scholarly journals Instructional Moves that Increase Chances of Engaging All Students in Learning Mathematics

Mathematics ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 582
Author(s):  
Janette Bobis ◽  
James Russo ◽  
Ann Downton ◽  
Maggie Feng ◽  
Sharyn Livy ◽  
...  
Keyword(s):  
Instructional Practices ◽  
Professional Learning ◽  
A Priori ◽  
Intervention Group ◽  
Essential Element ◽  
Academic Needs ◽  
Post Intervention ◽  
Negative Beliefs ◽  
Learning Mathematics ◽  
Post Intervention Group

Despite the construct of challenge being recognized as an essential element of mathematics instruction, concerns have been raised about whether such approaches benefit students with diverse academic needs. In this article, we focus on the beliefs and instructional practices of teachers teaching students in the first three years of school (5 to 8 years of age). These teachers participated in professional learning focused on challenging mathematical tasks differentiated through their open-ended design and the use of enabling and extending prompts. The instructional practices are explained using the Theory of Didactical Situations. Questionnaire data from pre-intervention (n = 148) and post-intervention (n = 100) groups of teachers indicated that teachers in the post-intervention group held more negative beliefs than those in the pre-intervention group about the capability of instructional approaches involving a priori grouping of students by performance levels. Interviews with ten teachers from the post-intervention group revealed and characterized the ways teachers employed open-ended tasks with enabling and extending prompts to engage all learners. Findings reveal that teachers knowing their students as individual learners accompanied by knowledge of a range of teaching practices to differentiate instruction are central to engaging all learners.

scholarly journals 87. Utilization of Methicillin-Sensitive/Resistant Staphylococcus aureus Nares Screen to Decrease Vancomycin and Linezolid Use in Hospitalized Patients with Respiratory Infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S60-S60
Author(s):  
Noor F Zaidan ◽  
Rachel S Britt ◽  
David Reynoso ◽  
R Scott Ferren
Keyword(s):  
Staphylococcus Aureus ◽  
Respiratory Infections ◽  
Intervention Group ◽  
Kidney Injury ◽  
Post Intervention ◽  
Gram Positive ◽  
Stewardship Program ◽  
Screening Protocol ◽  
The Impact ◽  
Post Intervention Group

Abstract Background Pharmacist-driven protocols for utilization of methicillin-resistant Staphylococcus aureus (MRSA) nares screenings have shown to decrease duration of empiric gram-positive therapy and rates of acute kidney injury (AKI) in patients with respiratory infections. This study evaluated the impact of a pharmacist-driven MRSA nares screening protocol on duration of vancomycin or linezolid therapy (DT) in respiratory infections. Methods Patients aged 18 years and older with a medication order of vancomycin or linezolid for respiratory indication(s) were included. The MRSA nares screening protocol went into effect in October 2019. The protocol allowed pharmacists to order an MRSA nares polymerase chain reaction (PCR) for included patients, while the Antimicrobial Stewardship Program (ASP) made therapeutic recommendations for de-escalation of empiric gram-positive coverage based on negative MRSA nares screenings, if clinically appropriate. Data for the pre-intervention group was collected retrospectively for the months of October 2018 to March 2019. The post-intervention group data was collected prospectively for the months of October 2019 to March 2020. Results Ninety-seven patients were evaluated within both the pre-intervention group (n = 50) and post-intervention group (n = 57). Outcomes for DT (38.2 hours vs. 30.9 hours, P = 0.601) and AKI (20% vs. 14%, P = 0.4105) were not different before and after protocol implementation. A subgroup analysis revealed a significant reduction in DT within the pre- and post-MRSA PCR groups (38.2 hours vs. 24.8 hours, P = 0.0065) when pharmacist recommendations for de-escalation were accepted. Conclusion A pharmacist-driven MRSA nares screening protocol did not affect the duration of gram-positive therapy for respiratory indications. However, there was a reduction in DT when pharmacist-driven recommendations were accepted. Disclosures All Authors: No reported disclosures

scholarly journals 110. Impact of Diagnostic and Antimicrobial Stewardship on Time-to-Appropriate Therapy and Clinical Outcomes in Multi-Drug Resistant Pseudomonas Infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S69-S70
Author(s):  
Katie A McCrink ◽  
Kailynn DeRonde ◽  
Adriana Jimenez ◽  
Gemma Rosello ◽  
Yoichiro Natori ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Antimicrobial Stewardship ◽  
Patient Survival ◽  
Intervention Group ◽  
Culture Collection ◽  
Drug Resistant ◽  
Intervention Period ◽  
Post Intervention ◽  
Appropriate Therapy ◽  
Post Intervention Group

