Becker's Clinical Quality & Infection Control

46 QUALITY IMPROVEMENT & MEASUREMENT How UVA Health System is reducing unnecessary testing By Mackenzie Bean T he University of Virginia Health Sys- tem in Charlottesville has implement- ed a task force focused on eliminating unnecessary laboratory testing, which could serve as a national model for other hospitals to improve lab utilization. e task force is led by: • Andrew Parsons, MD, a hospitalist and assistant professor of medicine at UVA Health System • Joseph Wiencek, PhD, associate director of clinical chemistry at UVA Health System Many of the task force's initiatives focus on changing the culture of unnecessary lab test- ing through training and educational efforts with medical students, residents and fellows, according to Drs. Parsons and Wiencek. For example, UVA residents receive a weekly email that highlights individual and team lab ordering practices, so physicians can see how they compare to their peers. High utilizers receive email reminders, encouraging them to modify their practices. e health system is also developing a decision-support system that uses EHR data to guide more efficient lab ordering and creating a laboratory formulary committee, which will review the appropriateness of lab tests for various illnesses. Drs. Parsons and Wiencek outlined these strategies in a research paper published in Clinical Lab Manager. n BJC HealthCare achieves 75% drop in patient harm events By Mackenzie Bean S t. Louis-based BJC HealthCare credited a system- wide quality improvement effort for the health system's dramatic reduction in patient harm events over the last decade, according to a study published in The Joint Commission Journal on Quality and Patient Safety. In 2008, BJC HealthCare implemented a systemwide program to target five major causes of patient harm: pressure ulcers, adverse drug events, falls with injury, healthcare-associated infections and venous throm- boembolism. The system created multidisciplinary teams to over- see the effort, which involved the implementation of evidence-based interventions and core standards across the system. Leaders used standardized project management and surveillance methods to monitor progress. Patient harm decreased from 10,371 reported events in 2009 to 5,018 reported events in 2012. Progress continued over the next five years, with the system reporting just 2,605 events in 2017. This equates to a 74.9 percent reduction in harm since 2009. "A combination of project management discipline, rigorous surveillance and focused interventions, along with system-level support of local hospital improvement efforts, led to dramatic reductions in preventable harm and long-term sustainment of progress," researchers concluded. n Banning hospital advertising could increase readmissions, study finds By Andrea Park I n response to ongoing discussions about a potential ban on hospital advertising, a new study suggests that putting an end to hospital ads could disrupt patient flow and, ultimately, lead to an increase in readmissions. Proponents of the ban argue that advertising contributes to the spread of misinformation and is not an effective use of hospitals' limited budgets. The study, published Aug. 8 in the journal Marketing Science, however, concluded that hospital ads do in fact have a positive influence on many patients. The study's authors analyzed 220,000 patient visits in Massa- chusetts between September 2008 and August 2010. They found that hospitals that spent more on advertising offered a higher quality of care and fewer readmissions, with a cyclical effect: As these already high-quality hospitals continue to at- tract even more patients using ads, they contribute to overall improvements in population health. "Our research found that banning hospital advertising can negatively affect population health outcomes by increasing hospital readmissions within 30 days. A blanket ban on hospi- tal advertising can lead to an additional 1.2 hospital readmis- sions for every 100 hospital discharges," study author Tongil Kim, PhD, assistant professor of marketing at Atlanta-based Emory University, said in a statement. Dr. Kim continued, "In short, we found that when you inhibit a hospital's ability to attract new patients, you also negative- ly impact patient flow, and you contribute to an increase in hospital readmissions." n

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