Laboratory stewardship perceptions and testing patterns at a pediatric tertiary care center.

Tejas S Desai, Ken Tang, Viveak Kaul, Ivan M Blasutig, Melanie Buba
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Abstract

Background: Despite stewardship efforts, laboratory testing overuse persists across medicine.

Objectives: To understand laboratory stewardship perceptions and testing patterns at a tertiary care pediatric hospital so that we could identify potential improvement opportunities.

Methods: An electronic survey exploring laboratory stewardship was sent to all pediatric medicine resident and staff physicians. Laboratory testing data were also assessed for patterns of testing and overuse.

Results: The survey response rate was 54% (43/80). The results indicated good familiarity with stewardship but poor familiarity with testing specifics (eg, cost). A mobile reference application was the most preferred quality improvement intervention, and online modules were the least desired. Overuse was apparent, with as many as 53% of laboratory tests being repeated within 7 days and only half of repeated tests subsequently yielding abnormal results.

Conclusions: Altogether, the data we collated demonstrated poor understanding of laboratory stewardship and substantial repeat testing with few abnormal results. These study findings suggest that laboratory stewardship is lacking at our center, and that multiple improvement opportunities exist.

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儿科三级医疗中心的实验室管理认知和检测模式。
背景:尽管在管理方面做出了努力,但整个医学界仍存在实验室检测过度使用的现象:尽管在实验室管理方面做出了努力,但过度使用实验室检测的现象在整个医学界依然存在:目的:了解一家三级儿科医院对实验室管理的看法和检测模式,从而确定潜在的改进机会:方法:我们向所有儿科住院医师和工作人员发送了一份关于实验室管理的电子调查问卷。我们还对实验室检测数据进行了评估,以了解检测和过度使用的模式:结果:调查回复率为 54%(43/80)。结果表明,人们对管理工作的熟悉程度较高,但对检测的具体内容(如成本)的熟悉程度较低。移动参考应用程序是最受欢迎的质量改进干预措施,而在线模块则是最不受欢迎的。过度使用是显而易见的,多达 53% 的实验室检测项目在 7 天内重复进行,只有一半的重复检测项目随后出现异常结果:总之,我们整理的数据表明,人们对实验室管理的认识不足,重复化验次数多,但异常结果少。这些研究结果表明,我们的中心缺乏实验室管理,存在多种改进机会。
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Comparison of basic lymphocyte phenotype results between a diagnostic and a research laboratory. Evidence-based approach for the generation of a multivariate logistic regression model that predicts instrument failure. Correlation of the abundance of MDSCs, Tregs, PD-1, and PD-L1 with the efficacy of chemotherapy and prognosis in gastric cancer. Correction to: The utility of an algorithm based on procalcitonin monitoring in patients with sepsis. Implementing laboratory internal audit to improve compliance and quality of care in the municipal public health system-based ambulatory care health clinics in New York city.
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