Reducing waste: a guidelines-based approach to reducing inappropriate vitamin D and TSH testing in the inpatient rehabilitation setting

BMJ Open Quality, 2019 · DOI: 10.1136/bmjoq-2019-000674 · Published: October 9, 2019

Simple Explanation

The study addresses the problem of unnecessary Vitamin D and TSH testing in inpatient rehabilitation, which increases healthcare costs and can lead to negative health outcomes. The interventions included academic detailing with key stakeholders and computerized clinical decision support (CCDS) to limit Vitamin D testing based on specific criteria. Audit and feedback were used in a subsequent PDSA cycle to reinforce the reduction of unnecessary testing.

Study Duration

10 Months

Participants

421 patients admitted to Stroke, Spinal Cord Injury, Acquired Brain Injury and Amputee Rehabilitation units.

Evidence Level

Quality improvement report

Key Findings

1
Vitamin D testing on admission decreased by 97% after the interventions.
2
TSH testing on admission decreased by 43% after the interventions.
3
The interventions resulted in annualized cost savings of >$9000.

Research Summary

The study aimed to reduce inappropriate Vitamin D and TSH testing in inpatient rehabilitation settings using a guidelines-based approach. The interventions included academic detailing, CCDS, and audit and feedback, implemented through PDSA cycles. The interventions significantly reduced Vitamin D and TSH testing rates, resulting in cost savings and improved resource utilization.

Practical Implications

Reduce Unnecessary Testing

Implementing guidelines-based approaches can significantly reduce unnecessary Vitamin D and TSH testing in inpatient rehabilitation.

Improve Resource Utilization

Reducing unnecessary testing leads to cost savings and better allocation of healthcare resources.

Utilize CCDS

CCDS forcing functions are effective in reducing unnecessary testing by prompting clinicians to justify their orders.

Reducing waste: a guidelines-based approach to reducing inappropriate vitamin D and TSH testing in the inpatient rehabilitation setting

Simple Explanation

Key Findings

Research Summary

Practical Implications

Reduce Unnecessary Testing

Improve Resource Utilization

Utilize CCDS

Study Limitations

Your Feedback

Was this summary helpful?

Reducing waste: a guidelines-based approach to reducing inappropriate vitamin D and TSH testing in the inpatient rehabilitation setting

Simple Explanation

Key Findings

Research Summary

Practical Implications

Reduce Unnecessary Testing

Improve Resource Utilization

Utilize CCDS

Study Limitations

Your Feedback

Was this summary helpful?