The Laboratory Test Justified: An Effective Means to Reduce Routine Laboratory Testing
| Autor: | Louise Gillis, Marilyn Novich, Alfred I. Tauber |
|---|---|
| Rok vydání: | 1985 |
| Předmět: |
medicine.medical_specialty
Attitude of Health Personnel Diagnostic Tests Routine business.industry Cost-Benefit Analysis Routine laboratory General Medicine Laboratory testing Blood Cell Count Test (assessment) Laboratory test Physicians Humans Medicine Test performance Forms and Records Control Hospitals Municipal Hospitals Teaching business Intensive care medicine Blood Chemical Analysis |
| Zdroj: | American Journal of Clinical Pathology. 84:756-759 |
| ISSN: | 1943-7722 0002-9173 |
| Popis: | In an attempt to reduce clinical laboratory testing, a strategy was designed for a clinician-oriented restriction policy imposed on the laboratory test-ordering mechanism. The program examined the requirement of a written justification to accompany test requests. Directed justification, where specified conditions were required for test performance, was applied to the prothrombin and partial thromboplastin times and resulted in a mean reduction of 44% (P less than 0.001) in these tests; a nonspecific justification directive for leukocyte differentials, where any clinical condition listed generated the test, reduced differentials 35% (P less than 0.001). The justification policy then was extended more broadly and applied on a trial basis to general medical wards. Although no review was made on validity of listed test rationalizations, the justification process alone significantly reduced four common laboratory tests from 28% (BUN/creatinine) to 45% (electrolytes); significant reductions were not seen in less frequently ordered tests. The authors concluded that the most common clinical laboratory tests may be reduced by demanding that the clinician perform a clerical justification when requesting these tests. This mild restrictive policy in the ordering process allows the clinician to maintain responsibility over laboratory testing, while effectively reducing laboratory volume. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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