Clinical decision support to improve CBC and differential ordering.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-08-01 DOI:10.1093/ajcp/aqae024

Grace K Mahowald, Kent B Lewandrowski, Anand S Dighe

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Abstract

Objectives: Complete blood count and differential (CBC diff) is a common laboratory test that may be overused or misordered, particularly in an inpatient setting. We assessed the ability of a clinical decision support (CDS) alert to decrease unnecessary orders for CBC diff and analyzed its impact in the laboratory.

Methods: We designed 3 CDS alerts to provide guidance to providers ordering CBC diff on inpatients at frequencies of daily, greater than once daily, or as needed.

Results: The 3 alerts were highly effective in reducing orders for CBC diff at the frequencies targeted by the alert. Overall, test volume for CBC diff decreased by 32% (mean of 5257 tests per month) after implementation of the alerts, with a corresponding decrease of 22% in manual differentials performed (mean of 898 per month). Turnaround time for manual differentials decreased by a mean of 41.5 minutes, with a mean decrease of up to 90 minutes during peak morning hours.

Conclusions: The 3 CDS alerts successfully decreased inpatient orders for CBC diff and improved the quality of patient care by decreasing turnaround time for manual differentials.

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改进全血细胞计数和鉴别诊断排序的临床决策支持。

目的：全血细胞计数和差值（CBC diff）是一种常见的实验室检验，可能会被过度使用或错误下单，尤其是在住院环境中。我们评估了临床决策支持（CDS）警报减少不必要的 CBC diff 订单的能力，并分析了其对实验室的影响：方法：我们设计了 3 个 CDS 提示，为医疗服务提供者提供指导，使其能够以每天一次、多于每天一次或根据需要的频率为住院患者下达 CBC diff 订单：结果：这 3 个警报非常有效地减少了警报所针对的 CBC diff 检验单。总体而言，在实施警报后，CBC diff 的检测量减少了 32%（平均每月 5257 例），人工鉴别的检测量也相应减少了 22%（平均每月 898 例）。人工鉴别的周转时间平均缩短了 41.5 分钟，在上午高峰时段平均缩短了 90 分钟：3 个 CDS 警报成功减少了住院病人的 CBC diff 订单，并通过缩短人工鉴别的周转时间提高了病人护理质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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