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Research Article| Volume 19, ISSUE 4, P867-876, December 1999

The Effect of Benchmarking Clinical Practice with the Clinical Laboratory: An Institutional Case Study

  • Michael G. Bisseil
    Correspondence
    Address reprint requests to: Michael G. Bisseil, MD, PhD, MPH, Department of Clinical Pathology, Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA 15212
    Affiliations
    Department of Pathology, MCP/Hahnemann University School of Medicine; and the Department of Clinical Pathology, Allegheny General Hospital, Pittsburgh, Pennsylvania
    Search for articles by this author
DOI:https://doi.org/10.1016/S0272-2712(18)30095-7
The Effect of Benchmarking Clinical Practice with the Clinical Laboratory: An Institutional Case Study
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      This paper is only available as a PDF. To read, Please Download here.
      The improvement of quality in clinical care can greatly benefit form continuous benchmarking with information based on laboratory data. To be most effective, the information is best provided in the form of real-time disease management decision support. Such an approach requires advances in the implementation of hospital information systems. This article describes ground-breaking work at LDS Hospital in Salt Lake City, Utah that provides examples of major well-documented impacts of the “intelligent laboratory report” on patient outcomes.
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      References

        • Berwick D.M.
        Payment by capitation and the quality of care.
        N Engl J Med. 1996; 335: 1060-1063
        • Bryan C.S.
        • Reynolds K.L.
        • Bremer E.R.
        Analysis of 1,186 episodes of gram-negative bacteremia in non-university hospitals: The effects of antimicrobial therapy.
        Rev Infect Dis. 1983; 5: 629-638
        • Castle M.
        • Wilfert C.M.
        • Cate T.R.
        • et al.
        Antibiotic use at Duke University Medical Center.
        JAMA. 1977; 237: 2819-2822
        • Classen D.C.
        • Evans R.S.
        • Pestotnik S.L.
        • et al.
        The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection.
        N Engl J Med. 1992; 326: 281-286
        • Craig W.A.
        • Uman S.J.
        • Shaw W.R.
        • et al.
        Hospital use of antimicrobial drugs: Survey at 19 hospitals and result of antimicrobial control program.
        Ann Intern Med. 1978; 89: 793-795
        • Cunningham A.
        Transforming Plague—the laboratory and the identity of infectious disease.
        in: Cunningham A. Williams P. The Laboratory Revolution in Medicine. England, Cambridge University Press, Cambridge1992: 209-244
        • Evans R.S.
        • Classen D.C.
        • Pestotnik S.L.
        • et al.
        A decision support tool for antibiotic therapy.
        in: Gardner R.M. Nineteenth Annual Symposium on Computer Applications in Medical Care. Hanley & Belfus, Philadelphia1995: 651-655
        • Evans R.S.
        • Classen D.C.
        • Pestotnik S.L.
        • et al.
        Improving empiric antibiotic selection using computer decision support.
        Arch Intern Med. 1994; 154: 878-884
        • Evans R.S.
        • Pestotnik S.L.
        • Classen D.C.
        • et al.
        A computer-assisted management program for antibiotics and other anti-infective agents.
        N Engl J Med. 1998; 338: 232-260
        • Finland M.
        Empiric therapy for bacterial infections: The historical perspective.
        Rev Infect Dis. 1983; 5: S2-S8
        • Hepler C.D.
        • Clyne K.E.
        • Donta S.T.
        Rationales expressed by empiric antibiotic prescribers.
        Am J Hosp Pharm. 1982; 39: 1647-1655
        • Johnston M.E.
        • Langton K.B.
        • Haynes R.B.
        • et al.
        Effects of computer-based clinical decision support systems on clinician performance and patient outcomes.
        Ann Intern Med. 1994; 120: 135-142
        • Kunin C.M.
        • Tupasi T.
        • Craig W.A.
        Use of antibiotics: A brief exposition of the problem and some tentative solutions.
        Ann Intern Med. 1973; 79: 555-560
        • Kushniruk A.
        • Patel V.
        • Fleiszer D.
        Analysis of medical decision-making: A cognitive perspective on medical informatics.
