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Related Experiment Videos

"Lipase Only, Please": Reducing Unnecessary Amylase Testing.

Horatio Holzer, Adam Reisman, Kathryn E Marqueen

    Joint Commission Journal on Quality and Patient Safety
    |September 17, 2019
    PubMed
    Summary
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    Serum amylase testing is often unnecessary for acute pancreatitis diagnosis. A quality improvement initiative successfully reduced amylase orders in hospitals through education and electronic medical record (EMR) advisories, saving costs.

    Area of Science:

    • Quality Improvement
    • Healthcare Management
    • Clinical Practice Optimization

    Background:

    • Serum amylase testing is frequently ordered for acute pancreatitis, despite not being recommended.
    • Unnecessary diagnostic testing contributes to healthcare costs and resource utilization.

    Purpose of the Study:

    • To evaluate the effectiveness of a quality improvement initiative in reducing unnecessary serum amylase orders.
    • To assess the impact of education and electronic medical record (EMR) interventions on laboratory test ordering.

    Main Methods:

    • A pre-post study design was implemented across two urban hospitals (academic and community).
    • Interventions included an educational campaign, decoupling amylase from order sets, and EMR advisory statements.
    • Serum amylase orders were tracked for emergency department visits and hospital admissions from January 2016 to May 2018.

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    Main Results:

    • Significant and sustained reductions in monthly amylase orders were observed at both hospitals.
    • The academic hospital saw a decrease from 3,214 to 2,348 orders/month (p=0.011).
    • The community hospital saw a decrease from 100 to 23 orders/month (p=0.001).
    • EMR advisory statements were independently associated with reduced ordering.
    • An estimated net annual cost reduction of $44,999 was achieved.

    Conclusions:

    • A student-led initiative effectively reduced unnecessary serum amylase ordering through a multi-faceted approach.
    • Education, publicity, and EMR changes were key components of the successful intervention.
    • This initiative demonstrates a practical strategy for optimizing diagnostic test utilization in acute care settings.