Promoting appropriate utilisation of laboratory tests for inflammation at an academic medical centre

Bartlett, Kristen J; Vo, Ann P; Rueckert, Justin; Wojewoda, Christina; Steckel, Elizabeth H; Stinnett-Donnelly, Justin; Repp, Allen B

doi:10.1136/bmjoq-2019-000788

Cited by 10 publications

(12 citation statements)

References 8 publications

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“…Many studies combine several tools [ 14 , 17 , 19 ], which has been shown to have an additive effect on the overall outcome [ 20 ]. In addition, the collaboration of laboratory specialists and clinicians together with audits, feedbacks, reminders and multiple plan-do-study-act (PDSA) cycles will further improve efficiency in terms of a continuous improvement process [ 12 , 14 , 18 , 19 ].…”

Section: Possible Strategies To Avoid Inappropriate Test Utilizationmentioning

confidence: 99%

“…Along with educational sessions, audits and feedback, Bartlett et al [ 14 ] introduced a panel for CRP and ESR testing. CRP was preselected, and an explanation referred to the recommended indications for these tests.…”

Section: Possible Strategies To Avoid Inappropriate Test Utilizationmentioning

confidence: 99%

“…Only a minority of surveyed clinicians stated that cost information frequently influenced their decisions. In general, cost control is endorsed by clinicians, but reductions in expenditure may be also achieved by implementing DM strategies, which combat overutilization [ 14 , 16 , 17 , 19 , 21 , 26 , 28 , 29 , 30 , 31 ].…”

Section: Possible Strategies To Avoid Inappropriate Test Utilizationmentioning

confidence: 99%

“…Overutilization may lead to unnecessary follow-up investigations or treatments, increased workload and costs as well as patient anxiety, while underutilization may result in missed or delayed diagnoses [ 5 , 11 , 12 ]. Lack of knowledge, insecurity, pure habit, patient pressure or fear of lawsuits are possible causes for inappropriate testing [ 13 , 14 , 15 ]. The lack of knowledge is reflected by various studies, which observed inappropriate orders despite available guidelines or recommendations on the implementation of demand management (DM) tools [ 12 , 14 , 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…Lack of knowledge, insecurity, pure habit, patient pressure or fear of lawsuits are possible causes for inappropriate testing [ 13 , 14 , 15 ]. The lack of knowledge is reflected by various studies, which observed inappropriate orders despite available guidelines or recommendations on the implementation of demand management (DM) tools [ 12 , 14 , 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Laboratory Demand Management Strategies—An Overview

et al. 2021

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Inappropriate laboratory test selection in the form of overutilization as well as underutilization frequently occurs despite available guidelines. There is broad approval among laboratory specialists as well as clinicians that demand management strategies are useful tools to avoid this issue. Most of these tools are based on automated algorithms or other types of machine learning. This review summarizes the available demand management strategies that may be adopted to local settings. We believe that artificial intelligence may help to further improve these available tools.

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Section: Possible Strategies To Avoid Inappropriate Test Utilizationmentioning

confidence: 99%

Section: Possible Strategies To Avoid Inappropriate Test Utilizationmentioning

confidence: 99%

Section: Possible Strategies To Avoid Inappropriate Test Utilizationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Laboratory Demand Management Strategies—An Overview

et al. 2021

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Promoting scholarship in improvement science: A model for academic clinical departments

DeVoe

Kennedy

Tompkins

et al. 2022

Learning Health Systems

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Introduction Clinical departments at academic medical centers strive to deliver clinical care, provide education and training, support faculty development, and promote scholarship. These departments have experienced increasing demands to improve the quality, safety, and value of care delivery. However, many academic departments lack a sufficient number of clinical faculty members with expertise in improvement science to lead initiatives, teach, and generate scholarship. In this article, we describe the structure, activities, and early outcomes of a program within an academic department of medicine to promote scholarly improvement work. Methods The Department of Medicine at the University of Vermont Medical Center launched a Quality Program with three primary goals: (a) improve care delivery, (b) provide education and training, and (c) promote scholarship in improvement science. The program serves as a resource center for students, trainees and faculty, offering education and training, analytic support, consultation in design and methodology, and project management. It strives to integrate education, research, and care delivery to learn, apply evidence and improve health care. Results Over the first 3 years of full implementation, the Quality Program supported an average of 123 projects annually, including prospective clinical quality improvement initiatives, retrospective assessment of clinical programs and practices, and curriculum development and evaluation. The projects have yielded a total of 127 scholarly products, defined as peer‐reviewed publications and abstracts, posters, and oral presentations at local, regional, and national conferences. Conclusions The Quality Program may serve as a practical model for promoting care delivery improvement, training, and scholarship in improvement science while advancing the goals of a learning health system at the level of an academic clinical department. Dedicated resources within such departments offer the potential to enhance care delivery while promoting academic success for faculty and trainees in improvement science.

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