Dear colleague,
In our laboratory information system (the labcomputer) we have implemented so
called "repeat-periods" for many tests. The repeat period can be set to a different
number of day's for out-patients, clinical patients and patients of general practitioners,
this of course in a test-specific way.
If a test is re-ordered within the repeat-period, a warning message ("request within
repeat-period") is displayed automatically to the technician entering the request. At
this point the technician denies the request unless specific action not to do so has
been taken. This specific action can be a telephone call by the doctor to the clinical
chemist explaining why the extra measurement is necessary or a written
comment/question on the form. If a test is denied due to a repeat-period we report
"test already done at ddmmyy, at that time the result was x". This gives doctor B an
answer if doctor A asked for a test recently.
The repeat-periods implemented are based on literature and practice and are
discussed in our regular feedback-meetings with the different disciplines. An overview
of all repeat-periods is communicated regularly. For the implementation we used the
salami-tactic: only one test or a few tests at a time. Our argument used was that
doctor B from discipline Y does not know what doctor A from discipline X has already
ordered and that we wanted to prevent unnecessary double work (which was true).
We almost met no opposition.
On our request-forms we have a check-mark "deny repeat-period". When checked
we grant the request even within the repeat-period. However, when we feel the
check-mark is routinely used we contact the doctor. If things don't improve then we
tell the doctor we are going to ignore his or her check-marks for "deny repeat period".
On a regular basis we generate an overview out of our lab computer of who checked
"deny repeat-period" how many times. This easily identifies people we have to talk
with.......;-)
I hereby send you our latest list of set repeat periods as an Excel
file. If the test names are unclear please feel free to ask for explanation.
I will gladly be of assistance.
I would love to have feedback, especially on where you disagree. Any new
"inventions" are very welcome also...
Best regards,
Christian
dr. C.H.H. Schoenmakers, EurClinChem
Clinical Chemist
Department of Clinical Chemistry, Elkerliek Hospital
P.O. box 98, 5700 AB Helmond
The Netherlands
(+)31-492-595052 (tel), (+)31-492-595059 (fax)
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---- File information -----------
File: Repeatperiods_2006_09_11.xls
Date: 8 Jan 2007, 12:14
Size: 25600 bytes.
Type: Excel-sheet
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