Optimal Utilization of Laboratory Testing

Improved Test Utilization: Assistance from Clinical Practice Committee

November 2011

Here's some other hints for improving test utilization. You might consider setting up a Clinical Practice Committee. We've had this for many years in our practice and we’ve helped others set up their Clinical Practice Committee or Utilization Committees. This shows that we have general oversight of the patient care related activities in lab medicine and we really try to look at promotion of best practice—evidence-based laboratory medicine in a fiscally responsible way. We also want to make sure our decision making processes are driven by the literature in evidence-based lab medicine and pathology. For example, let's say you have several breast tumor markers and you want to decide which one you'd like to standardize in your practice, this would be a perfect example to take to you Clinical Practice Committee. If you want to get rid of some tests, for example, bleeding time, this is a good place to take that, get people to think about it, to examine the literature and to have a game plan to really get rid of that test and to introduce better, newer, more judicious tests.

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Jump to section:

• Introduction
• Objectives
• Assumptions to Forego
• Roger's Adopter Categories Based on Degree of Innovativeness¹
• Changes to Manual Requisitions^2,7
• Is This Test Misused?
• Overused/Misused Tests: Good Literature Support
• Bleeding Time³
• Anti–Single–Stranded DNA: Another Misused Test^4,5,6
• Use of Algorithms
• Laboratory Test Utilization
• Thyroid Testing Guidelines
• Thyroid Function Ordering Algorithm
• Pernicious Anemia Testing Guidelines
• Pernicious Anemia Testing Cascade
• Diarrhea Work Up Guidelines
• Parasitic Investigation of Stool Specimens Algorithm
• Obsolete Tests: Laboratory Directors' Opinions⁷
• Overused/Misused Tests — Opinion
• Frequency of Testing
• Newer Tests and Panels on the Horizon
• Hints on Improving Lab Utilization
• Hints on Improving Lab Utilization (2)
• Interventions to Improve Lab Utilization⁷
• Algorithm for Assessing Send–out Tests
• Improved Test Utilization: Assistance from Clinical Practice Committee
• Other Benefits of Clinical Practice Committee
• Summary
• References
• I Welcome Your Questions
• Questions?