Optimizing laboratory test utilization in long-term acute care hospitals.
Laboratory tests can be considered inappropriate if overused or when repeated, unnecessary "routine" testing occurs. For chronically critically ill patients treated in long-term acute care hospitals (LTACHs), inappropriate testing may result in unnecessary blood draws that could potentially harm pat...
| Published in: | Baylor University Medical Center Proceedings Vol. 30; no. 1; pp. 26 - 30 |
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| Main Authors: | , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Taylor & Francis Ltd
2017
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=120161578&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 120161578 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 08998280 1XEP jtl: Baylor University Medical Center Proceedings issn: 08998280 maglogo: N pubinfo: dt: 2017 vid: 30 iid: 1 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 120161578 120161578 120161578 10.1080/08998280.2017.11929516 120161578 ppf: 26 ppct: 4 formats: fmt: @attributes: type: P tig: atl: Optimizing laboratory test utilization in long-term acute care hospitals. aug: au: Mora, Adan Krug, Brian S. Grigonis, Antony M. Dawson, Amanda Yuqing Jing Hammerman, Samuel I. affil: Baylor University Medical Center at Dallas, Pennsylvania sug: subj: Long Term Care Methicillin-Resistant Staphylococcus Aureus Critically Ill Patients Patient Safety Personnel, Health Facility Repeated Measures T-Tests Descriptive Statistics Data Collection Inpatients Panel Studies ab: Laboratory tests can be considered inappropriate if overused or when repeated, unnecessary "routine" testing occurs. For chronically critically ill patients treated in long-term acute care hospitals (LTACHs), inappropriate testing may result in unnecessary blood draws that could potentially harm patients or increase infections. A quality improvement initiative was designed to increase physician awareness of their patterns of lab utilization in the LTACH environment. Within a large network of LTACHs, 9 hospitals were identified as having higher patterns of lab utilization than other LTACHs. Meetings were held with administrative staff and physicians, who designed and implemented hospital-specific strategies to address lab utilization. Lab utilization was measured in units of lab tests ordered per inpatient day (lab UPPD) for 8 months prior to the initial meeting and 7 months after the meeting. A repeated measures mixed model determined that postintervention lab utilization improved, on average and adjusted by case mix index, by 0.37 lab UPPD (t = -3.61, 95% CI 0.17 to 0.58) compared to the preintervention period. Overall, the case mix index 8 months prior to the intervention was no different than it was 7 months after the initial meeting (t[8] = -0.96, P = 0.37). Patient safety and outcome measures, including percentage of patients weaned from a ventilator, readmission rates, central catheter utilization rates, and the incidence of methicillin-resistant Staphylococcus aureus and other multidrug resistant organisms, showed no significant change. Hospital staff meetings focused on lab utilization and the development and deployment of tailored lab utilization strategies were associated with LTACHs achieving significantly lower lab utilization without negatively impacting quality outcomes. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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