OBJECTIVES: Study objectives included addressing overuse of @entity2718 laboratory testing by decreasing submission rates of nondiarrheal stool specimens and specimens from @entity1  <=12 months of age and determining resultant @entity1 and laboratory cost savings associated with decreased testing. METHODS: A multifaceted initiative was developed, and components included multiple provider education methods, computerized order entry modifications, and automatic declination from laboratory on testing stool specimens of nondiarrheal consistency and from @entity1  <=12 months old. A run chart, demonstrating numbers of nondiarrheal plus @entity1 stool specimens submitted over time, was developed to analyze the initiative's impact on clinicians' test-ordering practices. A p-chart was generated to evaluate the percentage of these submitted specimens tested biweekly over a 12-month period. Cost savings for @entity1 and the laboratory were assessed at the study period's conclusion. RESULTS: Run chart analysis revealed an initial shift after the interventions, suggesting a temporary decrease in testing submission; however, no sustained differences in numbers of specimens submitted biweekly were observed over time. On the p-chart, the mean percentage of specimens tested before the intervention was 100%. After the intervention, the average percentage of specimens tested dropped to 53.8%. Resultant laboratory cost savings totaled nearly  3600, and @entity1 savings on testing charges were     32   000. CONCLUSIONS: Automatic laboratory declination of nondiarrheal stools submitted for CDI testing resulted in a sustained decrease in the number of specimens tested, resulting in significant laboratory and @entity1 cost savings. Despite multiple educational efforts, no sustained changes in physician ordering practices were observed.

Reducing Overutilization of Testing for XXXX Infection in a Pediatric Hospital System: A Quality Improvement Initiative.

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'patient', 'infant'] @entity2718 :: ('1496', 'Species') :: ['Clostridium difficile']
@entity2718 :: (1496,Species) :: ['Clostridium difficile']
