提高高凝固工作的理解和利用:质量改进倡议
Colleen Bramwell1, Keerthy Joseph2, Yuan Liu1
1Internal Medicine, St. Luke's University Health Network, Easton, USA.
Cureus
|September 2, 2025
概括
这项质量改善计划减少了住院患者不适当的高凝血检测. 通过加强提供者教育和电子医疗记录 (EMR) 系统,干预措施将适当的测试订单从9.7%提高到40.2%.
科学领域:
- 临床病理学
- 改善医疗保健的质量
- 医疗诊断
背景情况:
- 在住院患者中,高凝血测试经常被过度使用,特别是在急性血栓形成或抗凝血治疗期间.
- 测试结果可能不可靠,不太可能影响这些环境中的管理.
- 这种过度利用意味着医疗服务的质量差距很大.
研究的目的:
- 提高供应商对高凝血性检测指南的理解.
- 为了减少不适当的高凝血测试订单的发生率.
- 改善住院诊断测试的整体质量.
主要方法:
- 通过电子医疗记录 (EMR) 修改和针对性提供者教育实施了质量改进计划.
- 在干预前和干预后进行了回顾性图表审查,以评估血栓组的适当性.
- 根据高凝血性测试的既定临床指导方针进行了评估.
主要成果:
- 在干预前,262个血栓面板中的90. 5%是不合适的;干预后,适当的排序增加到40. 2%.
- 蛋白质C,蛋白质S和抗血栓III测试的不适当排序显著下降.
- 在没有明确的迹象或确定的静脉血栓塞瘤的情况下,观察到显著的测试减少.
结论:
- 将EMR变化与有针对性的教育相结合,有效地提高了适当的高凝血测试利用率.
- 这项质量改善举措成功减少了低价值测试,并促进了准则的遵守.
- 这些干预措施支持更有效的临床决策,并优化医疗保健的资源配置.
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