Literature DB >> 1517456

Computerised protocols for laboratory investigation and their effect on use of medical time and resources.

D Mutimer1, B McCauley, P Nightingale, M Ryan, M Peters, J Neuberger.   

Abstract

AIMS: To devise a computerised management system protocol which not only proposes the laboratory investigations to be performed on each patient but also performs related clinical functions.
METHODS: The system was designed by senior members of staff. The protocols defined all laboratory investigations including haematology, biochemistry, immunology and cross-matching, and included static and dynamic rules. Patients can be changed to different or additional protocols, as required; likewise proposed tests can be deleted or added. The software is written in MUMPS and runs on a 386 PC running MSM MUMPS under MSDOS.
RESULTS: The number of clinical chemistry tests requested per patient per day fell by 9.5% (p less than 0.01) for transplant recipients and by 28.8% (p less than 0.01) for non-transplant recipients. The average time spent by junior medical staff requesting laboratory investigations and enquiring about results fell from 10 minutes per patient per day to 4.1 minutes (p less than 0.001).
CONCLUSIONS: The introduction of this system in no way abrogates clinicians' responsibility for the management of patients, because all proposed investigations must be confirmed or modified by the authorising doctor. The system allows for the audit of requesting patterns and subsequent improvement in protocols by recording any alterations made to the proposed investigations. Significant benefits in terms of better use of house officer time and medical resources were also achieved.

Entities:  

Mesh:

Year:  1992        PMID: 1517456      PMCID: PMC495179          DOI: 10.1136/jcp.45.7.572

Source DB:  PubMed          Journal:  J Clin Pathol        ISSN: 0021-9746            Impact factor:   3.411


  8 in total

1.  Trial of strategy for reducing the use of laboratory tests.

Authors:  F G Fowkes; R Hall; J H Jones; M F Scanlon; G H Elder; D R Hobbs; A Jacobs; I A Cavill; S Kay
Journal:  Br Med J (Clin Res Ed)       Date:  1986-03-29

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3.  Effect of feedback to clinical staff of information on clinical biochemistry requesting patterns.

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Journal:  Clin Chem       Date:  1981-10       Impact factor: 8.327

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Authors:  E T Wong; M M McCarron; S T Shaw
Journal:  JAMA       Date:  1983-06-10       Impact factor: 56.272

5.  A trial of two strategies to modify the test-ordering behavior of medical residents.

Authors:  A R Martin; M A Wolf; L A Thibodeau; V Dzau; E Braunwald
Journal:  N Engl J Med       Date:  1980-12-04       Impact factor: 91.245

6.  Use of laboratory tests in a teaching hospital: long-term trends: reductions in use and relative cost.

Authors:  P F Griner
Journal:  Ann Intern Med       Date:  1979-02       Impact factor: 25.391

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Authors:  D W Young
Journal:  Br Med J       Date:  1980-12-13

8.  Medical audit in general medicine.

Authors:  D A Heath
Journal:  J R Coll Physicians Lond       Date:  1981-07
  8 in total
  8 in total

1.  Modifying the request behaviour of clinicians.

Authors:  T E Blecher
Journal:  J Clin Pathol       Date:  1992-08       Impact factor: 3.411

2.  The use of count data models in biomedical informatics evaluation research.

Authors:  Jing Du; Young-Taek Park; Nawanan Theera-Ampornpunt; Jeffrey S McCullough; Stuart M Speedie
Journal:  J Am Med Inform Assoc       Date:  2011-06-29       Impact factor: 4.497

3.  Managing test demand by clinicians: computer assisted guidelines.

Authors:  M Peters
Journal:  J Clin Pathol       Date:  1995-02       Impact factor: 3.411

4.  Implementing clinical guidelines. Computers allow instant access.

Authors:  G G Baily; M R Hammer; S P Hanley; M G Pattrick; D M De Kretser
Journal:  BMJ       Date:  1993-09-11

5.  A rule-based decision support application for laboratory investigations management.

Authors:  L Boon-Falleur; E Sokal; M Peters; J M Ketelslegers
Journal:  Proc Annu Symp Comput Appl Med Care       Date:  1995

6.  Making finance work for you--strategic issues in clinical directorates.

Authors:  J Stuart; P C Spurgeon; A Cook
Journal:  BMJ       Date:  1995-01-28

7.  Effects of a computerised protocol management system on ordering of clinical tests.

Authors:  P G Nightingale; M Peters; D Mutimer; J M Neuberger
Journal:  Qual Health Care       Date:  1994-03

8.  Computerised order entry systems and pathology services--a synthesis of the evidence.

Authors:  Andrew Georgiou; Johanna I Westbrook
Journal:  Clin Biochem Rev       Date:  2006-05
  8 in total

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