1987
DOI: 10.1177/000456328702400301
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Strategies to Modify the Test-Requesting Patterns of Clinicians

Abstract: SUMMARY. Studies of the effectiveness of various strategies for influencing clinicians' test-requesting behaviour are reviewed. Numerical rationing. although crude. effectively reduces unnecessary repeat testing without detriment to patient outcome. Educational programmes involving peer review show pronounced but short-lived effects. Simple feedback of information about numbers of tests requested and their costs is surprisingly ineffectual. Direct financial incentives. in a private health care system. also fai… Show more

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Cited by 85 publications
(43 citation statements)
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“…[7][8][9] Unnecessary tests may be ordered for several reasons, such as patient expectations and fear of litigation. 10 The practice of routinely submitting resection specimens for pathological examination goes back almost a century and is still required by some state governments such as California and Pennsylvania.…”
Section: Discussionmentioning
confidence: 99%
“…[7][8][9] Unnecessary tests may be ordered for several reasons, such as patient expectations and fear of litigation. 10 The practice of routinely submitting resection specimens for pathological examination goes back almost a century and is still required by some state governments such as California and Pennsylvania.…”
Section: Discussionmentioning
confidence: 99%
“…A further approach is to limit the test repertoire available to the requestor (or at least to more junior requestors), for example, by redesigning the request form (or electronic patient request screen). 11 Indeed, one of the Healthcare Commission Acute Hospital Portfolio assessment criteria for diagnostic services in 2005 emphasized the importance of this by asking the total number of tests that could be requested if the requestor ticked all the boxes on the form. Use of disease-specific profiles can also limit testing, 12,13 though it must be carefully monitored and, like most demand management approaches, agreed with the clinical team.…”
Section: So How Do We Manage Demand?mentioning
confidence: 99%
“…The main objection to them is that they may result in increased unnecessary testing because they are designed for the average patient. 10 Deviations from protocols are often due to poor communication by senior clinical staff, lack of understanding by junior staff who are naturally concerned that important tests are not omitted, all compounded by the physical impossibility of computing manually a large number of different investigation schedules comprising complex and/or multiple protocols." They are more likely to succeed if they are based on local feedback data (see above) and agreed jointly between laboratory and clinical staff, with regular review and refinement.…”
Section: Protocolsmentioning
confidence: 99%