Hawai'i-Pacific Chapter
A quarterly e-newsletter for the Hawai'i Pacific Chapter of ACHE Winter 2018 Vol. 4
In This Issue
Messages from Chapter Leadership
Message from the Regent
Message from the Chapter President
Diversity
Diversity and Delivery of Healthcare Services: A Journey
Articles of Interest
Sales Representatives in Healthcare: Partnering to fill a need for Healthcare Organizations
The Importance of Laboratory Test Utilization Management
Ask-an-Exec
Calendars and Recent Events
2018 Leadership in Action Conference
Calendar of Events
Calendar of Educational Events
News & Committee Updates
News from the Education Committee
News from the Guam Local Program Chapter
Student Corner
Membership Report: New Fellows, Members, and Recertified Fellows
ACHE Resources
ACHE National News
Career Corner
Disclaimers/Sponsors
Ensure delivery of Chapter E-newsletter (Disclaimer)
Thank you to all our Sponsors for 2018!
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CHAPTER OFFICERS

   

 

REGENT
Gidget Ruscetta, FACHE
gidget.ruscetta@palimomi.org

PRESIDENT
Micah Ewing, MBA, FACHE
micah.ewing@hawaiipacifichealth.org


IMMEDIATE PAST PRESIDENT
Nick Hughey, RN, MBA, FACHE 
nhughey@wcchc.com


CHAIR, GUAM LOCAL COUNCIL
Chuck Tanner, FACHE
chuck.tanner88@gmail.com


TREASURER
Suzie So-Miyahira
suzie.so-miyahira@kapiolani.org

SECRETARY
Emiline LaWall, MA
emiline.lawall@hawaiipacifichealth.org



COMMITTEE CHAIRS

Josh Carpenter | Education
Josh.Carpenter@trane.com

Sally Belles | Communications
sally.belles@hawaiihealthpartners.org

Bobbie Ornellas, FACHE | Diversity
bornellas001@hawaii.rr.com 

Nick Hughey, FACHE | Sponsorship
nhughey@wcchc.com


DIRECTORS

Travis Clegg
cleggtl@ah.org 

Andrew Giles
andrew.t.giles@kp.org

Laura Bonilla
laurab@kapiolani.org

Ryan Sutherland
ryansuth55@gmail.com

 

STUDENT REPRESENTATIVE

Denise Della
ddella@wcchc.com



Articles of Interest
The Importance of Laboratory Test Utilization Management
Kristen Croom, MLS(ASCP), MB(ASCP)
Some research has shown that approximately 70% of medical decisions are based on laboratory tests.  Most clinicians and healthcare workers realize the importance of the laboratory and acknowledge the vital role that laboratory medicine plays in the care of our patients.  The push by the government to base reimbursement on quality measures has put a spotlight on the laboratory to ensure that testing is appropriate for the patient.  
 
Along with ensuring quality patient care the healthcare institutions are expected to operate within tighter margins due to reduction of reimbursements from payer across the board. One method to ensure quality patient care and reducing overall healthcare resource utilization is to evaluate laboratory test utilization within an inpatient and outpatient setting.  An inappropriate test can fall into one of three categories:  tests are ordered but are not directly indicated, initial testing is inappropriate based on patient evaluation, or repeated “routine” testing is not a necessity (Mora et al., 2017).   One study stated that the ordering of a complete blood count (CBC) was the most common routine test ordered and accounted for $32.7 million in 2009 (Rao, 2014).  In addition to a waste of money inappropriate lab orders can result in unnecessary blood draws that could result in patient harm and increase false-positive results (Mora et al.)  
 
There are a multitude of scientific articles that have researched the advantages to creating a laboratory utilization program in each healthcare organization.  Mora et al. provided the ten most frequent processes used to optimize lab test utilization:
 
1. Determine the clinical reasoning behind the most frequently ordered lab tests;
2. Present comprehensive aggregate data to physicians: case mix index, lab tests costs, budgeted goals, outcomes, quality metrics, trends, and individual physician ordering practices;
3. Provide information from peer-reviewed publications that include evidence-based lab utilization practices for the patient populations being treated;
4. Provide information on the potential clinical implications of lab ordering patterns;
5. Provide comparative data from other units or hospitals that have different patterns of lab utilization but have similar types of patients or similar case mix index values;
6. Select a physician champion who will organize educational sessions and provide the information required for improving lab test utilization;
7. Develop goals and a method for measuring and communication successful lab test utilization management through frequent meetings that will sustain practice changes;
8. Reduce or eliminate standing orders for lab tests;
9. Determine whether specific directives are necessary, e.g. having blood drawn on specific days unless there is a specific medical necessity;
10. Engage all executive administrative staff and provide effective and non-judgmental communications to all physicians involved in patient care.
 
The bottom line is that a lab utilization program can save patients’ lives and save the healthcare institution money.  While the structure of the programs may vary from institutions to institution, the key factors are open, honest communication using evidence-based practice in a non-judgmental environment.
 
References
 
1.  Mora, MD, A., Krug, MHA, B. S., Grigonis, PhD,, A. M., Dawson, PhD., A., Jing, MS, Y., & Hammerman, MD, S. I. (2017). Optimizing laboratory test utilization in long-term acute care hospitals. Baylor University Medical Center Proceedings, 26-29.
2.  Rao, S. K. (2014). Utilization management in the changing health-care environment. Clinical Chimica Acta, 109-110.
 

 
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