• Mandeep S Kalsi, Chuan Tai Foo, Parisa Farzanehfar, Sandy Ayoub, Mark Tacey, and Kristen Pearson.
• Department of Medicine, Northern Health, Melbourne, Victoria, Australia.
• Emerg Med Australas. 2020 Dec 1; 32 (6): 1071-1073.

ObjectiveTo evaluate the effectiveness of two different strategies designed to facilitate implementation of Choosing Wisely Australia guidelines, aiming to reduce unnecessary coagulation study blood tests in patients presenting to a metropolitan hospital ED.MethodIn this real-world quality improvement study, the first intervention tested was an education strategy. The second intervention was physically removing coagulation pathology tubes from the bedside trolleys in the ED. Data were collected about clinical appropriateness of testing, as per the Choosing Wisely Australia guideline and total volume of coagulation studies ordered.ResultsNo reduction in inappropriate coagulation testing was observed following the education intervention whereas a significant reduction in inappropriate coagulation testing was seen after the second intervention (inappropriate testing reduced from 73.8% to 53.0%).ConclusionPhysically removing coagulation pathology tubes from the trolleys was found to be effective at reducing unnecessary testing.© 2020 Australasian College for Emergency Medicine.

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