Improving Healthcare Stewardship with Embedded Diagnostic Consultation Services
AbstractObjective: To better inform physicians about how to find guidelines for diagnostic testing, and to provide clinical advice on which diagnostic tests should be ordered. Methods: A clinical laboratory scientist joined the Patient Care Rounding Team (PCRT) at Augusta University to provide consultation regarding diagnostic testing as part of the first national doctorate in Clinical Laboratory Science (CLS) program. Documentation and analysis of diagnostics-related questions accumulated during PCRT rounds demonstrated the need for advice about diagnostic testing in clinician rounding. The PCRT did not have a defined logic model to order diagnostic tests, place the test orders, test methodology, and determine the clinical value (cost/benefit) of the tests. The Doctor of CLS resident requested an embedded librarian from Greenblatt Library provide evidence-based research to support clinical decisions to better inform the rounding teams. The librarian demonstrated how to systematically search for evidence to support the choice in diagnostic testing and how to interpret test results to the DCLS team. Results: Within the first eight months of the Doctor of CLS consultation service on PCRT, there were 1238 consultations that resulted in over $149,308 in cost savings. This was calculated by the Doctorate of CLS resident by accounting for eliminated unnecessary tests and revised ordered tests to better serve diagnostic needs. The librarian providing evidence-based research consulted on lesser known connections between symptoms and conditions, improving diagnostic clinical decision-making. Both the Doctor of CLS resident and librarian offered evidence and expertise that decreased inappropriate test utilization while potentially improving clinical outcomes. Conclusions: Informationists and other scientists can help a physician team be more responsible in their financial stewardship by reducing unnecessary testing and utilizing in-house resources.
AffiliationRobert B. Greenblatt, M.D. Library
DescriptionPaper presented at the 2018 Annual Meeting of Southern Chapter of the Medical Library Association, October 25-28, 2018 Orlando, FL
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