Abstract Background Timely effective therapy in multi-drug resistant (MDR) Pseudomonas (PsA) infections has a direct impact on patient survival. We aimed to determine the impact of diagnostic and antimicrobial stewardship (AMS) on time-to-appropriate therapy (TAP) and clinical outcomes of patients with MDR PsA infections utilizing novel beta-lactam/beta-lactamase inhibitors (BL/BLIs). Methods Retrospective cohort study of adult patients with MDR PsA infections at a 1,500-bed University-affiliated public hospital in Miami, Florida who received ≥72 hours of ceftazidime-avibactam (C/A) or ceftolozane-tazobactam (C/T). During the pre-intervention period (12/2017-12/2018), additional susceptibilities for C/A and C/T were performed upon providers’ request. In the post intervention period (01/2019 – 12/2019), we implemented automatic reflex algorithms (Figure 1) for faster identification and susceptibilities for MDR PsA, including carbapenemase producers. Results were communicated in real-time to the AMS team. Figure 1. Reflex Testing Algorithm for MDR Pseudomonas Isolates from Any Source Results Seventy-six patients were included; median age was 56 years (IQR 37.5–67.0), 40 (52.6%) were in an intensive care unit at time of culture collection; median APACHE II score was 20 (IQR 15.0 – 26.0). Three isolates were carbapenemase producers (VIM = 2; KPC = 1). The most common infections were pneumonia (56.6%) and bacteremia (18.4%). We found a significant decrease in median TAP (120.1 [IQR 82.5–164.6] vs 75.9 [IQR 51.3–101.7] hours, p = 0.003). Median time from culture collection to final susceptibility results was shorter in the post-intervention group (122.2 vs 90.5 hours; p < 0.001). Median length-of-stay after culture collection was numerically lower in the post-intervention group (26.0 [11.6–59.4] vs 19.7 [12.9–37.8] days; p = 0.33). Controlling for ICU admission, our intervention was not associated with decreased 30-day inpatient mortality (OR = 1.62, 95% CI 0.45–5.79). Conclusion Our study identified an improvement in TAP in MDR PsA infections with implementation of diagnostic and AMS initiatives. In an adequately powered study, our intervention could potentially impact patient survival through timely initiation of effective therapy with novel BL/BLIs. Disclosures All Authors: No reported disclosures

scholarly journals Implementation of an Emergency Department Sepsis Bundle and System Redesign: A Process Improvement Initiative

CJEM ◽  
2016 ◽  
Vol 19 (2) ◽  
pp. 112-121 ◽  
Author(s):  
Tamara McColl ◽  
Mathieu Gatien ◽  
Lisa Calder ◽  
Krishan Yadav ◽  
Ryan Tam ◽  
...  
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Intervention Group ◽  
Critical Conditions ◽  
Absolute Difference ◽  
Antibiotic Administration ◽  
Post Intervention ◽  
Sepsis Management ◽  
Sepsis Bundle ◽  
Post Intervention Group

AbstractBackgroundIn 2008–2009, the Canadian Institute for Health Information reported over 30,000 cases of sepsis hospitalizations in Canada, an increase of almost 4,000 from 2005. Mortality rates from severe sepsis and septic shock continue to remain greater than 30% in Canada and are significantly higher than other critical conditions treated in the emergency department (ED). Our group formed a multidisciplinary sepsis committee, conducted an ED process of care analysis, and developed a quality improvement protocol. The objective of this study was to evaluate the effects of this sepsis management bundle on patient mortality.MethodsThis before and after study was conducted in two large Canadian tertiary care EDs and included adult patients with suspected severe infection that met at least two systemic inflammatory response syndrome (SIRS) criteria. We studied the implementation of a sepsis bundle including triage flagging, RN medical directive, education campaign, and a modified sepsis protocol. The primary outcomes were 30-day all-cause mortality and sepsis protocol use.ResultsWe included a total of 167 and 185 patients in the pre- and post-intervention analysis, respectively. Compared to the pre-intervention group, mortality was significantly lower in the post-intervention group (30.7% versus 17.3%; absolute difference, 13.4%; 95% CI 9.8–17.0; p=0.006). There was also a higher rate of sepsis protocol use in the post-intervention group (20.3% versus 80.5%, absolute difference 60.2%; 95% CI 55.1–65.3; p<0.001). Additionally, we found shorter time-intervals from triage to MD assessment, fluid resuscitation, and antibiotic administration as well as lower rates of vasopressor requirements and ICU admission.InterpretationThe implementation of our multidisciplinary ED sepsis bundle, including improved early identification and protocolized medical care, was associated with improved time to achieve key therapeutic interventions and a reduction in 30-day mortality. Similar low-cost initiatives could be implemented in other EDs to potentially improve outcomes for this high-risk group of patients.

