TY - JOUR
T1 - Reducing Unnecessary Phlebotomy Testing Using a Clinical Decision Support System
AU - Strockbine, Valerie L.
AU - Gehrie, Eric A.
AU - Zhou, Qiuping Pearl
AU - Guzzetta, Cathie E.
N1 - Publisher Copyright:
© National Association for Healthcare Quality.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Introduction:Reducing unnecessary tests reduces costs without compromising quality. We report here the effectiveness of a clinical decision support system (CDSS) on reducing unnecessary type and screen tests and describe, estimated costs, and unnecessary provider ordering.Methods:We used a pretest posttest design to examine unnecessary type and screen tests 3 months before and after CDSS implementation in a large academic medical center. The clinical decision support system appears when the test order is initiated and indicates when the last test was ordered and expires. Cost savings was estimated using time-driven activity-based costing. Provider ordering before and after the CDSS was described.Results:There were 26,206 preintervention and 25,053 postintervention specimens. Significantly fewer unnecessary type and screen tests were ordered after the intervention (12.3%, n = 3,073) than before (14.1%, n = 3,691; p <.001) representing a 12.8% overall reduction and producing an estimated yearly savings of $142,612. Physicians had the largest weighted percentage of unnecessary orders (31.5%) followed by physician assistants (28.5%) and advanced practice nurses (11.9%).Conclusions:The CDSS reduced unnecessary type and screen tests and annual costs. Additional interventions directed at providers are recommended. The clinical decision support system can be used to guide all providers to make judicious decisions at the time of care.
AB - Introduction:Reducing unnecessary tests reduces costs without compromising quality. We report here the effectiveness of a clinical decision support system (CDSS) on reducing unnecessary type and screen tests and describe, estimated costs, and unnecessary provider ordering.Methods:We used a pretest posttest design to examine unnecessary type and screen tests 3 months before and after CDSS implementation in a large academic medical center. The clinical decision support system appears when the test order is initiated and indicates when the last test was ordered and expires. Cost savings was estimated using time-driven activity-based costing. Provider ordering before and after the CDSS was described.Results:There were 26,206 preintervention and 25,053 postintervention specimens. Significantly fewer unnecessary type and screen tests were ordered after the intervention (12.3%, n = 3,073) than before (14.1%, n = 3,691; p <.001) representing a 12.8% overall reduction and producing an estimated yearly savings of $142,612. Physicians had the largest weighted percentage of unnecessary orders (31.5%) followed by physician assistants (28.5%) and advanced practice nurses (11.9%).Conclusions:The CDSS reduced unnecessary type and screen tests and annual costs. Additional interventions directed at providers are recommended. The clinical decision support system can be used to guide all providers to make judicious decisions at the time of care.
KW - clinical decision support system
KW - phlebotomy testing
KW - unnecessary laboratory test
KW - unnecessary type and screen testing
UR - http://www.scopus.com/inward/record.url?scp=85081376161&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85081376161&partnerID=8YFLogxK
U2 - 10.1097/JHQ.0000000000000245
DO - 10.1097/JHQ.0000000000000245
M3 - Article
C2 - 31972663
AN - SCOPUS:85081376161
VL - 42
SP - 98
EP - 105
JO - Journal of quality assurance : a publication of the National Association of Quality Assurance Professionals
JF - Journal of quality assurance : a publication of the National Association of Quality Assurance Professionals
SN - 1062-2551
IS - 2
ER -