Improving the Timing of Laboratory Studies in Hospitalized Children: A Quality Improvement Study.

Autor:	Ramazani SN; Department of Pediatrics, Golisano Children's Hospital suzanne_ramazani@urmc.rochester.edu., Gottfried JA; Department of Pediatrics, Golisano Children's Hospital., Kaissi M; Department of Pediatrics, Golisano Children's Hospital., Lynn J; Department of Pediatrics, Golisano Children's Hospital., Leonard MS; Department of Pediatrics, Golisano Children's Hospital.; Department of Public Health Sciences, University of Rochester, Rochester, New York., Schriefer J; Department of Pediatrics, Golisano Children's Hospital., Bayer ND
Jazyk:	angličtina
Zdroj:	Hospital pediatrics [Hosp Pediatr] 2021 Jul; Vol. 11 (7), pp. 670-678. Date of Electronic Publication: 2021 Jun 22.
DOI:	10.1542/hpeds.2020-005793
Abstrakt:	Objectives: For hospitalized children and their families, laboratory study collection at night and in the early morning interrupts sleep and increases the stress of a hospitalization. To change this practice, our quality improvement (QI) study developed a rounding checklist aimed at increasing the percentage of routine laboratory studies ordered for and collected after 7 am. Methods: Our QI study was conducted on the pediatric hospital medicine service at a single-site urban children's hospital over 28 months. Medical records from 420 randomly selected pediatric inpatients were abstracted, and 5 plan-do-study-act cycles were implemented during the intervention. Outcome measures included the percentage of routine laboratory studies ordered for and collected after 7 am. The process measure was use of the rounding checklist. Run charts were used for analysis. Results: The percentage of laboratory studies ordered for after 7 am increased from a baseline median of 25.8% to a postintervention median of 75.0%, exceeding our goal of 50% and revealing special cause variation. In addition, the percentage of laboratory studies collected after 7 am increased from a baseline median of 37.1% to 76.4% post intervention, with special cause variation observed. Conclusions: By implementing a rounding checklist, our QI study successfully increased the percentage of laboratory studies ordered for and collected after 7 am and could serve as a model for other health care systems to impact provider ordering practices and behavior. In future initiatives, investigators should evaluate the effects of similar interventions on caregiver and provider perceptions of patient- and family-centeredness, satisfaction, and the quality of patient care. Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. (Copyright © 2021 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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