scholarly journals 1774. Impact of a Multiplex Polymerase Chain Reaction Assay on the Clinical Management of Adults Undergoing a Lumbar Puncture for Suspected Community-Onset Central Nervous System Infections

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S654-S654
Author(s):  
Matthew Moffa ◽  
Rawiya Elrufay ◽  
Thomas L Walsh ◽  
Dustin R Carr ◽  
Nathan Shively ◽  
...  
Keyword(s):  
Multiplex Polymerase Chain Reaction ◽  
Intervention Group ◽  
Turnaround Time ◽  
Cns Infection ◽  
Chain Reaction ◽  
Pcr Assay ◽  
Post Intervention ◽  
Multiplex Pcr Assay ◽  
Polymerase Chain ◽  
Post Intervention Group

Abstract Background Patients admitted from the community with a suspected central nervous system (CNS) infection require prompt antimicrobial treatment and diagnostic evaluation. Our health network recently implemented a multiplex polymerase chain reaction (PCR) assay in-house. Methods This was a pre-/post-intervention study evaluating the impact that a multiplex PCR assay had on the clinical management of patients ≥18 years of age admitted from the community with a lumbar puncture (LP) performed for a suspected CNS infection. The primary outcome was Herpes Simplex Virus (HSV) PCR turnaround time (TAT). Secondary outcomes included inpatient length of stay (LOS), total antimicrobial days of therapy (DOT), and antiviral DOT. Patients were excluded if an LP was performed after hospital day 3, if they were on a systemic antimicrobial for a non-CNS indication, if they were a neurosurgical patient, and if they had a fungal CNS infection. Results The pre- and post-intervention groups each had 57 patients. The average age was 51 and 52 years in the pre- and post-intervention groups, respectively. Four patients (7%) in the pre-intervention group were immunocompromised, compared with 9 (16%) in the post-intervention group. Four patients in the pre-intervention group had a positive PCR assay for either HSV or Varicella Zoster Virus (VZV), compared with 5 patients in the post-intervention group. Neither group had a positive cerebrospinal fluid culture, bacterial antigen assay, or bacterial PCR assay. The median (IQR) HSV PCR TAT was significantly longer in the pre-intervention group, 85 (78, 96) vs. 3.9 hours (2.9, 4.7), P < 0.001. The mean LOS was numerically greater in the pre-intervention arm (7 vs. 4.7 days, P = 0.069), as were the total antimicrobial DOT (9 vs. 7.4 days, P = 0.279) and antiviral DOT (3.9 vs. 2.7 days, P = 0.136). Pre-intervention antiviral DOT was significantly greater (3.1 vs. 1.6 days, P = 0.011) in patients without a positive HSV or VZV PCR. Conclusion Implementing a multiplex PCR assay for adults undergoing an LP for a suspected CNS infection significantly reduced the HSV PCR turnaround time. Antiviral DOT was significantly shorter in patients with a negative PCR result post-intervention. We also found a non-significant reduction in LOS, total antimicrobial DOT, and antiviral DOT. Disclosures All authors: No reported disclosures.

scholarly journals Assessment of Direct Oral Anticoagulant Prescribing and Monitoring Pre- and Post-Implementation of a Pharmacy Protocol at a Community Teaching Hospital

2017 ◽  
Vol 52 (3) ◽  
pp. 207-213 ◽  
Author(s):  
Christina Miele ◽  
Mary Taylor ◽  
Aditi Shah
Keyword(s):  
Teaching Hospital ◽  
Vitamin K Antagonists ◽  
Intervention Group ◽  
Adult Patients ◽  
Patient Specific ◽  
Post Intervention ◽  
Appropriate Prescribing ◽  
The Impact ◽  
Post Intervention Group ◽  
Community Teaching

