Influencing physician practice patterns

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 97; no. 4; pp. S55 - S56
• Main Authors: Lavery, J.Patrick, Kindle, Mary, Hutchinson, Linda, Janssen, Jane
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-05-2001; The American College of Obstetricians and Gynecologists
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1016/S0029-7844(01)01278-9

Objective: A program was initiated to change physician ordering patterns to reduce routine postpartum blood count (CBS) determinations and ensure cost-effective quality care.
Methods: A retrospective review showed that routine CBS determinations after vaginal deliveries did not affect patient care. Subsequently, a review of 1,618 charts was made over an 11-month study period. Three periods were studied: first, a baseline period assessing routine CBS use; second, after a physician education program about the negligible benefit of routine postpartum CBS use; third, after the routine order for ‘CBS in am postpartum was deleted from the preprinted order sheet. Maternal complications, including readmission and anemia-associated events, also were assessed.
Results:
∗
Study Period—Patients
% Routine postpartum CBS
1st—463
65.8%
2nd—256
50.0% −
P < 0.05 from 1st
∗
3rd—899
14.3% −
P < 0.005 from 2nd
∗
∗
X-analysis
The cost savings from reduced lab testing were projected to be $22,112, based on an annual delivery rate of 2,639 births.
Conclusion: Physician practice patterns were modified somewhat by education but to a greater degree by influencing ordering habits. In this case, modification of preprinted orders had the greatest impact. Cost-effectiveness of this program was demonstrated, and quality of care was maintained.