Alerting Wisely: Reducing Inappropriate Blood Chemistry Panel Orders Using a Clinical Decision Support Tool

被引：4

作者：

Anderson, Jonathan W. ^{[1
]}

Greenwood, Mark R. ^{[2
]}

Borsato, Gisele G. ^{[1
]}

Kuttler, Kathryn G. ^{[3
]}

机构：

[1] Intermt Healthcare, Salt Lake City, UT 84103 USA

[2] Intermt Healthcare, Family Med Serv, Salt Lake City, UT USA

[3] Intermt Healthcare, Intermt Healthcares Clin Decis Support, Salt Lake City, UT USA

来源：

JOURNAL FOR HEALTHCARE QUALITY | 2020年 / 42卷 / 01期

关键词：

decision support tool; inappropriate tests; primary care; QUALITY IMPROVEMENT; HEALTH-CARE; INTERVENTION; MANAGEMENT; PHYSICIANS; TRIAL;

D O I：

10.1097/JHQ.0000000000000175

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

The Choosing Wisely (CW) initiative provides recommendations for healthcare providers, aimed at reducing unnecessary or inappropriate tests and procedures. A clinical decision support (CDS) alert in the electronic health record was developed to reflect organizational CW guidelines regarding blood chemistry panel ordering in the primary care setting. An interrupted time series design was used to analyze the weekly proportion of inappropriate blood chemistry panel orders prior to and after implementation of the CDS alert in treatment and control groups. Implementation of the CDS alert significantly decreased the average weekly proportion of inappropriate blood chemistry panels from 28.64% to 15.69% in the treatment group (p < .001). Apart from other efforts implemented simultaneously to reduce inappropriate lab ordering, the CDS alert produced a significant reduction in inappropriate lab ordering. We conclude that CDS alerts can be an effective strategy for healthcare organizations seeking to more closely adhere to CW guidelines.

引用

页码：12 / 18

页数：7

共 20 条

[1] [Anonymous], 2017, CHOOSING WISELY INTE
[2] A randomized trial of a computer-based intervention to reduce utilization of redundant laboratory tests
Bates, DW
Kuperman, GJ
Rittenberg, E
Teich, JM
Fiskio, J
Ma'luf, N
Onderdonk, A
Wybenga, D
Winkelman, J
Brennan, TA
Komaroff, AL
Tanasijevic, M
[J]. AMERICAN JOURNAL OF MEDICINE, 1999, 106 (02) : 144 - 150
[3] Effectiveness of Clinical Decision Support in Controlling Inappropriate Imaging
Blackmore, C. Craig
Mecklenburg, Robert S.
Kaplan, Gary S.
[J]. JOURNAL OF THE AMERICAN COLLEGE OF RADIOLOGY, 2011, 8 (01) : 19 - 25
[4] Data feedback efforts in quality improvement: lessons learned from US hospitals
Bradley, EH
Holmboe, ES
Mattera, JA
Roumanis, SA
Radford, MJ
Krumholz, HM
[J]. QUALITY & SAFETY IN HEALTH CARE, 2004, 13 (01): : 26 - 31
[5] Is health care ready for six sigma quality?
Chassin, MR
[J]. MILBANK QUARTERLY, 1998, 76 (04) : 565 - +
[6] Lean Management to support Choosing Wisely in healthcare: the first evidence from a systematic literature review
Crema, Maria
Verbano, Chiara
[J]. INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE, 2017, 29 (07) : 889 - 895
[7] Donaldson MS, 1998, URGENT NEED IMPROVE
[8] Decrease in unnecessary vitamin D testing using clinical decision support tools: making it harder to do the wrong thing
Felcher, Andrew H.
Gold, Rachel
Mosen, David M.
Stoneburner, Ashley B.
[J]. JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION, 2017, 24 (04) : 776 - 780
[9] Standardized Best Practices and Individual Craft-Based Medicine A Conversation About Quality
Goitein, Lara
James, Brent
[J]. JAMA INTERNAL MEDICINE, 2016, 176 (06) : 835 - 838
[10] A comprehensive Choosing Wisely quality improvement initiative reduces unnecessary transfusions in an Academic Department of Surgery
Hicks, Caitlin W.
Liu, Jing
Yang, William W.
DiBrito, Sandra R.
Johnson, Daniel J.
Brito, Alexandra
Higgins, Robert S. D.
Frank, Steven M.
Wick, Elizabeth C.
[J]. AMERICAN JOURNAL OF SURGERY, 2017, 214 (04) : 571 - 576

← 1 2 →