Going beyond audit and feedback: towards behaviour-based interventions to change physician laboratory test ordering...

Area of Science:

• Medical practice
• Health services research
• Behavioral science

Background:

• Physician test ordering behavior is influenced by various factors.
• Identifying these factors is crucial for developing targeted interventions.
• Understanding physician decision-making in laboratory test utilization is essential for healthcare efficiency.

Purpose of the Study:

• To identify key factors influencing physician laboratory test ordering.
• To evaluate the effectiveness of an audit and feedback intervention on physician ordering behavior.
• To assess the impact of behavior-based interventions on reducing unnecessary laboratory tests.

Main Methods:

• A pilot study surveyed 50 medical professionals (students, interns, residents, pediatricians) using questionnaires.
• Factors influencing test ordering and commonly ordered tests were identified.
• An audit and feedback intervention was implemented at two intervals over three months.

Main Results:

• Routine tests and peer/supervisor pressure were identified as primary influences on ordering behavior.
• The intervention led to a significant reduction in laboratory tests ordered, from 908 to 389 and 361.
• Audit and feedback correlated with a significant decrease in 7 specific laboratory tests, including complete blood count and C-reactive protein.

Conclusions:

• Audit and feedback interventions can effectively modify physician test ordering behavior, even with short-term application.
• Behavior-based interventions should be tailored to address specific contributing factors identified in physician practices.
• Further research is needed to confirm the long-term efficacy of these strategies in changing physician behavior.