Bridges Sharon A, Papa Linda, Norris Anne E, Chase Susan K
J Healthc Qual. 2014 May-Jun;36(3):46-53. doi: 10.1111/j.1945-1474.2012.00219.x. Epub 2012 Sep 10.
Redundant testing contributes to reductions in healthcare system efficiency. The purpose of this study was to: (1) determine if the use of a computerized alert would reduce the number and cost of duplicated Acute Hepatitis Profile (AHP) laboratory tests and (2) assess what patient, test, and system factors were associated with duplication. This study used a quasi-experimental pre- and post-test design to determine the proportion of duplication of the AHP test before and after implementation of a computerized alert intervention. The AHP test was duplicated if the test was requested again within 15 days of the initial test being performed and the result present in the medical record. The intervention consisted of a computerized alert (pop-up window) that indicated to the clinician that the test had recently been ordered. A total of 674 AHP tests were performed in the pre-intervention period and 692 in the postintervention group. In the pre-intervention period, 53 (7.9%) were duplicated and in postintervention, 18 (2.6%) were duplicated (p<.001). The implementation of the alert was shown to significantly reduce associated costs of duplicated AHP tests (p≤.001). Implementation of computerized alerts may be useful in reducing duplicate laboratory tests and improving healthcare system efficiency.
重复检测会降低医疗系统的效率。本研究的目的是：（1）确定使用计算机化警报是否会减少重复的急性肝炎检测项目（AHP）实验室检测的数量和成本，以及（2）评估哪些患者、检测和系统因素与重复检测相关。本研究采用类实验前后测设计，以确定在实施计算机化警报干预前后AHP检测的重复比例。如果在首次检测后的15天内再次要求进行该检测且病历中有检测结果，则该AHP检测被视为重复。干预措施包括一个计算机化警报（弹出窗口），向临床医生提示该检测最近已被开出。干预前共进行了674次AHP检测，干预后组进行了692次。在干预前期，有53次（7.9%）检测被重复，干预后有18次（2.6%）被重复（p<0.001）。警报的实施显著降低了重复AHP检测的相关成本（p≤0.001）。实施计算机化警报可能有助于减少重复的实验室检测并提高医疗系统效率。
