Rationalisation of laboratory tests ordering and consumption at Armed Forces Hospital, Jazan

Laboratory testing is one of the major and important component of medical diagnosis. However, unrationalised laboratory test ordering may lead to misdiagnosis of diseases which would delay treatment of the patients. It would also lead to wasting the laboratory resources that adversely impact the hos...

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Main Authors: Manal Ahmed Aldiba, Essa Mohammad Jamali, Ahmed Dighriri, Ahmed Mohammad Abdulhaq, Ali Mohammad Otaif, Bader Yahya Safhi, Ali Al-Fageeh, Ahmed Al-Sharif, Yara Rabia Ali
Format: Article
Language:English
Published: BMJ Publishing Group 2023-06-01
Series:BMJ Open Quality
Online Access:https://bmjopenquality.bmj.com/content/12/2/e002114.full
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author Manal Ahmed Aldiba
Essa Mohammad Jamali
Ahmed Dighriri
Ahmed Mohammad Abdulhaq
Ali Mohammad Otaif
Bader Yahya Safhi
Ali Al-Fageeh
Ahmed Al-Sharif
Yara Rabia Ali
author_facet Manal Ahmed Aldiba
Essa Mohammad Jamali
Ahmed Dighriri
Ahmed Mohammad Abdulhaq
Ali Mohammad Otaif
Bader Yahya Safhi
Ali Al-Fageeh
Ahmed Al-Sharif
Yara Rabia Ali
author_sort Manal Ahmed Aldiba
collection DOAJ
description Laboratory testing is one of the major and important component of medical diagnosis. However, unrationalised laboratory test ordering may lead to misdiagnosis of diseases which would delay treatment of the patients. It would also lead to wasting the laboratory resources that adversely impact the hospital budget. The aim of this project was to rationalise laboratory tests ordering and ensure effective utilisation of resources at Armed Forces Hospital Jizan (AFHJ). This study included two major steps: (1) the development and implementation of quality improvement interventions to reduce the unnecessary and abuse of laboratory testing in the AFHJ and (2) evaluation of the effectiveness of these interventions. In order to determine the possible causes of the problem, fishbone diagram was used to structure a brainstorming session. Pareto analysis was used to prioritise the causes so that the emphasis can be laid on most significant one. After interventions implementation, the data analysed and found that there was significant differences between 2019 and 2021 of total patients percentage and distribution that was revealed by box plot, who had a request of Hemoglobin A1c (HbA1c) (p=0.002), Thyroid Stimulating Hormone (TSH) (p=0.002), Free Thyroine (FT4) (p=0.002), Free Triiodothyronine (FT3) (p=0.001), Follicle-Stimulating Hormone (FSH) (p=0.002), Luteinizing Hormone (LH) (p=0.002) and Prolactin (PRL) (p=0.001). We achieved a 33% reduction in total laboratory tests cost and the total laboratory budget decreased from 6 000 000 SR in 2019 to about 4 000 000 Saudi Riyals (SR) in 2021. A change in laboratory resource consumption requires changes in physicians awareness. A modification of the electronic ordering system applied more restrictions to the ordering physicians. Extending these measures to the entire hospital might lead to significant reduction in the healthcare costs.
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spelling doaj-art-5c05795457d4484d88f1ca7d6cbb91c02025-08-20T01:58:12ZengBMJ Publishing GroupBMJ Open Quality2399-66412023-06-0112210.1136/bmjoq-2022-002114Rationalisation of laboratory tests ordering and consumption at Armed Forces Hospital, JazanManal Ahmed Aldiba0Essa Mohammad Jamali1Ahmed Dighriri2Ahmed Mohammad Abdulhaq3Ali Mohammad Otaif4Bader Yahya Safhi5Ali Al-Fageeh6Ahmed Al-Sharif7Yara Rabia Ali8Laboratory, Armed Forces Hospital Jizan, Jizan, Saudi ArabiaMedical Laboratory, Armed Forces Hospital, Jizan, Saudi ArabiaMedical Laboratory, Armed Forces Hospital, Jizan, Saudi ArabiaMedical Laboratory, Armed Forces Hospital, Jizan, Saudi ArabiaMedical Laboratory, Armed Forces Hospital, Jizan, Saudi ArabiaMedical Laboratory, Armed Forces Hospital, Jizan, Saudi ArabiaMedical Laboratory, Armed Forces Hospital, Jizan, Saudi ArabiaMedical Laboratory, Armed Forces Hospital, Jizan, Saudi ArabiaMedical Laboratory, Armed Forces Hospital, Jizan, Saudi ArabiaLaboratory testing is one of the major and important component of medical diagnosis. However, unrationalised laboratory test ordering may lead to misdiagnosis of diseases which would delay treatment of the patients. It would also lead to wasting the laboratory resources that adversely impact the hospital budget. The aim of this project was to rationalise laboratory tests ordering and ensure effective utilisation of resources at Armed Forces Hospital Jizan (AFHJ). This study included two major steps: (1) the development and implementation of quality improvement interventions to reduce the unnecessary and abuse of laboratory testing in the AFHJ and (2) evaluation of the effectiveness of these interventions. In order to determine the possible causes of the problem, fishbone diagram was used to structure a brainstorming session. Pareto analysis was used to prioritise the causes so that the emphasis can be laid on most significant one. After interventions implementation, the data analysed and found that there was significant differences between 2019 and 2021 of total patients percentage and distribution that was revealed by box plot, who had a request of Hemoglobin A1c (HbA1c) (p=0.002), Thyroid Stimulating Hormone (TSH) (p=0.002), Free Thyroine (FT4) (p=0.002), Free Triiodothyronine (FT3) (p=0.001), Follicle-Stimulating Hormone (FSH) (p=0.002), Luteinizing Hormone (LH) (p=0.002) and Prolactin (PRL) (p=0.001). We achieved a 33% reduction in total laboratory tests cost and the total laboratory budget decreased from 6 000 000 SR in 2019 to about 4 000 000 Saudi Riyals (SR) in 2021. A change in laboratory resource consumption requires changes in physicians awareness. A modification of the electronic ordering system applied more restrictions to the ordering physicians. Extending these measures to the entire hospital might lead to significant reduction in the healthcare costs.https://bmjopenquality.bmj.com/content/12/2/e002114.full
spellingShingle Manal Ahmed Aldiba
Essa Mohammad Jamali
Ahmed Dighriri
Ahmed Mohammad Abdulhaq
Ali Mohammad Otaif
Bader Yahya Safhi
Ali Al-Fageeh
Ahmed Al-Sharif
Yara Rabia Ali
Rationalisation of laboratory tests ordering and consumption at Armed Forces Hospital, Jazan
BMJ Open Quality
title Rationalisation of laboratory tests ordering and consumption at Armed Forces Hospital, Jazan
title_full Rationalisation of laboratory tests ordering and consumption at Armed Forces Hospital, Jazan
title_fullStr Rationalisation of laboratory tests ordering and consumption at Armed Forces Hospital, Jazan
title_full_unstemmed Rationalisation of laboratory tests ordering and consumption at Armed Forces Hospital, Jazan
title_short Rationalisation of laboratory tests ordering and consumption at Armed Forces Hospital, Jazan
title_sort rationalisation of laboratory tests ordering and consumption at armed forces hospital jazan
url https://bmjopenquality.bmj.com/content/12/2/e002114.full
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