I was interested to see your list and I must applaud you for keeping it so
conservative. There is no exclusion on inpatients and most of the tests are
quite eosteric in nature. I have been looking at doing something like this
myself and though it is very obvious to change the criteria according to
site of origin of the request I must confess the thought completely
escaped. A bit like missing the elephant in the room. Can you let me know
how much money or effort you have saved with this and are you going to
continue expanding the list of tests
Elizabeth Mac Namara
JGH Montreal
At 06:23 2007-01-08, dr. C.H.H. Schoenmakers wrote:
>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)
>[log in to unmask]
>
>
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