NOV 12, 2020 7:30 AM PST

Keynote Presentation: Choosing Wisely lab utilization first steps: addressing the low hanging fruit

C.E. Credits: P.A.C.E. CE Florida CE
Speaker
  • Professor of Laboratory Medicine and Pathobiology at the University of Toronto and Director of Laboratory Utilization at Sunnybrook Health Sciences Centre in Toronto
    Biography

      Jeannie L. Callum, MD, FRCPC, is a Transfusion Medicine Specialist and Hematologist at Sunnybrook Health Sciences Center in Toronto and Professor in the Department of Laboratory Medicine and Pathobiology at the University of Toronto. She is the Director of Utilization for the Department of Laboratory Medicine and Molecular Diagnostics. She also serves as the sponsor lead for the Ontario Regional Blood Coordinating Network for Central Ontario. Her primary interests in transfusion medicine include error tracking and the management of the coagulopathy associated with traumatic injury and post cardiac surgery. She has been involved with numerous transfusion clinical trials including ABLE, PROPPR, FIIRST, TACS and FIBRES. She has written extensively about issues in transfusion medicine, publishing more than 100 peer-reviewed articles and authoring numerous book chapters. She also was the lead author on the Provincial (Ontario) transfusion handbook titled “Bloody Easy,” now preparing its fourth edition. In addition, she is on the editorial board for the “Transfusion Medicine Reviews” and “Transfusion” journals.


    Abstract

    In 2012, the Choosing Wisely initiative was commenced by the ABIM with numerous societies putting forward lists of overused tests or procedures. The Choosing Wisely movement has spread to numerous countries including the UK, Canada, and Australia. The movement has spurred 1000s of quality improvement projects worldwide. Improving utilization and/or efficiency in the laboratory includes: curtailing inappropriate laboratory tests from being ordered, electronically stopping unnecessary duplicate tests, automating manual processes, eliminating paper-based processes, implementing testing cascades, and curtailing unnecessary transfusions. Since the choice of quality improvement projects appears limitless, it makes it difficult to know where to get started! If you elect to address overuse of a common laboratory test, numerous avenues are available to assist you with narrowing your list: ask your clinicians which tests your hospital is overusing (they know!), look at variability of test use by clinicians within the same area, consult the quality improvement literature for analytes that others have addressed, and sift through the choosing wisely statements for items you have not addressed. There are also numerous system levers you can pull to bring utilization under control: education (grand rounds, screen savers on computers, alerts on the log-in page of your EMR or landing page for the hospital internet), computerized provider order entry controls, middleware controls allowing identification of duplicate tests, removal of overused tests from requisitions and ordersets, implementation of criteria for certain test types, and audit and feedback to high users. Evaluation of success should be measured in repeated quality improvement cycles of plan-do-study-act (PDSA). Never be surprised if your first attempt fails to improve utilization. Lastly, don’t forget to share your successes by publishing your results – this will assist with more rapid improvement in healthcare.

    Learning Objectives:

    1. Identify areas of inefficiency in the lab that need improving

    2. Identify tests that are commonly overused Evaluate system changes necessary to bring utilization down

    3. Assess how to know if your system change was successful


    Show Resources
    You May Also Like
    SEP 10, 2020 9:00 AM PDT
    C.E. CREDITS
    SEP 10, 2020 9:00 AM PDT
    Date: September 10, 2020 Time: 9:00am (PDT), 12:00pm (EDT) Osmolality testing is relevant throughout the entire bioprocessing workflow. As customers look to refine mAb and gene therapy workf...
    NOV 18, 2020 8:00 AM PST
    C.E. CREDITS
    NOV 18, 2020 8:00 AM PST
    DATE: November 18, 2020 TIME: 08:00am PDT We develop and implement technologies to solve some of the major bottlenecks in biomedical research. In particular, we establish new imaging approac...
    AUG 25, 2020 8:00 AM PDT
    C.E. CREDITS
    AUG 25, 2020 8:00 AM PDT
    DATE: August 25, 2020 TIME: 8:00am PDT, 10:00am CDT, 11:00am EDT Recombinant lentivirus (LV) and adeno-associated virus (AAV) are critical components of cell and gene therapies, which show g...
    DEC 15, 2020 10:00 AM PST
    C.E. CREDITS
    DEC 15, 2020 10:00 AM PST
    DATE: December 15, 2020 TIME: 10:00am PST Scientists from Thermo Fisher Scientific will walk us through the world of microorganisms. They will discuss their most recent research on viruses,...
    NOV 16, 2020 8:00 AM PST
    C.E. CREDITS
    NOV 16, 2020 8:00 AM PST
    Date: November 16, 2020 Time: 8:00am (PST), 11:00am (EST) CRISPR screening has become the prime discovery tool in modern biomedical research and drug discovery. At the same time, most screen...
    OCT 29, 2020 6:00 AM PDT
    C.E. CREDITS
    OCT 29, 2020 6:00 AM PDT
    Date: October 29, 2020 Time: 6:00am (PDT), 9:00am (EDT), Chronic inflammation can occur as a result of a combination of genetic predispositions and environmental factors. Epigenetic modifica...
    Loading Comments...
    Show Resources