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An interventional program for diagnostic testing in the emergency department
Author(s) -
Stuart Peter J,
Crooks Shelley,
Porton Mark
Publication year - 2002
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2002.tb04697.x
Subject(s) - emergency department , medicine , intervention (counseling) , audit , test (biology) , emergency medicine , medical emergency , nursing , management , economics , biology , paleontology
Objective: To evaluate an intervention developed to improve test‐ordering practice. Setting: Public hospital emergency department with an annual census of 42 500. The study comprised a six‐month pre‐intervention stage (November 1998 to April 1999), which was compared with a similar post‐intervention period (November 1999 to April 2000), and trends were examined over an 18‐month post‐intervention period (May 1999 to October 2000). Intervention: The intervention comprised three integrated components: implementation of a protocol for test ordering; education program for medical staff; and audit/feedback process. Main outcome measure: Test utilisation (assessed as cost per patient). Results: There was a 40% decrease in the ordering of investigations in the emergency department (95% CI, 29%–50%), with test utilisation falling from a mean of $39.32/patient to $23.72/patient. The decrease was similar for both laboratory and imaging tests and was sustained for the duration of the 18‐month follow‐up. Conclusions: Our intervention appears to have produced long term modification of test ordering in the emergency department of a public teaching hospital.