Background Direct oral anticoagulants (DOACs) have become popular alternatives to vitamin K antagonists for the treatment and prevention of thromboembolic diseases; however, there are limited data regarding the appropriate use of DOACs in clinical practice. To ensure safety and efficacy of these medications, it is important that decisions regarding their use in patients rely on the available evidence. Objective The purpose of this study was to evaluate the appropriateness of DOAC prescribing in adult patients before and after the implementation of a pharmacist-driven DOAC protocol. Methods Data were collected on adult patients admitted to a community teaching hospital who received DOAC therapy for at least 2 days between January and March 2015 (pre-intervention group) and between January and March 2016 (post-intervention group). These data were analyzed to measure inappropriately prescribed DOACs, defined based on DOAC indication, renal function, drug interactions, and other pertinent patient-specific factors. Prior to the start of data collection for the post-intervention group, a pharmacist-driven protocol was developed and implemented. DOAC education was provided to pharmacists, including an evidence-based prescribing table to guide appropriate DOAC therapy. Comparisons were made between the pre-intervention and post-intervention groups to determine the impact of the pharmacist-driven service on appropriate DOAC prescribing. Results Fifty patients were analyzed in the pre-intervention group compared with 85 patients in the post-intervention group, with a total of 333 and 816 doses administered, respectively. Of the total doses administered, 32.4% were considered inappropriate in the pre-intervention group compared with 13.8% in the post-intervention group (adjusted odds ratio [OR], 0.42, 95% CI, 0.19-0.96; p = 0.039). Conclusions Implementing a pharmacist-driven DOAC service significantly improved appropriate prescribing of these agents. Provider education regarding DOAC use is essential to further increase appropriate prescribing of DOACs, optimize patients' therapy, and prevent adverse drug events.

scholarly journals Effects of Active Video Games on Children’s Psychosocial Beliefs and School Day Energy Expenditure

2019 ◽  
Vol 8 (9) ◽  
pp. 1268 ◽  
Author(s):  
Zan Gao ◽  
Zachary C. Pope ◽  
Jung Eun Lee ◽  
Minghui Quan
Keyword(s):  
Social Support ◽  
Self Efficacy ◽  
Intervention Group ◽  
Outcome Expectancy ◽  
Caloric Expenditure ◽  
Post Intervention ◽  
Active Video Games ◽  
Active Video ◽  
School Day ◽  
Post Intervention Group

Purpose: Examine the effects of active video games (AVGs) on children’s school-day energy expenditure (EE) and physical activity (PA)-related self-efficacy, social support, and outcome expectancy over 9 months. Method: Participants were 81 fourth grade students ( X ¯ age = 9.23 years, SD = 0.62; 39 girls) from two urban Minnesota elementary schools. A once-weekly 50 min AVG intervention was implemented in the intervention school for 9 months in 2014–2015 while the control school continued regular recess. Children’s school-day EE (daily caloric expenditure) and mean daily metabolic equivalent (MET) values were estimated via accelerometry whereas self-efficacy, social support, and outcome expectancy were assessed with psychometrically-validated questionnaires. All measures were completed at baseline and at the 4th and 9th months. Results: We observed significant interaction effects for daily caloric expenditure, F(1, 58) = 15.8, p < 0.01, mean daily MET values, F(1, 58) = 11.3, p < 0.01, and outcome expectancy, F(1, 58) = 4.5, p < 0.05. Specifically, intervention children had greater increases in daily caloric expenditure (91 kilocalorie/day post-intervention group difference), with control children decreasing daily caloric expenditure over time. We observed identical trends for mean daily MET values (0.35 METs/day post-intervention group difference). Interestingly, we observed outcome expectancy to increase in the control children, but decrease among intervention children, at post-intervention (1.35 group difference). Finally, we observed a marginally significant interaction effect for social support, F(1, 58) = 3.104, p = 0.08, with an increase and decrease seen in the intervention and control children, respectively. We observed no interaction or main effects for self-efficacy. Discussion: Observations suggested an AVG intervention contributed to longitudinal increases in school-day EE and social support compared to the control condition. Future research should examine how self-efficacy and outcome expectancy might be promoted during school-based AVG interventions.

