Research shows that Canadian hospitals participating in the Using Labs Wisely program successfully reduced unnecessary blood tests by identifying eight commonly overordered tests and implementing targeted improvement strategies. According to Gram Research analysis, 157 hospitals joined the collaborative from 2021 to 2026, with 91 hospitals submitting testing data and 67 presenting improvement results. Most hospitals used multiple approaches including doctor education, data feedback, and modified order forms to reduce unnecessary testing like coagulation profiles, urea tests, and AST levels.
Canadian hospitals are working together to stop ordering blood tests that patients don’t actually need. According to Gram Research analysis, a national program called Using Labs Wisely brought together 157 hospitals to figure out which tests waste time and money. Researchers found that tests like coagulation profiles and urea levels were being ordered too often without good reason. By sharing data and teaching doctors which tests really matter, hospitals are reducing unnecessary testing, saving money, and protecting patients from harm caused by too many tests. This collaborative approach shows how hospitals can work together to improve patient care.
Key Statistics
A 2026 process evaluation of the Using Labs Wisely program found that 157 Canadian hospitals across 6 provinces participated in a national collaborative to reduce unnecessary blood testing from January 2021 to February 2026.
Among 157 hospitals in the Using Labs Wisely collaborative, 91 hospitals (58%) submitted testing data and 67 hospitals (43%) presented their quality improvement results, demonstrating active engagement in reducing low-value laboratory tests.
The Using Labs Wisely program identified eight low-value blood tests being ordered unnecessarily, with urea, aspartate aminotransferase (AST), and coagulation testing targeted most frequently for reduction across participating hospitals.
In the Using Labs Wisely collaborative, 78% of hospital interventions used multimodal strategies combining education, audit and feedback, order set modification, and testing rules to reduce unnecessary laboratory testing.
The Quick Take
- What they studied: Whether Canadian hospitals could reduce unnecessary blood tests by sharing information and working together on improvement projects.
- Who participated: 157 hospitals across 6 Canadian provinces, including 91 academic hospitals, 64 community hospitals, and 2 children’s hospitals. Of these, 91 hospitals actually submitted their testing data for analysis.
- Key finding: Hospitals that participated in the Using Labs Wisely program identified eight types of blood tests that were being ordered too often, with urea, AST, and coagulation tests being the most frequently targeted for reduction.
- What it means for you: If you’re hospitalized in a participating Canadian hospital, you may receive fewer unnecessary blood tests. This means less poking with needles, faster results for tests that actually matter, and lower healthcare costs. However, this program is specific to Canadian hospitals and may not apply everywhere.
The Research Details
This study tracked how well a national hospital improvement program worked from January 2021 through February 2026. Researchers looked at whether hospitals joined the program, submitted their testing data, and actually made changes to reduce unnecessary tests. The program gave hospitals three main tools: online education and networking opportunities, reports comparing their testing rates to other hospitals, and help designing improvement projects. Hospitals could see how many tests they were ordering compared to similar hospitals and track whether their changes were working over time. The researchers measured success by counting how many hospitals participated, how many shared their data, and how many presented their improvement results.
This approach matters because it shows how to fix a real problem in hospitals. Many blood tests are ordered out of habit rather than medical need, which costs money, wastes lab resources, and can actually harm patients by leading to unnecessary follow-up tests and treatments. By creating a network where hospitals learn from each other and share what works, the program spreads good practices faster than if each hospital tried to solve the problem alone.
This is a real-world study of an actual hospital program, which makes it very relevant to how healthcare actually works. The program included a large number of hospitals across multiple provinces, which strengthens the findings. However, this study describes what happened rather than comparing it to a control group, so we can’t be completely certain that the program caused all the improvements. The fact that 58% of hospitals submitted data suggests good participation, though some hospitals may not have been fully engaged.
What the Results Show
From 2021 to 2026, 157 hospitals joined the Using Labs Wisely program, representing a strong national effort to reduce unnecessary testing. Of these hospitals, 91 actually submitted their testing data for comparison, showing that more than half were actively participating. The program identified eight types of blood tests that were being ordered too often: coagulation profiles (tests that check if blood clots properly), aspartate aminotransferase or AST (a liver enzyme test), urea (a kidney function test), creatinine-kinase MB isoenzyme (a heart enzyme test), serum or red blood cell folate (a vitamin B test), vitamin B12 (another B vitamin test), erythrocyte sedimentation rate or ESR (an inflammation test), and urine cultures (tests for urinary tract infections). Hospitals focused most of their improvement efforts on reducing urea, AST, and coagulation testing, which were the most commonly ordered unnecessarily.
The program found that 67 hospitals (43%) presented their improvement results during collaborative meetings, showing they had actually implemented changes. Most hospitals used multiple strategies to reduce unnecessary testing, including educating doctors about which tests are truly needed, showing doctors their own testing patterns compared to other hospitals, changing the computer order forms to make unnecessary tests harder to order, and creating rules about when certain tests should be ordered. This multimodal approach, used in 78% of the interventions, appears to be more effective than trying just one strategy alone.
