Audit and feedback to reduce inappropriate Full Blood Count pathology testing

Abstract

Objective: This study was designed to reduce inappropriate Full Blood Count (FBC) pathology testing on specific hospital wards. It was hoped that by auditing requested Full Blood Counts, the researcher would be able to determine and benchmark appropriateness before conducting feedback interventions to promote appropriate pathology test ordering.Methods: To reduce inappropriate Full Blood Count pathology test ordering, the researcher audited patient notes and pathology test request forms in June 2015 before conducting audit and feedback interventions in July, August, and September 2015 on the hospital ward areas. The feedback intervention consisted of auditing patient notes, pathology request forms, and the local pathology clinical integration systems to determine Full Blood Count appropriateness. This data was then communicated to the attending doctor and requesting doctor during feedback sessions. To conceptualize appropriate pathology test ordering, the researchers highlighted the “Framework for analysis of test ordering” during scheduled feedback sessions. It was hypothesized that audit and feedback would decrease the amount of inappropriate Full Blood Counts ordered.Results: After receiving the audit and feedback intervention, clinicians were more likely not to order inappropriate Full Blood Counts (64.60% vs. 23.40%), specifically providing adequate clinical reasoning for the test, t(4.6706) = 0.0429, p = .05.Conclusions: This study found that audit and feedback sessions significantly improved appropriate pathology test ordering and the clinical reasoning associated with Full Blood Counts.