scholarly journals An Electronic Alert for HIV Screening in the Emergency Department Increases Screening but not the Diagnosis of HIV

2014 ◽  
Vol 05 (01) ◽  
pp. 299-312 ◽  
Author(s):  
N. Liu ◽  
J. Sperling ◽  
R. Green ◽  
S. Clark ◽  
D. Vawdrey ◽  
...  
Keyword(s):  
Emergency Department ◽  
New York ◽  
Hiv Testing ◽  
Intervention Group ◽  
Hiv Screening ◽  
Intervention Period ◽  
Post Intervention ◽  
Hiv Test ◽  
The Impact ◽  
Post Intervention Group

SummaryObjective: Based on US. Centers for Disease Control and Prevention recommendations, New York State enacted legislation in 2010 requiring healthcare providers to offer non-targeted human immunodeficiency virus (HIV) testing to all patients aged 13–64. Three New York City adult emergency departments implemented an electronic alert that required clinicians to document whether an HIV test was offered before discharging a patient. The purpose of this study was to assess the impact of the electronic alert on HIV testing rates and diagnosis of HIV positive individuals.Methods: During the pre-intervention period (2.5–4 months), an electronic “HIV Testing” order set was available for clinicians to order a test or document a reason for not offering the test (e.g., patient is not conscious). An electronic alert was then added to enforce completion of the order set, effectively preventing ED discharge until an HIV test was offered to the patient. We analyzed data from 79,786 visits, measuring HIV testing and detection rates during the pre-intervention period and during the six months following the implementation of the alert.Results: The percentage of visits where an HIV test was performed increased from 5.4% in the pre-intervention period to 8.7% (p<0.001) after the electronic alert. After the implementation of the electronic alert, there was a 61% increase in HIV tests performed per visit. However, the percentage of patients testing positive per total patients-tested was slightly lower in the post-intervention group than the pre-intervention group (0.48% vs. 0.55%), but this was not significant. The number of patients-testing positive per total-patient visit was higher in the post-intervention group (0.04% vs. 0.03%).Conclusions: An electronic alert which enforced non-targeted screening was effective at increasing HIV testing rates but did not significantly increase the detection of persons living with HIV. The impact of this electronic alert on healthcare costs and quality of care merits further examination.Citation: Schnall R, Liu N, Sperling J, Green R, Clark S, Vawdrey D. An electronic alert for HIV screening in the emergency department increases screening but not the diagnosis of HIV. Appl Clin Inf 2014; 5: 299–312 http://dx.doi.org/10.4338/ACI-2013-09-RA-0075

scholarly journals Efficacy of hand washing beeswax food wrap in household use

2019 ◽  
Author(s):  
Celine Hsin ◽  
BCIT School of Health Sciences, Environmental Health ◽  
Dale Chen
Keyword(s):  
Cold Water ◽  
Intervention Group ◽  
P Value ◽  
Cross Contamination ◽  
Post Intervention ◽  
Food Residue ◽  
Specific Category ◽  
Single Use ◽  
The Mean ◽  
Post Intervention Group

  Background: Over the years, many reusable products have been invented to replace single-use disposable items to reduce waste. One of such products is the reusable beeswax food wrap, which aims to replace plastic film wraps to store food. According to manufacturer instructions, the beeswax wrap can only be washed with cold water and detergent. This presents the question whether the beeswax wrap can be effectively cleaned, as continuous reuse may present cross contamination issues. This study examines if manufacturer instructions is effective in cleaning the beeswax wrap. Methods: ATP analysis was used to determine the level of cleanliness on the beeswax wrap between the pre-intervention and post-intervention treatments. Pre-intervention samples are the new beeswax wraps. Post- intervention samples are wraps that have been contaminated with avocado, washed, and dried. ATP counts (RLU) were measured with Hygiena SystemSURE Plus ATP monitoring system. Paired T-Test was done on NCSS to analyze the results. Results: The mean of the pre-intervention group was measured at 8 RLU, which is considered clean under the Hygiena standard. The mean for the post-intervention group was measured at 67 RLU, which is considered a fail on cleanliness under the Hygiena standard. This shows that the manufacturer instructions on washing the beeswax wrap does not effectively clean the beeswax wrap. Statistical analysis show p-value is 0.000, therefore one can conclude there is a statistically significance difference in the mean ATP count between pre-intervention and post-intervention beeswax wrap samples. Conclusion: Results show that some food residue remained on the wrap after washing. This means manufacturer instructions cannot effectively clean beeswax wrap. Therefore, it is recommended that manufactures should put a label on their packaging to let their customers know that the wrap can’t be thoroughly cleaned, and certain foods should be avoided for its use. During its use, the wraps should be labeled for the specific category of food it is used for. BCCDC can also use this result to add into the reusable container guideline.  

