Naslov
Using Utilization Management Approach to Reduce Inappropriate Use of Highly Differentiated Coagulation Tests

Autori
Coen Herak, Desiree ; Rimac, Vladimira

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Izvornik
Clinical chemistry and laboratory medicine / Plebani, Mario - , 2015, EA24-eA24

Skup
3rd EFLM-BD European Conference on Preanalytical Phase

Mjesto i datum
Porto, Portugal, 20.03.2015. - 21.03.2015

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
utilization management approach, laboratory test utilization, coagulation tests

Sažetak
Background: Efficient managing of laboratory test utilization is required as overutilization of diagnostic laboratories is constantly increas-ing. The implementation of hospital information system has improved the communication between laboratory and clinic, but at the same time has enabled uncontrolled placing of electronic laboratory orders even for highly differentiated coagulation tests. The aim of this study was to determine whether testing for fibrinogen (Fbg) and antithrombin (AT) antigen concentration is ordered appropriately. Materials and methods: A two-step procedure was employed in the study. First we performed the analysis of all requests for the determination of Fbg and AT antigen in a 1-year period by searching through the laboratory information system. The appropriateness of each request was evaluated in the second step by analyzing if determination of functional activity was required prior to requesting the determination of specific antigen concentration. Results: In the investigated period, a total of 48 requests for Fbg:Ag and 72 requests for AT:Ag were identified. Among them, 27/48 requests for Fbg:Ag and 10/72 requests for AT:Ag were inappropriate as functional activities were not performed in those patients. The determination of Fbg:Ag was not performed in 7/48 patients and of AT:Ag in 35/72 patients because functional activities were within the reference intervals. We provided this comment with each report so that physicians may understand why the requested test was not performed. Finally, due to decreased functional activities, Fbg:Ag and AT:Ag were determined in 14/48 and 27/72 patients, respectively, and were clinically indicated. Conclusions: According to obtained results, the majority of requests were inappropriate, especially for Fbg:Ag as physicians were actually requesting the determination of fibrinogen functional activity. Probably this was the consequence of the availability of requesting functional activity and antigen concentration for Fbg and AT in the same computerized laboratory order with no restriction.

Izvorni jezik
Hrvatski

Znanstvena područja
Javno zdravstvo i zdravstvena zaštita

POVEZANOST RADA