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Med J Aust. 1999 Jan 4;170(1):11-4.

A quality management intervention to improve clinical laboratory use in acute myocardial infarction.

Author information

1
Division of Public Health, University of Western Sydney, Macarthur, NSW. g.isouard@uws.edu.au

Abstract

OBJECTIVE:

To assess the effect of a total quality management (TQM) approach on the appropriateness of clinical laboratory testing of patients with acute myocardial infarction.

DESIGN:

Retrospective, control-group, quasi-experimental study.

SETTING:

Two metropolitan teaching hospitals: one involved in the intervention (TQM experimental group); the other had no intervention (control group).

INTERVENTION:

A multidisciplinary team involved in the development of improvement strategies, including laboratory testing guidelines, education programs, data collection, monitoring and feedback.

OUTCOME MEASURES:

Total number of requested clinically indicated and non-clinically indicated tests.

RESULTS:

The proportion of clinically indicated tests that were requested increased from 77.5% to 88.2% (P < 0.01) and the number of non-clinically indicated tests was reduced by 81.7% with the introduction of the TQM strategies (P < 0.01).

CONCLUSIONS:

The introduction of a TQM approach has improved the appropriateness of test ordering in acute myocardial infarction. The reduction in non-clinically indicated tests could produce substantial savings in hospital pathology costs, and the increase in clinically indicated tests provides better patient care.

PMID:
10026666
[Indexed for MEDLINE]

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