scholarly journals The Effect of Strengthened Physical Education on Academic Achievements in High School Students: A Quasi-Experiment in China

2019 ◽  
Vol 16 (23) ◽  
pp. 4688
Author(s):  
Yunting Zhang ◽  
Xiaochen Ma ◽  
Jin Zhao ◽  
Hong Shen ◽  
Fan Jiang
Keyword(s):  
High School ◽  
High School Students ◽  
Physical Education ◽  
English Language ◽  
Intervention Group ◽  
School Students ◽  
Post Intervention ◽  
Math Scores ◽  
School Based ◽  
Post Intervention Group

Objectives: Evidence of school-based physical activity (PA) on academic performance in children and adolescents was inconsistent, especially in high school students who face a high academic burden. In this study, we tested the efficacy of a strengthened physical education (PE) program on academic outcomes in Shanghai. Methods: A quasi-experimental design was conducted to investigate the effect of strengthened PE on academic scores by calculating the grade-cohort difference before and after the intervention. PE curriculum switched from traditional short duration (40 minutes) general fitness training to long duration (90 minutes) specialized sports (e.g., football, aerobics). A total of 460 high school students (236 pre-intervention and 224 post-intervention) were enrolled in grade 10 and followed for two and three semesters. The academic outcome was assessed by district-standardized test scores. A difference-in-difference approach was employed. Results: After two semesters, the standardized Chinese language scores and English language scores for the post intervention group were increased by 0.61 SD (95% confidence interval (CI): 0.44, 0.78, p < 0.001) and 0.28 SD (95% CI: 0.09, 0.47, p = 0.01). However, the standardized math scores for the post intervention group were decreased in girls. After three semesters, standardized Chinese language scores for the post intervention group were increased by 0.27 SD (95% CI: 0.06, 0.48, p = 0.01). Math scores and English language scores decreased by 0.18 SD (95% CI: −0.36, −0.01, p = 0.04) and 0.23 SD (95% CI: −0.38, −0.09, p = 0.00), respectively. Conclusion: A school-based physical education program had mixed effects on academic scores in high school students.

Decreasing Resource Utilization without Compromising Care through Minimizing Preoperative Laboratories

2018 ◽  
Vol 84 (7) ◽  
pp. 1185-1188 ◽  
Author(s):  
Lauren Beliveau ◽  
Denise Buddenhagen ◽  
Billy Moore ◽  
Daniel Davenport ◽  
Mandy Burton ◽  
...  
Keyword(s):  
Laboratory Testing ◽  
Intervention Group ◽  
Cost Savings ◽  
Cost Effective ◽  
Time Frame ◽  
Post Intervention ◽  
Preoperative Testing ◽  
Post Trial ◽  
Algorithm Implementation ◽  
Post Intervention Group

Approximately 18 billion dollars is spent annually on preoperative testing. The purpose of this study was to determine whether implementation of an algorithm aimed at minimizing pre-operative tests resulted in decreased costs without compromising care. We performed a pre–post trial comparing January 2016 to April 2016 with May 2016 to July 2017. In May 2016, an algorithm was instituted in which laboratories were canceled based on an algorithm that incorporated patient and procedural factors. Total number of laboratories canceled before orthopedic, urologic, or general surgical procedures was documented. Case cancellations during this time were recorded. There were 22,175 laboratories during the study time frame. There was a significant decrease of 2.4 per cent in expected laboratories in the post-intervention group. There was an overall cost savings of $33,032.00. The per cent of patients who were seen in preoperative testing clinic and still needed medical optimization decreased after algorithm implementation (3.3% vs 2.1% P < 0.01). No cases were canceled because of lack of laboratory information. An algorithm for selective preoperative laboratory testing provides overall cost savings. Decreasing the number of unnecessary laboratories ordered reduced case cancellations. Instituting an algorithm for preoperative laboratory testing is cost-effective without compromising care.

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