BMJ Open Quality (Aug 2021)

Does admission order form design really matter? A reduction in urea blood test ordering

  • Pamela Mathura,
  • Narmin Kassam,
  • Reidar Hagtvedt,
  • Cole Boettger,
  • Yvonne Suranyi

DOI
https://doi.org/10.1136/bmjoq-2020-001330
Journal volume & issue
Vol. 10, no. 3

Abstract

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Introduction Laboratory blood testing is one of the most high-volume medical procedures and continues to increase steadily with instances of inappropriate testing resulting in significant financial implications. Studies have suggested that the design of a standard hospital admission order form and laboratory request forms influence physician test ordering behaviour, reducing inappropriate ordering and promoting resource stewardship.Aim/method To redesign the standard medicine admission order form-laboratory request section to reduce inappropriate blood urea nitrogen (BUN) testing.Results A redesign of the standard admission order form used by general internal medicine physicians and residents in two large teaching hospitals in one health zone in Alberta, Canada led to a significant step reduction in the ordering of the BUN test on hospital admission.Conclusions Redesigning the standard medicine admission order form-laboratory request section can have a beneficial effect on the reduction in BUN ordering altering physician ordering patterns and behaviour.