Diagnostic Stewardship

Diagnostic stewardship consists of interventions to modify the ordering, processing, and reporting of diagnostic tests in order to provide the right test for the right patient, prompting the right action. Diagnostic stewardship aims to affect patient outcomes and educate clinicians through real-time practice changes. These interventions are often at the institutional level and involve interprofessional collaboration among Clinical Microbiology, Infection Prevention, and Antimicrobial Stewardship. This chapter discusses diagnostic stewardship techniques and best available evidence with respect to common syndromes, including urinary tract, C. difficile, bloodstream, respiratory, and gastrointestinal infections. Current controversies and challenges, such as patient-centered outcomes versus cost or metrics, are also discussed.