Development of a Rational Laboratory Test Ordering Approach at Lam Thap Hospital, Krabi Province

Abstract

This study is an action research project comprising planning, action, observation, and reflection. The objective is to develop guidelines and evaluate the implementation outcomes based on the criteria for hospital development in rational laboratory test ordering. A mixed-method research approach was employed, including a quantitative study of patient data from laboratory test orders during 2023–2024 and a qualitative study using focus group discussions with the clinical leadership team at Lam Thap Hospital.

            The results of the study are as follows: (1) The developed guidelines for rational laboratory test ordering at Lam Thap Hospital include three key patient groups: annual health check-ups, infectious diseases, and diabetes mellitus. (2) Following the implementation of the guidelines in 2024, the first indicator— the percentage of diabetic patients undergoing repeat HbA₁C testing within 90 days (1.56%). The second indicator—the percentage of diabetic patients undergoing at least one HbA₁C test per year (70.62%). The third indicator demonstrated that the hospital met the criteria for rational laboratory test ordering and achieved cost savings of 13,358 THB (52.84%) in lipid profile and renal function tests for annual health check-ups among hospital personnel. Additionally, the hospital generated a revenue increase of 110,700 THB (39.64%) from HbA₁C tests conducted according to the established guidelines for diabetic patients.