Improving the Timing of Laboratory Studies in Hospitalized Children: A Quality Improvement Study
| Autor: | Michael S. Leonard, Julie Albright Gottfried, Justin Lynn, Jan Schriefer, Nathaniel D. Bayer, Maha Kaissi, Suzanne N. Ramazani |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Quality management Psychological intervention Run chart Pediatrics Post-intervention 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Health care Humans Medicine 030212 general & internal medicine Child business.industry Medical record Outcome measures General Medicine Hospitals Pediatric Quality Improvement Checklist Caregivers Pediatrics Perinatology and Child Health Emergency medicine Laboratories business Child Hospitalized |
| Zdroj: | Hospital Pediatrics. 11:670-678 |
| ISSN: | 2154-1671 2154-1663 |
| DOI: | 10.1542/hpeds.2020-005793 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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