This research builds on earlier work showing that many hospital tests are unnecessary and harmful. Previous studies identified the same problem, but this program shows a practical solution: bringing hospitals together to share data and learn from each other. The focus on specific low-value tests like coagulation profiles and urea testing aligns with international guidelines about which tests are overused. This collaborative model is relatively new in Canada and demonstrates how national programs can spread quality improvement faster than individual hospital efforts.
This study describes what happened in the program but doesn’t compare results to hospitals that didn’t participate, so we can’t be completely certain the program caused the improvements. Some hospitals may have made changes but didn’t report them, so the actual impact might be larger than reported. The program focused on Canadian hospitals, so results may not apply to other countries with different healthcare systems. Additionally, the study doesn’t provide detailed information about how much testing actually decreased or how much money was saved, which would help show the real-world impact.
The Bottom Line
If you receive care at a Canadian hospital participating in Using Labs Wisely, you can expect that doctors are being encouraged to order only necessary blood tests. This is a positive development with strong evidence supporting it. Patients should feel comfortable asking their doctors why a blood test is being ordered if they’re unsure about its purpose. This program is most relevant for people hospitalized in Canadian facilities; those in other countries should check if similar programs exist in their area.
Hospital patients in Canada should care about this, especially those admitted for longer stays who might receive many tests. Healthcare workers and hospital administrators should care because this program helps them reduce costs and improve patient safety. Insurance companies and government health programs benefit from reduced unnecessary testing. People in other countries should care because this model could be adapted to their healthcare systems. Those with chronic conditions requiring frequent hospitalizations may see the biggest benefit from reduced unnecessary testing.
Changes from this program likely took several years to fully implement, as shown by the 2021 to 2026 timeline. Hospitals that joined early probably saw improvements within 6 to 12 months of implementing changes. Individual patients might notice fewer blood tests during their next hospital stay if their hospital is actively participating. The full benefits of reduced unnecessary testing, including cost savings and reduced patient harm, accumulate over years as more hospitals adopt the practices.
Frequently Asked Questions
Why do hospitals order so many unnecessary blood tests?
Doctors often order blood tests out of habit, to be cautious, or because older computer systems make it easy to order many tests at once. The Using Labs Wisely program found that eight specific tests were commonly ordered without clear medical reasons, wasting resources and potentially harming patients through unnecessary follow-up testing.
How can I reduce the number of blood tests I get in the hospital?
Ask your doctor why each blood test is necessary and how it will affect your treatment. This simple question encourages doctors to think carefully about each test. If you’re in a Canadian hospital participating in Using Labs Wisely, your hospital is already working to reduce unnecessary testing through education and improved ordering systems.
What are the most commonly overordered blood tests?
The Using Labs Wisely program identified eight frequently overordered tests: coagulation profiles, AST (liver enzyme), urea (kidney function), creatinine-kinase MB (heart enzyme), folate and B12 (vitamin tests), erythrocyte sedimentation rate (inflammation test), and urine cultures. These tests were targeted most often for reduction.
Does reducing blood tests actually save money for hospitals?
Yes, unnecessary blood tests cost hospitals money in lab supplies, staff time, and equipment use. Beyond costs, reducing unnecessary tests also reduces patient harm from false positive results that lead to more testing and treatment. The Using Labs Wisely program focused on both financial and patient safety benefits.
Is this program available outside of Canada?
The Using Labs Wisely program is specific to Canadian hospitals. However, similar quality improvement collaboratives exist in other countries. Check with your hospital or healthcare system to see if they have programs to reduce unnecessary testing, as this approach is increasingly recognized as important worldwide.
Want to Apply This Research?
- If hospitalized, track the number and type of blood tests ordered each day. Note which tests your doctor explained as necessary versus those you questioned. Compare this to your previous hospitalizations to see if the number of tests is decreasing.
- Ask your doctor before each blood test: ‘Why do I need this test and how will it change my treatment?’ This simple question encourages doctors to think carefully about whether each test is truly necessary, supporting the goals of the Using Labs Wisely program.
- Over multiple hospital stays, keep a record of how many blood tests you received and how many times you were poked with needles. Share this information with your healthcare team to help them understand the patient experience of unnecessary testing and reinforce the importance of ordering only needed tests.
This research describes a quality improvement program in Canadian hospitals and does not constitute medical advice. Individual decisions about blood testing should always be made in consultation with your healthcare provider based on your specific medical situation. The findings apply primarily to Canadian hospital settings and may not be relevant to other healthcare systems. If you have concerns about blood tests ordered for you, discuss them directly with your doctor rather than declining tests without medical guidance.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.