Ordering of laboratory tests in a teaching hospital. Can it be improved?
E. T. Wong, M. M. McCarron and S. T. Shaw Jr
A review of ordering patterns for thyroid function tests and for
measurements of creatine kinase (CK) isoenzyme and lactate dehydrogenase
(LDH) isoenzyme levels indicated considerable misuse. We employed an
educational program for both types of tests, but changed the request form
only for ordering the thyroid function tests. No changes were made in the
forms for ordering CK and LDH isoenzyme tests. The effect was a prompt
decrease in ordering triiodothyronine radioimmunoassay and thyrotropin
tests to 38% and 61%, respectively, of baseline rates. There was no effect
on rates of ordering CK and LDH isoenzyme tests, which were 102% and 96%,
respectively, of baseline rates. The improved use of thyroid function tests
was likely because of the change in the laboratory request form, since the
educational strategy by itself had no effect on the ordering of CK and LDH
isoenzyme tests.
