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An educational program to modify laboratory use by house staff

J M Eisenberg

    Journal of Medical Education
    |July 1, 1977
    PubMed
    Summary
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    An educational program initially reduced routine prothrombin time (PT) testing in physicians, but usage returned to high levels within 18 months, highlighting the need for sustained interventions.

    Area of Science:

    • Medical Education
    • Clinical Laboratory Utilization
    • Healthcare Management

    Background:

    • Prothrombin time (PT) determination is frequently overused as a routine admission laboratory test.
    • Overutilization of laboratory tests contributes to increased healthcare costs and potential patient harm.

    Purpose of the Study:

    • To assess the effectiveness of an educational program in reducing the utilization of prothrombin time (PT) testing by house staff physicians.
    • To evaluate the long-term impact of educational interventions on physician ordering behavior.

    Main Methods:

    • An educational intervention was implemented for house staff physicians at a teaching hospital.
    • Prothrombin time (PT) test utilization rates were monitored before and at 6 and 18 months after the educational program.

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    Main Results:

    • Routine PT test utilization decreased significantly from 87% to 55% six months post-intervention.
    • However, PT test utilization reverted to baseline levels by 18 months after the educational program.

    Conclusions:

    • Educational programs can achieve short-term reductions in unnecessary laboratory test ordering.
    • Sustained physician behavior change requires ongoing reinforcement and long-term outcome evaluation.
    • Follow-up strategies are crucial for ensuring the lasting impact of medical education initiatives.