An Educational and Administrative Intervention to Promote Rational Laboratory Test Ordering on an Academic General Medicine Service

American Journal of Medicine

Volumn 130, Issue 1, 2017, Pages 47-53

  Wertheim, Bradley M ^a,b   Aguirre, Andrew J ^a,b   Bhattacharyya, Roby P ^a,b   Chorba, John ^a   Jadhav, Ashutosh P ^a   Kerry, Vanessa B ^a,b   Macklin, Eric A ^a   Motyckova, Gabriela ^a   Raju, Shveta ^a,c   Lewandrowski, Kent ^a,b   Hunt, Daniel P ^a,d   Wright, Douglas E ^a,b  

^a MASSACHUSETTS GENERAL HOSPITAL   (United States)

^b HARVARD MEDICAL SCHOOL   (United States)

^c MEDICAL COLLEGE OF GEORGIA   (United States)

^d EMORY UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Diagnostic tests; Medical education; Resource use

Indexed keywords

BICARBONATE; CHLORIDE; CREATININE; GLUCOSE; POTASSIUM; SODIUM;

ACUTE KIDNEY FAILURE; ADULT; ARTICLE; BICARBONATE BLOOD LEVEL; CHLORIDE BLOOD LEVEL; CLINICAL LABORATORY; CONTROLLED STUDY; CREATININE BLOOD LEVEL; DELAYED DIAGNOSIS; FEMALE; GENERAL PRACTICE; GLUCOSE BLOOD LEVEL; HUMAN; LABORATORY TEST; LENGTH OF STAY; MAJOR CLINICAL STUDY; MALE; MASSACHUSETTS; MEDICAL EDUCATION; MEDICAL STUDENT; MIDDLE AGED; PATIENT CARE; PHYSICIAN; POTASSIUM BLOOD LEVEL; PRACTICE GUIDELINE; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; SODIUM BLOOD LEVEL; STUDENT SATISFACTION; TERTIARY CARE CENTER; TREATMENT OUTCOME; UREA NITROGEN BLOOD LEVEL; IN SERVICE TRAINING; LABORATORY TECHNIQUE; ORGANIZATION AND MANAGEMENT; ORGANIZATIONAL POLICY; PHYSICIAN ORDER ENTRY SYSTEM; PROCEDURES; STATISTICS AND NUMERICAL DATA; UNIVERSITY HOSPITAL; UNNECESSARY PROCEDURE;

ACADEMIC MEDICAL CENTERS; BOSTON; CLINICAL LABORATORY TECHNIQUES; FEMALE; HUMANS; INSERVICE TRAINING; MALE; MEDICAL ORDER ENTRY SYSTEMS; MIDDLE AGED; ORGANIZATIONAL POLICY; TERTIARY CARE CENTERS; UNNECESSARY PROCEDURES;

EID: 85003864909     PISSN: 00029343     EISSN: 15557162     Source Type: Journal    
DOI: 10.1016/j.amjmed.2016.08.021     Document Type: Article

References (18)

1. 1 Peabody, F.W., The physician and the laboratory. Boston Med Surg J 187 (1922), 324–327.
2. 2 Griner, P.F., Liptzin, B., Use of the laboratory in a teaching hospital: implications for patient care, education, and hospital costs. Ann Intern Med 75 (1971), 157–163.
3. 3 Editorial: Routine laboratory tests–the physician's responsibility. N Engl J Med, 274, 1966, 222.
4. 4 van Walraven, C., Naylor, C.D., Do we know what inappropriate laboratory utilization is? A systematic review of laboratory clinical audits. JAMA 280 (1998), 550–558.
5. 5 Bates, D.W., Goldman, L., Lee, T.H., Contaminant blood cultures and resource utilization. the true consequences of false-positive results. JAMA 265 (1991), 365–369.
6. 6 Chant, C., Wilson, G., Friedrich, J.O., Anemia, transfusion, and phlebotomy practices in critically ill patients with prolonged ICU length of stay: a cohort study. Crit Care, 10, 2006, R140.
7. 7 Salisbury, A.C., Reid, K.J., Alexander, K.P., et al. Diagnostic blood loss from phlebotomy and hospital-acquired anemia during acute myocardial infarction. Arch Intern Med 171 (2011), 1646–1653.
8. 8 Thavendiranathan, P., Bagai, A., Ebidia, A., Detsky, A.S., Choudhry, N.K., Do blood tests cause anemia in hospitalized patients? The effect of diagnostic phlebotomy on hemoglobin and hematocrit levels. J Gen Intern Med 20 (2005), 520–524.
9. 9 Eisenberg, J.M., Physician utilization: the state of research about physicians' practice patterns. Med Care 40 (2002), 1016–1035.
10. 10 Axt-Adam, P., van der Wouden, J.C., van der Does, E., Influencing behavior of physicians ordering laboratory tests: a literature study. Med Care 31 (1993), 784–794.
11. 11 Solomon, D.H., Hashimoto, H., Daltroy, L., Liang, M.H., Techniques to improve physicians' use of diagnostic tests: a new conceptual framework. JAMA 280 (1998), 2020–2027.
12. 12 Kobewka, D.M., Ronksley, P.E., McKay, J.A., Forster, A.J., van Walraven, C., Influence of educational, audit and feedback, system based, and incentive and penalty interventions to reduce laboratory test utilization: a systematic review. Clin Chem Lab Med 53 (2015), 157–183.
13. 13 Iwashyna, T.J., Fuld, A., Asch, D.A., Bellini, L.M., The impact of residents, interns, and attendings on inpatient laboratory ordering patterns: a report from one university's hospitalist service. Acad Med 86 (2011), 139–145.
14. 14 Kellerman, S.E., Herold, J., Physician response to surveys. A review of the literature. Am J Prev Med 20 (2001), 61–67.
15. 15 Kroenke, K., Hanley, J.F., Copley, J.B., et al. Improving house staff ordering of three common laboratory tests. Reductions in test ordering need not result in underutilization. Med Care 25 (1987), 928–935.
16. 16 May, T.A., Clancy, M., Critchfield, J., et al. Reducing unnecessary inpatient laboratory testing in a teaching hospital. Am J Clin Pathol 126 (2006), 200–206.
17. 17 Neilson, E.G., Johnson, K.B., Rosenbloom, S.T., et al. The impact of peer management on test-ordering behavior. Ann Intern Med 141 (2004), 196–204.
18. 18 Sussman, E., Goodwin, P., Rosen, H., Administrative change and diagnostic test use. the effect of eliminating standing orders. Med Care 22 (1984), 569–572.