Inappropriateness of Repeated Laboratory and Radiological Tests for Transferred Emergency Department Patients
type: Article
item type: journalArticle
is part of: J Clin Med
authors: Person
  surname: Bertrand
  given name: J.
authors: Person
  surname: Fehlmann
  given name: C.
authors: Person
  surname: Grosgurin
  given name: O.
authors: Person
  surname: Sarasin
  given name: F.
authors: Person
  surname: Kherad
  given name: O.
subject: choosing wisely
subject: emergency medicine
subject: laboratory test
subject: less-is-more
subject: quality
subject: radiological procedure
subject: redundant
abstract: BACKGROUND: Laboratory and radiographic tests are often repeated during inter-hospital transfers from secondary to tertiary emergency departments (ED), despite available data from the sending structure. The aim of this study was to identify the proportion of repeated tests in patients transferred to a tertiary care ED, and to estimate their inappropriateness and their costs. METHODS: A retrospective chart review of all adult patients transferred from one secondary care ED to a tertiary care ED during the year 2016 was carried out. The primary outcome was the redundancy (proportion of procedure repeated in the 8 h following the transfer, despite the availability of the previous results). Factors predicting the repetition of procedures were identified through a logistic regression analysis. Two authors independently assessed inappropriateness. RESULTS: In 2016, 432 patients were transferred from the secondary to the tertiary ED, and 251 procedures were repeated: 179 patients (77.2%) had a repeated laboratory test, 34 (14.7%) a repeated radiological procedure and 19 (8.2%) both. Repeated procedures were judged as inappropriate for 197 (99.5%) laboratory tests and for 39 (73.6%) radiological procedures. CONCLUSION: Over half of the patients transferred from another emergency department had a repeated procedure. In most cases, these repeated procedures were considered inappropriate.
date: 2019-09-01
coverage: 31470615

J Clin Med
type: Journal
volume: 8
number: 9
identifier: DOI 10.3390/jcm8091342
identifier: ISSN 2077-0383 (Print) 2077-0383 (Electronic) 2077-0383 (Linking)