Background Unnecessary laboratory testing of hospitalized patients is prevalent. Objective We conducted a study focused on “mindful ordering” to decrease unnecessary laboratory ordering within an Internal Medicine residency program. Designs, Settings and Participants We collected survey data on resident/faculty perceptions of laboratory ordering as well as order information from the electronic medical record (EMR). Intervention Interventions focused on resident‐identified barriers such as knowledge, EMR, habit and faculty expectations. Interventions were cumulative and included resident/faculty education and EMR optimization. Main Outcomes and Measures We assessed basic and complete metabolic panels (BMP, CMP) and complete blood counts with and without differential (CBC w/diff, w/o diff). Primary outcomes included: total labs ordered per week, lab and frequency, and resident perception of ordering practices. Secondary outcomes included: length‐of stay (LOS) and venipuncture utilization. Results Survey data demonstrated increased resident perception of both mindful ordering and team discussion. Total labs ordered per week decreased 20% in the first year (1944 to 1500 labs/week). Residents' use of the “one‐time draw” option increased; use of “daily” frequency decreased. Trends showed an increase in BMP relative to CMP, and an increase in CBC w/o diff relative to CBC w/diff. These changes were sustained through 127 weeks. There was an approximately 10% decrease in monthly average of patients undergoing venipuncture each day (86.7% to 74.2%). The shifts in laboratory ordering in conjunction with increased discussion about labs suggest a sustained change in resident lab ordering behavior. This study shows the impact of focusing interventions on resident‐identified barriers to mindful ordering to create a sustained decrease laboratory orders.