Complete Number Research Articles

Effective stewardship strategies to enhance appropriateness of refer-out test requests in a Canadian tertiary centre laboratory

ObjectivesSpecialized testing conducted in reference laboratories is costly and often not optimally directed. Since 2016, our institution has worked to ensure the appropriateness of refer-out (RO) tests. We examine the impact of utilization initiatives on the patterns of requests and completed tests. Design and methodsIn 2016, 81 RO tests were selected for a more rigorous approval process. Physicians not pre-approved for testing received a prompt to consult with laboratory subject matter experts (SMEs) for further detail. After review, SMEs provided responses, approving or rejecting requests based on clinical relevance. Stewardship activities also included: repatriating tests locally, preferring Canadian over foreign institutions, unbundling tests, distributing educational memos, and introducing staged testing. We collected data on the number of requested (NoR) and number of completed (NoC) tests in 2015, before the implementation of the new vetting procedures, and for the post-implementation phase from 2016−2022. ResultsFor 62 targeted RO tests (including trace metals, vitamins, antibodies, and endocrine-related tests), there was a 33% reduction in NoR and a 51% reduction in NoC in 2022 compared to 2015. The total savings for the study period based on NoC was $807,736. The NoC rate for Neuronal antibody tests decreased to 48.6% in 2022, with cost savings of $17,123, and an additional $50,000 saved by changing the testing site. Insourcing apolipoprotein B and fecal calprotectin tests resulted in cost savings of $3,380 and $3,371, respectively, in 2022. ConclusionsAutomated messaging followed by a formal review of RO test requests is an effective utilization strategy that prevents redundant or clinically unjustified testing. This approach leads to significant economic savings and is expected to improve the efficiency of patient care.

PENINGKATAN AKTIVITAS BELAJAR PKn MELALUI MODEL PEMBELAJARAN KOOPERATIF TIPE JIGSAW SISWA KELAS V SD NEGERI 005 KOTO PERAMBAHAN KECAMATAN KAMPAR TIMUR KABUPATEN KAMPAR

This research aims increased the civics learning activities using the jigsaw learning model in class V SD Negeri005 Koto Perambahan Kecamatan Kampar Timur Kabupaten Kampar. This research was conducted at SDNegeri 005 Koto Perambahan Kecamatan Kampar Timur Kabupaten Kampar. The subject of this research is thestudents of class V with the number of students 34. This research was conducted two cycles. Each cycle uses theprocedure of research implementation that is planning, implementation of action, observation and reflection.The results of research showed student learning outcomes that in cycle I of the first meeting, the total number ofcomplete students is 11 students (32,35%). In the cycle I of the second meeting, the total number of completestudents is 13 students (38,23%). In the cycle I of the third meeting, the total number of complete students is 15students (44,11%). Furthermore, in the cycle II of the first meeting there is an increase in student learningoutcomes, the total number of complete students is 17 students (50%). In the cycle II of the second meeting, thetotal number of complete students is 19 students (55,88%). In the cycle II of the third meeting, the total numberof complete students is 25 students (73,52%). Based on the result of the research it can be concluded that the useof jigsaw learning model can improve the civics learning activities on materials explain the importance of theUnitary State of the Republic Indonesia students of class V SD Negeri 005 Koto Perambahan KecamatanKampar Timur Kabupaten Kampar.

PENGGUNAAN METODE DISKUSI KELOMPOK PADA MATA PELAJARAN MATEMATIKA DAN PKN UNTUK MENINGKATKAN HASIL BELAJAR SISWA KELAS V SDN 006 KOTO INUMAN KECAMATAN INUMAN

The background of this study is the low learning outcomes of mathematics and Civics students class V of SDN006 Koto Inuman Kecamatan Inuman. It can be seen from 17 students only 8 students (47,06%). On this basisresearchers do research by applying the method of discussion with the aim to improve learning outcomes. Thisresearch is a classroom action research conducted two cycles, each cycle is implemented based on four stages:planning, implementation, observation, and reflection. The result of research indicate that the result ofmathematics learning and student's Civic have improvement in each cycle, in cycle I the total number ofcomplete students is 13 students (76,47%) and in cycle II has increased with the total number of students is 17students (100 %). Based on the results of this study can be concluded that the application of discussion methodscan improve the learning outcomes of mathematics and Civics students class V of SDN 006 Koto InumanKecamatan Inuman.