, costs, and clinical utility of commonly ordered tests; and (4) audit and feedback with biweekly review of laboratory orders and structured feedback to clinical teams. The intervention is implemented at the hospital unit level and integrated into routine clinical processes.
Locations (8)
Hospital Municipal de Agudos Dr. Leónidas Lucero
Bahía Blanca, Buenos Aires, Argentina
Hospital Interzonal General de Agudos Dr. Diego Paroissien
Isidro Casanova, Buenos Aires, Argentina
Hospital Austral
Pilar, Buenos Aires, Argentina
Hospital Italiano de San Justo
San Justo, Buenos Aires, Argentina
Hospital General de Agudos Dalmacio Vélez Sarsfield
Buenos Aires, Buenos Aires F.D., Argentina
Hospital Italiano de Buenos Aires
Buenos Aires, Buenos Aires F.D., Argentina
Hospital Alemán
Buenos Aires, Buenos Aires F.D., Argentina
Hospital Privado Universitario de Córdoba
Córdoba, Córdoba Province, Argentina