Clostridioides difficile infection (CDI) bacteria can cause life-threatening diarrhea and is one of the most common healthcare-associated infections in the United States. There were more than 223,000 estimated cases in hospitalized patients in 2017 resulting in more than 12,00 deaths at an estimated attributed healthcare cost of $1 billion. This session explores diagnostic stewardship opportunities to reduce Hospital Onset-CDI through the lens of the UVA Health experiences including tools, outcomes and lessons learned. The speaker will review the importance of the culture set by institutional leadership to generate and sustain engagement, the integral role of nurses in testing decisions, the IT support needed to build a dashboard, track data and develop EMR changes, and a case review in partnership with the frontline staff and its importance in understanding current state and plan next steps. The work to mitigate HO-CDI is time intensive but important and effective.