Data quality associated with handwritten laboratory test requests: classification and frequency of data-entry errors for outpatient serology tests.

Objective: Manual data-entry of handwritten laboratory test requests into electronic information systems has implications for data accuracy. This study sought to identify the types and number of errors occurring for handwritten serology test requests received from outpatient clinics.

Methods: A 15-day audit at a serology laboratory in Sydney, Australia, compared the content of all transcribed serology outpatient test requests in the laboratory information system with the handwritten request form.

The effect of laboratory testing on emergency department length of stay: a multihospital longitudinal study applying a cross-classified random-effect modeling approach.

Objectives: The objective was to examine the relationship between laboratory testing (including test volume and turnaround time [TAT]) and emergency department (ED) length of stay (LOS), using linked patient-level data from four hospitals across 4 years.

Methods: This was a retrospective, multisite cohort study of patients presenting to any one of four EDs in New South Wales, Australia, during a 2-month period (August and September) in 2008, 2009, 2010, and 2011. Data from ED information systems were linked to laboratory test data.

Monitoring health IT integration--the effect of an EMR on laboratory service timeliness across six Australian hospitals.

The Electronic Medical Record (EMR) incorporates computerised provider order entry systems which allow clinicians to order diagnostic tests electronically, thus eliminating the need for cumbersome handwritten orders. In many situations the EMR relies on a manual transition of information across systems (e.g.

What is the effect of electronic pathology ordering on test re-ordering patterns for paediatric patients?

Electronic ordering systems have the potential to enhance the efficient utilisation of pathology services. The aim of this study was to assess the effect of electronic pathology ordering on repeat test ordering for paediatric patients (ages 0 to 18 years) who were in intensive care units (ICUs) and non-ICU wards. The dataset described 85,728 pathology tests ordered for 5,073 children before and after the implementation of electronic ordering.

Examination of changes in pathology tests ordered by Diagnosis-Related Group (DRGs) following CPOE introduction.

Electronic test ordering, via the Electronic Medical Record (EMR), which incorporates computerised provider order entry (CPOE), is widely considered as a useful tool to support appropriate pathology test ordering. Diagnosis-related groups (DRGs) are clinically meaningful categories that allow comparisons in pathology utilisation by patient groups by controlling for many potentially confounding variables. This study used DRG data linked to pathology test data to examine changes in rates of test ordering across four years coinciding with the introduction of an EMR in six hospitals in New South Wales, Australia.

The effect of electronic pathology ordering in emergency departments on one aspect of test turn around time: a failure time analysis.

Electronic ordering systems have the potential to enhance the effective and efficient utilisation of pathology services. This study examined the influence of electronic ordering of pathology tests in four emergency departments on data entry times, a contributing factor to test turnaround time using failure time analysis. Data relating to tests ordered for 50,854 emergency department patients at four hospitals were analysed.

Monitoring the impact of the electronic medical record on the quality of laboratory test ordering practices.

The aim of this study was to examine the impact of the Electronic Medical Record (EMR) on the quality of laboratory test orders made by clinicians. The study assessed the type and frequency of pre-analytical laboratory test order errors that were associated with the EMR across three hospitals and one pathology service. This involved a retrospective audit of the laboratory error logs for the period 1 March 2010 to 9 October 2011.

Volume, rates, source and types of add-on pathology test requests across five hospitals.

Background: Add-on test requests, where a clinician requests further test assays on an existing specimen, contribute disproportionately to pathology service workload. However, little research has quantified the volume, rates, source or types of add-on tests. This study provides a descriptive analysis of add-on testing within a pathology service serving five hospitals.

Changes, disruption and innovation: An investigation of the introduction of new health information technology in a microbiology laboratory.

Background: It is expected that health information technology (HIT) will deliver a safer, more efficient and effective health care system. The aim of this study was to undertake a qualitative and video-ethnographic examination of the impact of information technologies on work processes in the reception area of a Microbiology Department, to ascertain what changed, how it changed and the impact of the change.

Materials And Methods: The setting for this study was the microbiology laboratory of a large tertiary hospital in Sydney.

What do physicians tell laboratories when requesting tests? A multi-method examination of information supplied to the microbiology laboratory before and after the introduction of electronic ordering.

Background: The provision of relevant clinical information on pathology requests is an important part of facilitating appropriate laboratory utilization and accurate results interpretation and reporting.

Purpose: (1) To determine the quantity and importance of handwritten clinical information provided by physicians to the Microbiology Department of a hospital pathology service; and (2) to examine the impact of a Computerized Provider Order Entry (CPOE) system on the nature of clinical information communication to the laboratory.

Methods: A multi-method and multi-stage investigation which included: (a) a retrospective audit of all handwritten Microbiology requests received over a 1-month period in the Microbiology Department of a large metropolitan teaching hospital; (b) the administration of a survey to laboratory professionals to investigate the impact of different clinical information on the processing and/or interpretation of tests; (c) an expert panel consisting of medical staff and senior scientists to assess the survey findings and their impact on pathology practice and patient care; and (d) a comparison of the provision and value of clinical information before CPOE, and across 3 years after its implementation.

Information and communication processes in the microbiology laboratory--implications for computerised provider order entry.

The aim of this multi-method study based at a microbiology department in a major Sydney metropolitan teaching hospital was to: i) identify the role that information and communication processes play in a paper-based test request system, and ii) examine how these processes may affect the implementation and design of Computerised Provider Order Entry (CPOE) systems. Participants in this study reported that clinical information can impact on the urgency and type of tests undertaken and affect the interpretation of test results. An audit of 1051 microbiology test request forms collected over a three-day period showed that 47% of request forms included clinical notes which provide a variety of information often vital to the test analysis and reporting process.