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Интернет | Анонимные пользователи |
Оглавление
- Preface
- Table of contents
- 1 Introduction: clinical laboratory contribution to patient safety
- References
- 2 Inappropriateness in laboratory test requesting in the literature
- 2.1 Laboratory process-test request
- 2.2 Definition of inappropriate requests
- 2.3 Causes of inappropriate test requests
- 2.3.1 Laboratory
- 2.3.2 Requesting physician
- 2.3.3 The patient
- 2.3.4 Factors inherent in the system
- 2.4 Reducing inefficiency in the laboratory diagnostic process
- 2.5 Tools described in the literature for the management of the demand for laboratory tests: before, during, and after the request
- 2.5.1 Before
- 2.5.2 During the request
- 2.5.3 After the request
- 2.6 The future: where we are going
- References
- 3 Causes and negative effects of inappropriateness in laboratory test requesting
- 3.1 Introduction
- 3.2 Causes of inappropriateness in laboratory test requesting
- 3.2.1 Clinician’s unawareness about the test
- 3.2.2 Communication between clinical and laboratory departments
- 3.2.3 Others
- 3.3 Negative effects of inappropriateness in laboratory test requesting
- References
- 4 Strategies to correct inappropriateness in laboratory test requesting
- 4.1 Introduction
- 4.2 Types of strategy to correct inappropriateness in laboratory tests
- 4.2.1 Strategies based on education, audit, and feedback
- 4.2.2 Rules and agreements aimed at vetting test requests
- 4.2.3 Re-design of the request formularies
- 4.2.4 Computer physician order entry
- 4.3 Strategies to correct inappropriateness in laboratory test requesting and phase of intervention
- 4.3.1 Pre-requesting phase interventions
- 4.3.2 During requesting interventions
- 4.3.3 Post-requesting interventions
- 4.4 Laboratory medicine
- 4.5 Epilogue
- References
- 5 Practical pathway to design, establish, and monitor over time test requesting appropriateness strategies: indicators to detect the inappropriateness and to monitor after interventions
- 5.1 Introduction
- 5.2 The plan-do-check-act cycle as a basis in the design of strategies to correct inappropriateness in laboratory test requesting
- 5.3 Indicators that intervene in strategies to correct inappropriateness in laboratory test requesting
- 5.3.1 Indicators in clinical laboratory: general considerations
- 5.3.2 Indicators to detect test inappropriateness and to monitor after the establishment of the different interventions
- 5.4 A step-by-step description of strategies to correct inappropriateness in laboratory test requesting
- 5.4.1 Identify laboratory test inappropriateness
- 5.4.2 Selection of the test and target population
- 5.4.3 Generation of the idea
- 5.4.4 Pre-design of the strategy
- 5.4.5 Strategy final design
- 5.4.6 Strategy establishment
- 5.4.7 Monitoring through process indicators
- 5.4.8 Evaluation through outcome indicators
- 5.4.9 Final decision whether to continue or stop the strategy
- References
- 6 Potential of computer physician order entry (CPOE) to improve patient safety related to laboratory test requesting
- 6.1 What is a computer physician order entry (CPOE) system?
- 6.2 CPOE interventions
- 6.3 Design strategies
- 6.3.1 Re-design of the request formularies
- 6.3.2 Use of clinical (or “disease-specific”) profiles/panels
- 6.3.3 Customized formularies
- 6.3.4 Display costs/fees
- 6.3.5 Search functions
- 6.3.6 Research/clinical trial formularies
- 6.4 Clinical decision support rules
- 6.4.1 Specialty/staff-grade limitations
- 6.4.2 Minimum retest intervals
- 6.4.3 Asking for additional information: questions
- 6.4.4 Suggestions/corrections
- 6.5 CPOE advantages in pre-analytical phase
- 6.6 Conclusions
- References
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