Branda John A, Lewandrowski Kent
Department of Pathology, Massachusetts General Hospital and Harvard Medical School, United States.
Clin Chim Acta. 2014 Jan 1;427:173-7. doi: 10.1016/j.cca.2013.09.031. Epub 2013 Sep 29.
The available literature concerning utilization management in the clinical microbiology laboratory is relatively limited compared with that for high-volume, automated testing in the central Core Laboratory. However, the same strategies employed elsewhere in the clinical laboratory operation can be applied to utilization management challenges in microbiology, including decision support systems, application of evidence-based medicine, screening algorithms and gatekeeper functions. The results of testing in the microbiology laboratory have significant effects on the cost of clinical care, especially costs related to antimicrobial agents and infection control practices. Consequently many of the successful utilization management interventions described in clinical microbiology have targeted not just the volume of tests performed in the laboratory, but also the downstream costs of care. This article will review utilization management strategies in clinical microbiology, including specific examples from our institution and other healthcare organizations.
与中心核心实验室的高容量自动化检测相比，有关临床微生物实验室利用管理的现有文献相对有限。然而，临床实验室操作中其他地方采用的相同策略可应用于微生物学中的利用管理挑战，包括决策支持系统、循证医学的应用、筛查算法和把关功能。微生物实验室的检测结果对临床护理成本有重大影响，尤其是与抗菌药物和感染控制措施相关的成本。因此，临床微生物学中描述的许多成功的利用管理干预措施不仅针对实验室进行的检测数量，还针对下游护理成本。本文将回顾临床微生物学中的利用管理策略，包括来自我们机构和其他医疗组织的具体实例。
