Quality Improvement Intervention for Reduction of Redundant Testing.

Authors

Alan M Ducatman
Danyel H Tacker
Barbara S Ducatman, Beaumont Health
Dustin Long
Peter L Perrotta
Hannah Lawther
Kelly Pennington
Owen Lander
Mary Warden
Conard Failinger
Kevin Halbritter
Ronald Pellegrino
Marney Treese
Jeffrey A Stead
Eric Glass
Lauren Cianciaruso
Konrad C Nau

Document Type

Article

Publication Date

1-1-2017

Publication Title

Acad Pathol

Abstract

Laboratory data are critical to analyzing and improving clinical quality. In the setting of residual use of creatine kinase M and B isoenzyme testing for myocardial infarction, we assessed disease outcomes of discordant creatine kinase M and B isoenzyme +/troponin I (-) test pairs in order to address anticipated clinician concerns about potential loss of case-finding sensitivity following proposed discontinuation of routine creatine kinase and creatine kinase M and B isoenzyme testing. Time-sequenced interventions were introduced. The main outcome was the percentage of cardiac marker studies performed within guidelines. Nonguideline orders dominated at baseline. Creatine kinase M and B isoenzyme testing in 7496 order sets failed to detect additional myocardial infarctions but was associated with 42 potentially preventable admissions/quarter. Interruptive computerized soft stops improved guideline compliance from 32.3% to 58% (

Volume

4

First Page

2374289517707506

Last Page

2374289517707506

Recommended Citation

Ducatman AM, Tacker DH, Ducatman BS, Long D, Perrotta PL, Lawther H, Pennington K, Lander O, Warden M, Failinger C, Halbritter K, Pellegrino R, Treese M, Stead JA, Glass E, Cianciaruso L, Nau KC. Quality Improvement Intervention for Reduction of Redundant Testing. Acad Pathol. 2017 May 28;4:2374289517707506. doi: 10.1177/2374289517707506. PMID: 28725791; PMCID: PMC5497914.

DOI

10.1177/2374289517707506

ISSN

2374-2895

PubMed ID

28725791