Abstract
Inappropriate ordering of laboratory tests generates unnecessary excess of labour, ex-penses and waste. Here we present how the laboratory can proactively and effectively manage its workload using minimum re-testing intervals implemented in a com-puterized hospital laboratory test ordering system.The hospital information system was up-graded with a feature of checking and alert-ing to inappropriateness of a patient’s test request according to pre-set criteria (exist-ence of previous result within a defined time period, and a pending request for the same test). The project was implemented in two hospital wards and results were collected for emergency requests during April 2016. Overall, 4,094/20,495 requests violated the implemented criteria for the appropriate-ness of testing and generated alerts. As a consequence, 1,517 requests were dismissed (7% of all requests, 37% of alerted tests). Throughout the study, the total financial savings was 33,394 HRK (approximately 4,300 EUR). The average saving per test was 8.1%.A restriction of emergency tests requests resulted in substantial effectiveness, sug-gesting further implementation together with the promotion and education between clinicians and laboratory professionals.
Highlights
Laboratory testing is important and inevitable part of modern diagnostics and disease management. (1) An appropriate selection of a test repertoire, guided by scientific evidence with an appropriate interpretation of results, is a key target for both physicians and laboratory professionals. (2) Inappropriate ordering of tests generates unnecessary excess of labour, expenses and waste affecting laboratory budgets and healthcare systems worldwide. (2) a laboratory must be proactive in effectively managing its workload in order to provide the best service for patients within defined constraints. (3) The Department of Laboratory Diagnostics, University Hospital Centre Zagreb, performs about 3.9 million tests per year
The use of electronic medical records and computerized order entries available through hospital information system has an impact on laboratory test utilization (1) it opens the possibility for the management of retesting demand based on information technology, including laboratory formulary, order entry design, algorithms and reflex testing protocols, consultancy services and finance based restrictions
(4) we will describe the use of restriction of electronic order entry based on guideline-established minimum retesting intervals (5) for ten common laboratory tests ordered for inpatients as emergently needed
Summary
Laboratory testing is important and inevitable part of modern diagnostics and disease management. (3) The Department of Laboratory Diagnostics, University Hospital Centre Zagreb, performs about 3.9 million tests per year. About 70% of the entire number of tests was requested from hospital wards (inpatients). Inpatient samples are tested in the routine or in the emergency part of the laboratory, depending on the physician’s request based on the patient’s condition. The use of electronic medical records and computerized order entries available through hospital information system has an impact on laboratory test utilization (1) it opens the possibility for the management of retesting demand based on information technology, including laboratory formulary, order entry design, algorithms and reflex testing protocols, consultancy services and finance based restrictions. (4) we will describe the use of restriction of electronic order entry based on guideline-established minimum retesting intervals (5) for ten common laboratory tests ordered for inpatients as emergently needed The use of electronic medical records and computerized order entries available through hospital information system has an impact on laboratory test utilization (1) it opens the possibility for the management of retesting demand based on information technology, including laboratory formulary, order entry design, algorithms and reflex testing protocols, consultancy services and finance based restrictions. (4) we will describe the use of restriction of electronic order entry based on guideline-established minimum retesting intervals (5) for ten common laboratory tests ordered for inpatients as emergently needed
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