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Related Experiment Videos

Test ordering guidelines can alter ordering patterns in an academic emergency department.

A Sucov1, J J Bazarian, E A deLahunta

  • 1Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, NY, USA.

The Journal of Emergency Medicine
|May 25, 1999
PubMed
Summary

An educational program successfully modified laboratory test ordering behavior in an academic Emergency Department (ED), leading to significant cost savings. This demonstrates the effectiveness of targeted education in improving clinical practices and resource management.

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Area of Science:

  • Emergency Medicine
  • Health Services Research
  • Medical Education

Background:

  • Unnecessary laboratory test ordering in Emergency Departments (EDs) contributes to increased healthcare costs.
  • Standardizing test ordering practices is crucial for efficient patient care and resource allocation.
  • Educational interventions are a potential strategy to influence physician behavior regarding diagnostic testing.

Purpose of the Study:

  • To evaluate the impact of an educational program on laboratory test ordering behavior in an academic Emergency Department (ED).
  • To assess the economic consequences of modified test ordering practices following the educational intervention.

Main Methods:

  • An observational, before-and-after study design was employed at a university tertiary referral center and Emergency Medicine (EM) residency site.

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  • Evidence-based test ordering standards were developed and disseminated to all ED staff, including residents and medical students.
  • No restrictions were placed on actual test ordering; the intervention focused solely on education.

    • Main Results:

    • A significant decrease was observed in the frequency of total laboratory tests, complete blood count (CBC), and liver function tests (LFTs) ordered per 100 patients after the educational program.
    • While prothrombin time and blood culture ordering showed no significant change, chemistry test ordering frequency significantly increased.
    • The intervention resulted in an approximate cost saving of $50,000.

    Conclusions:

    • Test ordering behavior in an academic ED can be effectively modified through a targeted educational program.
    • Educational interventions demonstrate the potential for significant economic impact by optimizing laboratory test utilization.
    • Sustained modification of clinical practices through education is achievable and can lead to cost-effective healthcare delivery.