Impact of Interventions to Change CBC and Differential Ordering Patterns in the Emergency Department.

Title

Impact of Interventions to Change CBC and Differential Ordering Patterns in the Emergency Department.

Creator

Phelan Michael P; Nakashima Megan O; Good Daniel M; Hustey Fredric M; Procop Gary W

Publisher

American journal of clinical pathology

Date

2019
2019-01

Description

Objectives: A CBC with leukocyte differential (CBC-DIFF) is a frequently ordered emergency department (ED) test. The DIFF component often does not add to clinical decision making. Our objective was to evaluate the impact of a performance improvement project on CBC ordering. Methods: ED orders for CBC-DIFF were identified through the laboratory information system. Two interventions were evaluated: an educational intervention regarding CBC-DIFF uses and a reprioritization of ED CBC-DIFF and CBC in the electronic medical record (EMR) orders. Pearson chi2 tests were used to assess for differences in the proportions. Results: There was no difference in the proportion of CBC tests performed after the education intervention (175/6,192, 2.8% [95% CI, 2.39%-3.21%] vs 219/6,270, 3.5% [95% CI, 3.05%-3.95%]). There was a significant increase in CBC samples ordered following the EMR intervention (604/6,044, 9.1% [95% CI, 8.37%-9.83%]; P \textless .01). Conclusions: Reprioritizing EMR laboratory orders can reduce overutilization of CBC-DIFF testing.

Identifier

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

194–197

Issue

2

Volume

151

NEOMED College

NEOMED College of Medicine

NEOMED Department

Department of Obstetrics & Gynecology

Citation

Phelan Michael P; Nakashima Megan O; Good Daniel M; Hustey Fredric M; Procop Gary W, “Impact of Interventions to Change CBC and Differential Ordering Patterns in the Emergency Department.,” NEOMED Bibliography Database, accessed January 22, 2021, https://neomed.omeka.net/items/show/4169.

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