A Multifaceted Quality Improvement Initiative to Reduce Unnecessary Laboratory Testing on Internal Medicine Inpatient Wards
Abstrak
Background The American and Canadian Choosing Wisely campaigns recommend against routine complete blood count (CBC) and chemistry testing in the face of clinical stability in the inpatient internal medicine setting. Problem Patients on internal medicine units commonly have daily lab tests ordered at admission and lab testing is often bundled. Four ‘core’ lab tests (CBC, electrolytes, creatinine, and urea) account for more than half of all lab tests performed. Methods The Model for Improvement and the Donabedian framework was used to define the problem, evaluate the baseline state, and generate targeted improvements. A quality improvement (QI) initiative consisting of education and process change was implemented on one general internal medicine unit and multiple plan-do-study-act cycles were carried out. The outcome measure was the total number of core labs performed, and the process measure was the proportion of patients with tests ordered on a repeating daily basis. Results The initiative led to an 18.9% decrease in the total number of core labs ordered and an 18.2% absolute decrease in repeating daily lab orders. Conclusions A multifaceted QI initiative aimed at reducing unnecessary lab testing was successful at reducing the number of lab tests ordered and changing lab ordering process.
Penulis (3)
Inka Toman
Pamela Mathura
Narmin Kassam
Akses Cepat
- Tahun Terbit
- 2020
- Bahasa
- en
- Total Sitasi
- 7×
- Sumber Database
- CrossRef
- DOI
- 10.22374/cjgim.v15i2.357
- Akses
- Open Access ✓