Kroner Grace M, Richman Sandy, Fletcher Andrew, Dickerson Jane, Jackson Brian R
Department of Pathology, University of Utah, Salt Lake City, UT, USA.
ARUP Laboratories, Salt Lake City, UT, USA.
Acad Pathol. 2022 Aug 9;9(1):100039. doi: 10.1016/j.acpath.2022.100039. eCollection 2022.
Appropriate laboratory test utilization is of growing interest in the face of rising healthcare costs and documented evidence of over- and under-utilization. Building from published literature, laboratory organizations have recently published guidelines for establishing laboratory utilization management programs. However, systematic reviews and meta-analyses have consistently struggled to define rigorous evidence-based best practice recommendations due to the paucity of published data or the heterogeneity of available data. We sought to gain information about utilization practices and programs currently in use and which factors contribute to their success by distributing a survey among laboratory professionals. The survey received seventy-four eligible respondents. We observed a wide range in the duration of laboratory utilization programs and the number of stewardship initiatives. In addition, there was great variety in the utilization practices used and the tests or processes targeted by programs. There was similarity in how initiatives are evaluated and who is involved with utilization programs. Finally, respondents often credited a multidisciplinary committee, support from leadership, and strong IT support/data access as important factors for their program's perceived success. Many of these factors agree with previously published literature.
面对不断上涨的医疗成本以及已记录在案的过度使用和使用不足的证据，合理利用实验室检测越来越受到关注。基于已发表的文献，实验室组织最近发布了建立实验室利用管理计划的指南。然而，由于已发表数据的匮乏或现有数据的异质性，系统评价和荟萃分析一直难以确定严格的基于证据的最佳实践建议。我们试图通过向实验室专业人员进行调查，了解当前正在使用的利用实践和计划，以及哪些因素促成了它们的成功。该调查收到了74名合格受访者的回复。我们观察到实验室利用计划的持续时间和管理举措的数量差异很大。此外，所采用的利用实践以及计划所针对的检测或流程也多种多样。在评估举措的方式以及参与利用计划的人员方面存在相似之处。最后，受访者经常将多学科委员会、领导层的支持以及强大的信息技术支持/数据访问视为其计划取得成功的重要因素。其中许多因素与先前发表的文献一致。
