Inappropriateness of Repeated Laboratory and Radiological Tests for Transferred Emergency Department Patients

Journal of Clinical Medicine

Omar Kherad¹  François Sarasin²  Olivier Grosgurin²  Christophe Fehlmann²  Jérôme Bertrand² 

[1] Department of Internal Medicine and University of Geneva, La Tour Hospital, CH-1217 Geneva, Switzerland;Emergency Department, Department of Acute Medicine, Geneva University Hospitals, CH-1205 Geneva, Switzerland;

关键词: quality;    redundant;    less-is-more;    choosing wisely;    emergency medicine;    laboratory test;    radiological procedure;   

DOI  :  10.3390/jcm8091342

来源: DOAJ

【 摘 要 】

Background: Laboratory and radiographic tests are often repeated during inter-hospital transfers from secondary to tertiary emergency departments (ED), despite available data from the sending structure. The aim of this study was to identify the proportion of repeated tests in patients transferred to a tertiary care ED, and to estimate their inappropriateness and their costs. Methods: A retrospective chart review of all adult patients transferred from one secondary care ED to a tertiary care ED during the year 2016 was carried out. The primary outcome was the redundancy (proportion of procedure repeated in the 8 h following the transfer, despite the availability of the previous results). Factors predicting the repetition of procedures were identified through a logistic regression analysis. Two authors independently assessed inappropriateness. Results: In 2016, 432 patients were transferred from the secondary to the tertiary ED, and 251 procedures were repeated: 179 patients (77.2%) had a repeated laboratory test, 34 (14.7%) a repeated radiological procedure and 19 (8.2%) both. Repeated procedures were judged as inappropriate for 197 (99.5%) laboratory tests and for 39 (73.6%) radiological procedures. Conclusion: Over half of the patients transferred from another emergency department had a repeated procedure. In most cases, these repeated procedures were considered inappropriate.

【 授权许可】

Unknown