Improving diagnostic accuracy of 72-hour supervised fasting test for hypoglycemia evaluation: A quality improvement project

a bundle order set for 72-HSFT, and multiple different models of interactive educational sessions. The project was conducted in the emergency department and the inpatient wards of the medicine department. In a plan-do-study-act 1 cycle, testing inaccuracy was reduced from 66% to 20%, with C-peptide orders reducing from 4 tests to 1.2 tests per patient. In plan-do-study-act 2, testing inaccuracy dropped to 0% with one C-peptide test ordered per patient. This QIP demonstrates that system-level changes, combined with conventional interventions such as targeted education and advanced technology-based interventions like clinical decision support tools, can significantly improve test accuracy and reduce unnecessary resource utilization in endocrinological diagnostics.