        in: Gardner R.M. Nineteenth Annual Symposium on Computer Applications in Medical Care. Hanley & Belfus, Philadelphia1995: 193-197
        • Maki D.G.
        • Schuna A.A.
        A study of antimicrobial misuse in a university hospital.
        Am J Med Sci. 1978; 275: 271-282
        • McDonald C.J.
        Protocol-based computer reminders, the quality of care, and the nonperfectibility of man.
        N Engl J Med. 1976; 295: 1351-1355
        • McGowan J.E.
        Antimicrobial resistance in hospital organisms and its relation to antibiotic use.
        Rev Infect Dis. 1983; 5: 1033-1048
        • McGowan J.E.
        Improving antibiotic use has become essential—can surgery lead the way?.
        Infect Control Hosp Epidemiol. 1990; 11: 575
        • Miwa L.F.
        • Kennedy D.L.
        • Friedman J.P.
        US hospital anti-infective use from 1985 to 1990.
        Pharmacy and Therapeutics. 1992; 17: 983-985
        • Moody M.L.
        • Burke J.P.
        Infections and antibiotic usage in a large private hospital, January, 1971.
        Arch Intern Med. 1972; 130: 260-266
        • Moss F.
        • McSwiggan D.A.
        • McNicol M.W.
        • et al.
        Survey of antibiotic prescribing in a district general hospital. 1: Pattern of use.
        Lancet. 1981; 2: 349-352
        • Oniki T.A.
        • Clemmer T.P.
        • Arthur L.K.
        • et al.
        Using statistical quality control techniques to monitor blood glucose levels.
        in: Gardner R.M. Nineteenth Annual Symposium on Computer Applications in Medical Care. Hanley & Belfus, Philadelphia1995: 586-590
        • Parry M.F.
        Epidemiology and mechanisms of antimicrobial resistance.
        Am J Infect Control. 1989; 17: 286-294
        • Pestotnik S.L.
        • Classen D.C.
        • Evans R.S.
        • et al.
        Implementing antibiotic practice guidelines through computer-assisted decision support: Clinical and financial outcomes.
        Ann Intern Med. 1996; 124: 884-890
        • Pestotnik S.L.
        • Evans R.S.
        • Burke J.P.
        • et al.
        Therapeutic antibiotic monitoring: Surveillance using a computerized expert system.
        Am J Med. 1990; 88: 43-48
        • Pryor T.A.
        • Gardner R.M.
        • Clayton P.D.
        • et al.
        The HELP system.
        J Med Sys. 1985; 7: 87-102
        • Sailors R.M.
        • East T.D.
        • Wallace C.J.
        • et al.
        A successful protocol for the use of pulse oximetry to classify arterial oxygenation into four fuzzy categories.
        in: Gardner R.M. Nineteenth Annual Symposium on Computer Applications in Medical Care. Hanley & Belfus, Philadelphia1995: 248-252
        • Schaffner W.
        • Ray W.A.
        • Federspiel C.F.
        Surveillance of antibiotic prescribing in office practice.
        JAMA. 1983; 250: 1728-1732
        • Sittig D.F.
        • Stead W.W.
        Computer-based physician order entry: The state of the art.
        J Am Med Inform Assoc. 1994; 1: 108-123
        • Tate K.E.
        • Gardner R.M.
        • Scherting K.
        Nurses, pagers and patient-specific criteria: Three keys to improved critical value reporting.
        in: Gardner R.M. Nineteenth Annual Symposium on Computer Applications in Medical Care. Hanley & Belfus, Philadelphia1995: 164-168
        • Wallace C.J.
        • Metcalf S.
        • Zhang X.
        • et al.
        Cost effective computerized decision support: Tracking caregiver acceptance at the point of care.
        in: Gardner R.M. Nineteenth Annual Symposium on Computer Applications in Medical Care. Hanley & Belfus, Philadelphia1995: 810-813
        • Weinstein L.
        Antimicrobial agents—general considerations.
        in: Goodman L.S. Gilman A. The Pharmacological Basis of Therapeutics. ed 5. Macmillan, New York1975: 1090-1112
        • Yu V.L.
        • Stoehr G.P.
        • Starling R.C.
        • et al.
        Empiric antibiotic selection by physicians: Evaluation of reasoning strategies.
        Am J Med Sci. 1991; 301: 165-172

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      DOI: https://doi.org/10.1016/S0272-2712(18)30095-7

      Copyright

      © 1999 Elsevier Inc. Published by Elsevier Inc. All rights reserved.

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