Interventions That Can Help Reduce Diagnostic Errors

Astion, Michael L.; Dickerson, Jane A.

doi:10.1373/jalm.2018.026534

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…Test ordering habits could be changed through training of clinicians [26]. As part of this training, ways to limit the ordering of certain tests and to change test ordering habits have been suggested [27]. In another study that compared methods of informing clinicians, no feedback was provided to one group of clinicians; feedback was provided to a second group regarding their laboratory usage habits; for a third group, a document regarding the cost-effective use of laboratory testing was provided; while a fourth group received feedback about their own laboratory usage habits and the cost-effective use of the laboratory.…”

Section: Discussionmentioning

confidence: 99%

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2018

Ann Clin Anal Med

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Aim: The aim of the study was to evaluate the efficacy of software programs such as ALIN IQ, to prevent the regular practice of unnecessary testing in the preanalytical phase, which could save millions of dollars. Material and Method: This study was conducted using data obtained from certain tests using the ALIN IQ software developed by Abbott Core Laboratory. The software implements algorithms defined by the information management system of the hospital to manage laboratory test ordering by clinicians. In the study, three tests-AST, direct bilirubin, and free PSA-were blocked by the software. Instead, the software suggested ALT, total bilirubin, and total PSA tests as preferences when ordered along with other tests sent to the c16000 biochemistry analyzer. Results: In this study, data on numbers of tests (ALT, AST, PSA) run over a one-month period were acquired from ALIN IQ software in a laboratory that runs 2,444,024 tests per year. Findings showed that 11,137 AST, 6,856 direct bilirubin, and 1,340 free PSA tests were ordered unnecessarily over the course of the month, and that avoiding these three tests (AST, direct bilirubin, and free PSA) provided savings of 77.96% from AST, 77.22% from direct bilirubin, and 72.45% from free PSA, corresponding to a projected 231,996 unnecessary tests per year. Discussion: Given the rise of global healthcare costs, reducing laboratory expenditures costing billions of dollars has been discussed in many articles, and different suggestions have been put forward. The present study showed that in addition to the measures set in place in the preanalytical phase, the costs of medical tests could also be reduced through the use of intelligent software programs in the analytical phase.

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Section: Discussionmentioning

confidence: 99%

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2018

Ann Clin Anal Med

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Engaging Laboratory Staff in Stewardship: Barriers Experienced by Medical Laboratory Technologists in Canada

VanSpronsen

Zychla²,

Villatoro

et al. 2021

The Journal of Applied Laboratory Medicine

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Background Laboratory stewardship programs aim to improve the use of laboratory resources, including reducing inappropriate testing. These programs should engage all healthcare stakeholder groups, including all levels of laboratory staff. Medical laboratory technologists (MLTs) are highly skilled professionals and are well positioned to play a supportive role in stewardship but may be overlooked. The aim of this study is to identify the barriers to MLT participation in stewardship activities. Methods We developed and disseminated a self-administered survey to MLTs in Canada to assess their knowledge and attitudes toward inappropriate laboratory utilizatioz and explore perceived barriers to taking on an active role in stewardship initiatives. Themes were identified in open-ended responses and mapped to the Theoretical Domains Framework (TDF). Results MLTs feel accountable for helping ensure appropriate resource use and recognize that it is an important issue to address. However, they experience significant barriers and have low intention to act. The self-reported barrier most frequently described was lack of time arising from excessive workloads, but other constraints exist. Themes mapped to the TDF most strongly in the domain of environmental context and resources, supporting evidence that workplace structure and culture play key roles in impacting this group. Conclusions To meaningfully engage MLTs in stewardship activities, these barriers should be addressed. Highlighting MLT expertise and creating communication structures and opportunities for their unique contributions may be fruitful.

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Interventions That Can Help Reduce Diagnostic Errors

Cited by 2 publications

References 11 publications

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Engaging Laboratory Staff in Stewardship: Barriers Experienced by Medical Laboratory Technologists in Canada

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