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An interventional program for diagnostic testing in the emergency department.

Peter J Stuart¹, Shelley Crooks, Mark Porton

¹Lyell McEwin Health Service, Haydown Road, Elizabeth Vale, SA 5112, Australia. peter.stuart@nwahs.sa.gov.au

The Medical Journal of Australia

|August 1, 2002

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An intervention significantly reduced test ordering in an emergency department by 40%, lowering costs and demonstrating long-term effectiveness in improving diagnostic test utilization.

Area of Science:

Healthcare Management
Clinical Practice Improvement
Health Economics

Background:

Emergency departments face challenges with appropriate diagnostic test ordering.
Optimizing test utilization is crucial for cost-effectiveness and patient care.

Purpose of the Study:

To evaluate an intervention designed to enhance test-ordering practices.
To assess the impact of the intervention on diagnostic test utilization in an emergency department.

Main Methods:

A multi-component intervention including a protocol, staff education, and audit/feedback was implemented.
Study involved a six-month pre-intervention and a similar post-intervention period.
Test utilization was measured as cost per patient over 18 months.

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Main Results:

A 40% decrease in diagnostic test ordering was observed (95% CI, 29%-50%).
Mean test utilization decreased from $39.32 to $23.72 per patient.
Sustained reduction in test ordering for both laboratory and imaging tests.

Conclusions:

The intervention successfully modified test ordering practices in the emergency department.
Long-term improvements in diagnostic test utilization were achieved.
The findings support the effectiveness of structured interventions in public teaching hospitals.