Patient satisfaction with point-of-care laboratory testing: Report of a quality improvement program in an ambulatory practice of an academic medical center

Abstract Context.—Autopsy rates continue to decline in the United States. Objective.—Although many of the causes of this decline are external to pathology departments, we hypothesized that intradepartmental efforts to improve the quality of the service we provide to our clinical colleagues could increase our autopsy rate. Method.—We developed a multifaceted quality improvement program for our autopsy service aimed at increasing the visibility of the service, improving the service's reporting, and increasing the amount and quality of data available from the service. Setting.—A large academic medical center that performs approximately 250 autopsies each year. Results.—After implementation of our quality improvement program, the decline in our autopsy rate has not only stopped, but rates have even begun to increase. Additionally, physician satisfaction surveys conducted before and after implementation of our quality improvement initiatives showed an across-the-board improvement in clinician perception of the service. Conclusion.—Pathologists can and should be proactive in addressing the declining autopsy rate, rather than viewing it as someone else's problem or hoping that someone else will protect this important quality assurance tool for medical care.

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Implementation of Point-of-Care Testing in an Ambulatory Practice of an Academic Medical Center

American Journal of Clinical Pathology ◽

10.1309/ajcpyk1kv2kbcddl ◽

2014 ◽

Vol 142 (5) ◽

pp. 640-646 ◽

Cited By ~ 27

Author(s):

J. Benjamin Crocker ◽

Elizabeth Lee-Lewandrowski ◽

Nicole Lewandrowski ◽

Jason Baron ◽

Kimberly Gregory ◽

...

Keyword(s):

Medical Center ◽

Point Of Care ◽

Academic Medical Center ◽

Point Of Care Testing ◽

Academic Medical ◽

Ambulatory Practice

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Rethinking the routine: Preoperative laboratory testing among American Society of Anesthesiologists class 1 and 2 patients before low-risk ambulatory surgery in the 2017 National Surgical Quality Improvement Program cohort

Surgery ◽

10.1016/j.surg.2021.07.036 ◽

2021 ◽

Author(s):

George A. Taylor ◽

Lawrence B. Oresanya ◽

Sarah M. Kling ◽

Vishal Saxena ◽

Olga Mutter ◽

...

Keyword(s):

Quality Improvement ◽

Laboratory Testing ◽

Ambulatory Surgery ◽

Quality Improvement Program ◽

Low Risk ◽

Improvement Program ◽

Surgical Quality ◽

Class 1 ◽

American Society ◽

American Society Of Anesthesiologists

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A Quality Improvement Project to Decrease Length of Stay after Total Hip and Total Knee Arthroplasty Surgery at a Veteran Affairs Academic Medical Center

Perioperative Care and Operating Room Management ◽

10.1016/j.pcorm.2021.100230 ◽

2021 ◽

pp. 100230

Author(s):

William Wong ◽

Carla Bridges ◽

Molly Serebin ◽

Adam Gordon ◽

Sherréa Jones ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Quality Improvement ◽

Medical Center ◽

Academic Medical Center ◽

Improvement Project ◽

Veteran Affairs ◽

Academic Medical ◽

Total Knee ◽

Knee Arthroplasty Surgery ◽

Arthroplasty Surgery

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Evaluation of Patient Experience from Telemedicine Use for an Anesthesiology Pain Division: Time, Cost, and Patient Satisfaction Analysis (Preprint)

10.2196/preprints.33926 ◽

2021 ◽

Author(s):

Laleh Jalilian ◽

Irene Wu ◽

Jakun Ing ◽

Xuezhi Dong ◽

George Pan ◽

...

Keyword(s):

Patient Satisfaction ◽

Pain Management ◽

Travel Time ◽

Medical Center ◽

Academic Medical Center ◽

Cost Savings ◽

Travel Distance ◽

Patient Cost ◽

Academic Medical ◽

Pain Patients

BACKGROUND An increasing number of patients require outpatient and interventional pain management. To help meet the rising demand for anesthesia pain subspecialty care in rural and metropolitan areas, healthcare providers have utilized telemedicine for pain management of both interventional and chronic pain patients. OBJECTIVE This study describes telemedicine implementation for pain management at an academic pain division in a large metropolitan area. The study estimates patient cost savings from telemedicine, before and after the California COVID-19 "Safer at Home" directive, and patient satisfaction with telemedicine for pain management care. METHODS This was a retrospective, observational case series study of telemedicine use in a pain division at an urban academic medical center. From August 2019 to June 2020, we evaluated 1,398 patients and conducted 2,948 video visits for remote pain management care. We utilize publicly available IRS Statistics of Income data to estimate hourly earnings by zip code in order to estimate patient cost savings. We estimate median travel time, travel distance, direct cost of travel, and time-based opportunity savings and report patient satisfaction scores. RESULTS Telemedicine patients avoided an estimated median roundtrip driving distance of 26 miles and a median travel time of 69 minutes during afternoon traffic conditions. Within sample, the median hourly earnings was $28/hr. Patients saved a median of $22 on gas and parking and a total of $52 per telemedicine visit based on estimated hourly earnings and travel time. Patients evaluated serially with telemedicine for medication management saved a median of $156 over three visits. 91% of patients surveyed (n = 313) were satisfied with their telemedicine experience. CONCLUSIONS Telemedicine use for pain management reduced travel distance, travel time, and travel and time-based opportunity costs for pain patients. We achieved the successful implementation of telemedicine across a pain division in an urban academic medical center with high patient satisfaction and patient cost savings.

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Physician Survey of a Laboratory Medicine Interpretive Service and Evaluation of the Influence of Interpretations on Laboratory Test Ordering

Archives of Pathology & Laboratory Medicine ◽

10.5858/2004-128-1424-psoalm ◽

2004 ◽

Vol 128 (12) ◽

pp. 1424-1427 ◽

Cited By ~ 12

Author(s):

Martha E. Laposata ◽

Michael Laposata ◽

Elizabeth M. Van Cott ◽

Dion S. Buchner ◽

Mohammed S. Kashalo ◽

...

Keyword(s):

Laboratory Testing ◽

Medical Center ◽

Academic Medical Center ◽

Physician Satisfaction ◽

Patient Specific ◽

Diagnostic Process ◽

Reference Laboratory ◽

Academic Medical ◽

Coagulation Testing ◽

Test Ordering

Abstract Context.—Complex coagulation test panels ordered by clinicians are typically reported to clinicians without a patient-specific interpretive paragraph. Objectives.—To survey clinicians regarding pathologist-generated interpretations of complex laboratory testing panels and to assess the ability of the interpretations to educate test orderers. Design.—Surveys were conducted of physicians ordering complex coagulation laboratory testing that included narrative interpretation. Evaluation of order requisitions was performed to assess the interpretation's influence on ordering practices. Setting.—Physicians ordering coagulation testing at a large academic medical center hospital in Boston, Mass, and physicians from outside hospitals using the academic medical center as a reference laboratory for coagulation testing. Outcome Measures.—Physician surveys and evaluation of laboratory requisition slips. Results.—In nearly 80% of responses, the ordering clinicians perceived that the interpretive comments saved them time and improved the diagnostic process. Moreover, the interpretations were perceived by ordering clinicians to help prevent a misdiagnosis or otherwise impact the differential diagnosis in approximately 70% of responses. In addition, interpretations appeared to be able to train the ordering clinicians as to the standard ordering practices. Conclusions.—The results demonstrate physician satisfaction with an innovative information delivery approach that provides laboratory diagnostic interpretation and test-ordering education to clinicians in the context of their daily workflow.

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